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Senate
File
539
-
Introduced
SENATE
FILE
539
BY
CELSI
A
BILL
FOR
An
Act
relating
to
oversight
for
long-term
care
facilities.
1
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
2
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Section
1.
NEW
SECTION
.
10A.904
Definitions.
1
As
used
in
this
subchapter,
unless
the
context
otherwise
2
requires:
3
1.
“Assisted
living
program”
or
“program”
means
the
same
as
4
defined
in
section
231C.2.
5
2.
“Health
care
facility”
means
the
same
as
defined
in
6
section
135C.1.
7
3.
“Long-term
care
facility”
means
a
health
care
facility
8
or
an
assisted
living
program.
9
4.
“Long-term
care
facility
safety
council”
or
“safety
10
council”
means
the
long-term
care
facility
safety
council
11
created
in
section
10A.905.
12
5.
“Resident”
means
the
same
as
defined
in
section
135C.1.
13
6.
“Tenant”
means
the
same
as
defined
in
section
231C.2.
14
Sec.
2.
NEW
SECTION
.
10A.905
Long-term
care
facility
safety
15
council
——
membership
——
duties
——
meetings.
16
1.
A
long-term
care
facility
safety
council
is
created.
17
a.
The
safety
council
shall
include
the
following
voting
18
members:
19
(1)
The
director
of
health
and
human
services,
or
the
20
director’s
designee.
21
(2)
The
state
long-term
care
ombudsman,
or
the
state
22
long-term
care
ombudsman’s
designee.
23
(3)
The
director
of
an
area
agency
on
aging,
or
the
24
director’s
designee.
25
(4)
The
state
director
of
AARP,
or
the
state
director’s
26
designee.
27
(5)
Three
public
members
appointed
by
the
governor,
and
28
subject
to
confirmation
by
the
senate,
who
are
consumers
or
29
members
of
consumer
groups
or
consumer
organizations.
30
(6)
Two
health
care
professionals
appointed
by
the
31
governor,
and
subject
to
confirmation
by
the
senate,
who
do
not
32
have
a
conflict
of
interest
in
performing
the
duties
of
the
33
safety
council.
34
b.
The
safety
council
shall
also
include
the
director
or
the
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director’s
designee
as
a
nonvoting
member.
1
2.
The
long-term
care
facility
safety
council
shall
do
all
2
of
the
following:
3
a.
Determine
and
approve
standards,
including
those
relating
4
to
health
and
safety,
for
long-term
care
facilities.
5
b.
Conduct
informal
conferences
and
reviews
of
health
care
6
facility
applicants
and
licensees,
and
assisted
living
program
7
applicants
and
certificate
holders,
and
make
recommendations
8
for
departmental
action
pursuant
to
sections
135C.10A
and
9
231C.11B.
10
c.
Review
and
make
recommendations
to
the
department
11
regarding
violations
and
penalties
under
chapters
135C
and
12
231C.
13
d.
Make
recommendations
to
the
department
regarding
the
14
adoption
or
amendment
of
administrative
rules.
15
e.
Review
the
operation
of
long-term
care
facilities
for
16
which
the
department
has
referred
a
complaint
received
by
the
17
department
to
the
office
of
long-term
care
ombudsman.
18
f.
Receive
recommendations
from
the
state
long-term
care
19
ombudsman
regarding
inspections
of
specific
long-term
care
20
facilities,
and
changes
in
administrative
rules
regarding
the
21
health,
safety,
welfare,
and
rights
of
residents
and
tenants.
22
g.
Submit
an
annual
report
to
the
general
assembly
by
23
October
31
for
the
immediately
preceding
fiscal
year,
including
24
any
recommendations
for
changes
in
law
to
better
protect
25
residents
and
tenants,
and
a
summary
of
all
recommendations
26
made
by
long-term
care
facilities
during
informal
conferences.
27
h.
Review
a
change
of
ownership
application
of
a
previously
28
licensed
nursing
facility
pursuant
to
section
135C.7A,
taking
29
into
consideration
whether
the
new
ownership
will
improve
the
30
financial
status
or
health
status
of
the
nursing
facility.
The
31
department
shall
only
grant
a
change
of
ownership
application
32
upon
the
approval
of
the
application
by
the
safety
council.
33
3.
The
members
shall
elect
a
public
member
as
the
34
chairperson
of
the
safety
council
annually.
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4.
The
safety
council
shall
hold
an
organizational
meeting
1
in
July
each
year,
and
meetings
shall
be
held
as
necessary
2
to
enable
the
safety
council
to
expeditiously
discharge
its
3
duties.
Meeting
dates
shall
be
set
upon
adjournment
or
by
call
4
of
the
chairperson
upon
five
days’
notice
to
the
other
members.
5
Sec.
3.
Section
135C.1,
Code
2025,
is
amended
by
adding
the
6
following
new
subsection:
7
NEW
SUBSECTION
.
12A.
“Long-term
care
facility
safety
8
council”
or
“safety
council”
means
the
long-term
care
facility
9
safety
council
created
pursuant
to
section
10A.905.
10
Sec.
4.
Section
135C.10,
unnumbered
paragraph
1,
Code
2025,
11
is
amended
to
read
as
follows:
12
The
department
shall
have
the
authority
to
deny,
suspend,
or
13
revoke
a
license
in
any
case
where
the
department
finds
that
14
there
has
been
repeated
failure
on
the
part
of
the
a
facility
15
to
comply
with
the
provisions
of
this
chapter
or
the
rules
or
16
minimum
standards
promulgated
hereunder
under
this
chapter
,
or
17
for
any
of
the
following
reasons:
18
Sec.
5.
NEW
SECTION
.
135C.10A
Multiple
violations
19
within
a
twelve-month
period
——
informal
conference
and
review
20
by
long-term
care
facility
safety
council
——
recommended
21
departmental
actions.
22
1.
At
the
time
the
department
effects
delivery
of
notice
23
on
an
applicant
or
licensee
under
section
135C.11
to
deny,
24
suspend,
or
revoke
a
license,
the
department
shall
also
notify
25
the
long-term
care
facility
safety
council.
26
2.
a.
The
safety
council
shall
hold
an
informal
conference
27
with
the
applicant
or
licensee
within
ten
working
days
of
28
the
mailing
or
service
of
notice
to
review
the
applicant’s
29
or
licensee’s
history
of
violations
for
which
a
penalty
was
30
assessed
under
this
chapter,
and
the
response
by
the
applicant
31
or
licensee
in
correcting
such
violations.
32
b.
Following
the
informal
conference
and
review,
the
safety
33
council
shall
report
its
findings
to
the
department,
including
34
any
recommendations
for
departmental
action
as
authorized
under
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this
chapter.
The
department
shall
proceed
in
accordance
with
1
the
recommendations
of
the
safety
council.
A
health
care
2
facility
may
subsequently
request
a
formal
hearing
and
proceed
3
under
section
135C.11.
4
Sec.
6.
Section
135C.14,
unnumbered
paragraph
1,
Code
2025,
5
is
amended
to
read
as
follows:
6
The
department
shall,
in
accordance
with
chapter
17A
,
7
and
with
the
approval
of
the
long-term
care
facility
safety
8
council,
adopt
and
enforce
rules
setting
minimum
standards
9
for
health
care
facilities.
In
so
doing,
the
department
,
10
with
the
approval
of
the
long-term
care
facility
safety
11
council,
may
adopt
by
reference,
with
or
without
amendment,
12
nationally
recognized
standards
and
rules,
which
shall
be
13
specified
by
title
and
edition,
date
of
publication,
or
similar
14
information.
The
rules
and
standards
required
by
this
section
15
shall
be
formulated
in
consultation
with
the
director
of
16
health
and
human
services
or
the
director
of
health
and
human
17
services’
designee,
with
the
director,
with
the
state
long-term
18
care
ombudsman,
and
with
affected
industry,
professional,
19
and
consumer
groups,
and
shall
be
designed
to
further
the
20
accomplishment
of
the
purposes
of
this
chapter
and
shall
relate
21
to:
22
Sec.
7.
Section
231.42,
subsection
2,
Code
2025,
is
amended
23
by
adding
the
following
new
paragraph:
24
NEW
PARAGRAPH
.
f.
Make
recommendations
to
the
long-term
25
care
facility
safety
council
created
in
section
10A.905
26
regarding
inspections
of
specific
health
care
facilities
and
27
assisted
living
programs,
and
changes
in
administrative
rules
28
regarding
the
health,
safety,
welfare,
and
rights
of
residents
29
of
health
care
facilities
and
tenants
of
assisted
living
30
programs.
31
Sec.
8.
Section
231C.2,
Code
2025,
is
amended
by
adding
the
32
following
new
subsection:
33
NEW
SUBSECTION
.
7A.
“Long-term
care
facility
safety
council”
34
or
“safety
council”
means
the
long-term
care
facility
safety
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council
created
in
section
10A.905.
1
Sec.
9.
NEW
SECTION
.
231C.11B
Multiple
violations
2
within
a
twelve-month
period
——
informal
conference
and
review
3
by
long-term
care
facility
safety
council
——
recommended
4
departmental
actions.
5
1.
At
the
time
the
department
effects
delivery
of
notice
6
on
an
applicant
or
certificate
holder
under
section
231C.11,
7
based
on
the
assisted
living
program
having
been
issued
notice
8
of
three
violations
in
a
twelve-month
period
which
presented
9
imminent
danger
or
a
substantial
probability
of
resultant
10
death
or
physical
harm
to
a
tenant
and
for
which
a
penalty
11
was
assessed
under
section
231C.14,
the
department
shall
also
12
notify
the
long-term
care
facility
safety
council.
13
2.
a.
The
safety
council
shall
hold
an
informal
conference
14
with
the
applicant
or
certificate
holder
within
ten
working
15
days
of
the
mailing
or
service
of
notice
to
review
the
16
applicant’s
or
certificate
holder’s
history
of
violations
17
for
which
a
penalty
was
assessed
under
this
chapter,
and
the
18
response
by
the
applicant
or
certificate
holder
in
correcting
19
such
violations.
20
b.
Following
the
informal
conference
and
review,
the
safety
21
council
shall
report
its
findings
to
the
department,
including
22
any
recommendations
for
departmental
action
as
authorized
under
23
this
chapter.
The
department
shall
proceed
in
accordance
with
24
the
recommendations
of
the
safety
council.
An
assisted
living
25
program
may
subsequently
request
a
contested
case
hearing
and
26
proceed
under
section
231C.9A.
27
Sec.
10.
STUDY
AND
RECOMMENDATIONS
——
SPECIAL
FOCUS
LIST
FOR
28
LONG-TERM
CARE
FACILITIES.
The
long-term
care
facility
safety
29
council
created
in
section
10A.905,
as
enacted
in
this
Act,
30
shall
study
the
feasibility
of
creating
a
special
focus
list
31
for
long-term
care
facilities
in
the
state
based
on
a
review
32
of
special
focus
lists
in
other
states.
Following
completion
33
of
the
study,
the
safety
council
shall
submit
a
report
to
34
the
general
assembly
by
February
1,
2026,
including
specific
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descriptions
of
successful
special
focus
lists
in
other
states,
1
and
recommendations
for
the
creation
of
a
special
focus
list
2
in
Iowa
including
necessary
Code
changes
and
the
potential
3
framework
for
the
special
focus
list.
4
Sec.
11.
CODE
EDITOR
DIRECTIVE.
The
Code
editor
is
directed
5
to
create
a
new
subchapter
X
in
chapter
10A
as
follows:
6
subchapter
X
shall
be
entitled
“Long-term
Care
Facility
Safety
7
Council”
and
shall
include
sections
10A.904
and
10A.905.
8
EXPLANATION
9
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
10
the
explanation’s
substance
by
the
members
of
the
general
assembly.
11
This
bill
provides
for
oversight
for
long-term
care
12
facilities
(facilities).
13
The
bill
creates
a
long-term
care
facility
safety
council
14
(safety
council)
under
the
department
of
inspections,
appeals,
15
and
licensing
(DIAL)
to:
determine
and
approve
standards
16
for
long-term
care
facilities;
conduct
informal
conferences
17
and
reviews
of
health
care
facility
applicants
and
licensees
18
that
have
been
issued
three
or
more
class
I
violations
(a
19
violation
which
presents
an
imminent
danger
or
a
substantial
20
probability
of
death
or
physical
harm
to
the
residents
of
the
21
facility
in
which
the
violation
occurs)
within
a
12-month
22
period
for
which
a
penalty
was
assessed,
and
of
assisted
23
living
program
applicants
or
certificate
holders
that
have
24
been
issued
notice
of
three
violations
in
a
12-month
period
25
which
presented
imminent
danger
or
a
substantial
probability
26
of
resultant
death
or
physical
harm
to
a
tenant
and
for
which
27
a
penalty
was
assessed,
and
make
recommendations
to
DIAL
for
28
departmental
action;
review
and
make
recommendations
to
DIAL
29
regarding
violations
and
penalties;
make
recommendations
to
30
DIAL
regarding
the
adoption
or
amendment
of
administrative
31
rules;
review
the
operation
of
long-term
care
facilities
for
32
which
the
department
has
referred
a
complaint
received
by
33
the
department
to
the
office
of
long-term
care
ombudsman;
34
receive
recommendations
from
the
state
long-term
care
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ombudsman
and
submit
an
annual
report
to
the
general
assembly
1
with
recommendations
for
changes
in
law
to
better
protect
2
residents
and
tenants,
and
a
summary
of
recommendations
made
3
by
long-term
care
facilities
in
informal
conferences;
and
4
review
change
of
ownership
applications
of
previously
licensed
5
nursing
facilities.
The
voting
members
of
the
safety
council
6
include
the
director
of
health
and
human
services,
or
the
7
director’s
designee;
the
state
long-term
care
ombudsman,
or
the
8
ombudsman’s
designee;
the
director
of
an
area
agency
on
aging,
9
or
the
director’s
designee;
the
state
director
of
AARP,
or
the
10
state
director’s
designee;
three
public
members,
appointed
by
11
the
governor,
and
subject
to
confirmation
by
the
senate;
and
12
two
health
care
professions,
appointed
by
the
governor,
and
13
subject
to
confirmation
by
the
senate.
The
safety
council
also
14
includes
the
director
of
DIAL,
or
the
director’s
designee
as
a
15
nonvoting
member.
The
members
shall
annually
elect
a
public
16
member
as
the
chairperson
of
the
council.
The
safety
council
17
shall
hold
an
organizational
meeting
in
July
each
year
and
hold
18
other
meetings
as
necessary
to
enable
the
safety
council
to
19
expeditiously
discharge
its
duties.
20
The
bill
provides
that
at
the
time
DIAL
serves
notice
on
an
21
applicant
or
licensee
of
a
health
care
facility
for
denial,
22
suspension,
or
revocation
of
a
license,
DIAL
shall
also
23
notify
the
safety
council.
The
safety
council
shall
hold
an
24
informal
conference
with
the
applicant
or
licensee
within
10
25
working
days
of
the
mailing
or
service
of
notice
to
review
26
the
applicant’s
or
licensee’s
history
of
violations
for
which
27
a
penalty
was
assessed,
and
the
response
by
the
applicant
or
28
licensee
in
correcting
such
violations.
Following
the
informal
29
conference
and
review,
the
council
shall
report
its
findings
30
to
DIAL
including
recommendations
for
departmental
action,
31
in
accordance
with
which
DIAL
shall
proceed.
A
facility
may
32
subsequently
request
a
formal
hearing.
33
The
bill
also
requires
that
at
the
time
DIAL
effects
34
delivery
of
notice
on
an
assisted
living
program
applicant
or
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539
certificate
holder,
based
on
the
assisted
living
program
having
1
been
issued
notice
of
three
violations
in
a
12-month
period
2
which
presented
imminent
danger
or
a
substantial
probability
3
of
resultant
death
or
physical
harm
to
a
tenant,
and
for
which
4
a
penalty
was
assessed,
DIAL
shall
also
notify
the
long-term
5
care
facility
safety
council.
As
with
health
care
facilities,
6
the
safety
council
shall
hold
an
informal
conference
with
the
7
applicant
or
certificate
holder
within
10
working
days
of
8
the
mailing
or
service
of
notice
to
review
the
applicant’s
9
or
certificate
holder’s
history
of
violations
for
which
a
10
penalty
was
assessed,
and
the
response
by
the
applicant
or
11
certificate
holder
in
correcting
such
violations.
Following
12
the
informal
conference
and
review,
the
safety
council
shall
13
report
its
findings
to
DIAL,
including
any
recommendations
14
for
departmental
action,
with
which
DIAL
shall
proceed.
An
15
assisted
living
program
may
subsequently
request
a
contested
16
case
hearing.
17
The
bill
also
requires
DIAL
to
adopt
and
enforce
18
administrative
rules
that
set
minimum
standards
for
facilities
19
with
the
approval
of
the
safety
council,
rather
than
the
20
approval
of
the
council
on
health
and
human
services.
21
Additionally,
the
rules
and
standards
must
be
formulated
in
22
consultation
with
the
state
long-term
care
ombudsman.
23
The
bill
includes,
as
a
duty
of
the
state
long-term
care
24
ombudsman,
making
recommendations
to
the
long-term
care
25
facility
safety
council.
26
The
bill
requires
the
long-term
care
facility
safety
council
27
to
study
the
feasibility
of
creating
a
special
focus
list
for
28
long-term
care
facilities
in
the
state
based
on
a
review
of
29
special
focus
lists
in
other
states,
and
to
submit
a
report
to
30
the
general
assembly
by
February
1,
2026,
including
specific
31
descriptions
of
successful
special
focus
lists
in
other
states,
32
and
recommendations
for
the
creation
of
a
special
focus
list
33
in
Iowa
including
necessary
Code
changes
and
the
potential
34
framework
for
the
special
focus
list.
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