DIA supports health facilities in Iowa with licensing, certifications, surveys (inspections), and more. DIA’s Health Facilities Division currently maintains a database on a separate website where you can search survey reports for specific healthcare facilities. This database is currently in the process of being rebuilt and will be replaced sometime in the near future.
The following types of health facilities fall under the oversight and regulation of DIA:
Assisted living programs (ALPs) provide room and board in a homelike environment, as well as services that may include, but are not limited to: health-related care, personal care, and assistance with essential daily living activities. Tenants in ALPs are encouraged to participate in decision-making. Assisted living programs are defined in Iowa Code Chapter 231C.
An elder group home (EGH) is a single-family residence operated by a person who provides room, board, and personal care to three to five older adults who are not related to the person operating the residence. Elder group homes are defined in Iowa Code Chapter 231B.
Home health agencies (HHAs) provide skilled nursing services for patients in their homes, and at least one of the following other therapeutic services: physical, speech, or occupational therapy; or medical or social services of a home health aide. These services must follow a written plan of treatment established by each patient’s attending physician, in conjunction with agency staff. Home health agencies are defined in Title 42 of the Code of Federal Regulations.
Hospices provide an alternative way to care for terminally-ill individuals, stressing palliative care (medical relief of pain), as opposed to curative or restorative care. Hospice care is not limited to medical care, but also addresses all physical, psychological, and spiritual needs of the patient, as well as the emotional needs of the patient’s family. The emphasis of hospice programs is in keeping the patient at home with his or her family and friends as much as possible. Hospices are defined in Iowa Code Chapter 135J and Title 42 of the Code of Federal Regulations.
Hospitals are primarily devoted to the treatment or care for persons experiencing illness, injury, or deformity; for obstetrical care; or for chronic or convalescent care. Hospitals are defined in Iowa Code Chapter 135B and Title 42 of the Code of Federal Regulations (CFR). Hospitals may be accredited by two different organizations: The Joint Commission or the American Osteopathic Association, both of which meet all Medicare conditions of participation (CoP), except the required provision of active treatment in psychiatric hospitals. Non-accredited hospitals are surveyed by DIA to determine compliance with Medicare CoP.
Critical Access Hospitals
A critical access hospital (CAH) certified in the Medicare program and licensed as a CAH must be located in a rural area, designated by the Iowa Department of Public Health as a necessary provider, have an agreement with a network hospital, operate with 25 beds or fewer, and maintain an average length of stay of 96 hours or less. Critical access hospitals are defined in Iowa Code Chapter 135B and Title 42 of the Code of Federal Regulations.
Long-Term Care Hospitals
A long-term care hospital (LTCH) is certified as an acute-care hospital, and provides acute care for patients who stay for more than 25 days, on average. Many patients in long-term care hospitals have transferred from an intensive care or critical care unit. Long-term care hospitals specialize in treating patients with more than one serious condition who, with time and care, may improve and return home. Long-term care hospitals are defined in Title 42 of the Code of Federal Regulations.
A psychiatric hospital primarily provides services surrounding the diagnosis and treatment of mentally-ill persons by a doctor of medicine or osteopathy (M.D or D.O). Psychiatric hospitals are defined in Title 42 of the Code of Federal Regulations.
Rehabilitation hospitals, or “inpatient rehabilitation facilities,” provide psychiatric and/or rehabilitation services explicitly excluded, or not paid for, under the Medicare prospective payment system. Rehabilitation hospitals are defined in Title 42 of the Code of Federal Regulations.
A swing-bed hospital is a critical access hospital (CAH), participating in Medicare that the Centers for Medicare and Medicaid Services (CMS) has approved to provide post-hospital skilled nursing facility care and meets certain requirements. The definition of a swing-bed hospital can be found in Title 42 of the Code of Federal Regulations.
Intermediate care facilities for the intellectually-disabled (ICF/ID) provide health or rehabilitation services for persons with an intellectual disability. Intermediate care facilities for the intellectually-disabled are defined in Iowa Code Chapter 135C and Title 42 of the Code of Federal Regulations.
Intermediate care facilities for persons with mental illness (ICF/PMI) provide room and board and nursing care for those who primarily have a mental illness. Intermediate care facilities for persons with mental illness are defined in Iowa Code Chapter 135C and Title 42 of the Code of Federal Regulations.
Commonly referred to as “nursing homes” or long-term care (LTC) facilities, nursing facilities provide health-related care and services, including rehabilitation, for persons who require nursing care (for a physical or mental condition) and other services, in addition to room and board. Nursing homes are defined in Iowa Code Chapter 135C and Title 42 of the Code of Federal Regulations.
Residential care facilities (RCFs) provide accommodation, board, personal assistance and other essential daily living activities. Persons living in a residential care facility are unable to sufficiently or properly care for themselves because of illness, disease, or physical or mental infirmity, but do not require the services of a registered or licensed practical nurse – except for emergencies. There are specific RCFs for those who have intellectual disabilities, those who are mentally ill, and those who require care for dementia. Residential care facilities are defined in Iowa Code Chapter 135C.
Oversight Provided to Health Facilities by DIA
Health facilities subject to DIA’s oversight will interact with the department in a variety of ways. Surveyors from DIA conduct routine, unannounced on-site survey visits to assess the quality of care and services provided to clients. If any problems are discovered, DIA will work with the facility to ensure compliance with State and federal rules; department staff may also issue disciplinary action, if merited.
DIA staff also investigate complaints received regarding improper care or treatment of patients or clients in licensed health facilities. If specific complaints or concerns are received, DIA staff may complete on-site inspections in addition to routine compliance inspections.