Health Care Employment Agency Requirements
During the 2022 legislative session, the 89th Iowa General Assembly passed new legislation (House File 2521) requiring health care employment agencies that provide direct care to staff to certain health care facilities in Iowa to register with the Iowa Department of Inspections and Appeals (DIA) and pay an annual fee.
The department's administrative rules (Iowa Administrative Code 481-55) for the newly-created Iowa Code 135Q have been finalized. These new rules implementing House File 2521 go into effect on Jan. 4, 2023.
The rules require all existing health care employment agencies to register with the department by Jan. 4, 2023. The department is extending a 30-day grace period in which all existing health care employment agencies shall complete their registration.
How do agencies register with DIA?
The easiest way to register is via the online form.
However, health care employment agencies can also register by fax (515.281.5022) or mail. If registering by fax or mail (see address below), please include the following information on your company letterhead:
- All agency office locations operating in Iowa, including physical address with city, state, and ZIP code (Please note the staffing agency office doesn't have to be located in Iowa. Any office location that provides staff for Iowa health care facilities must register.);
- Owner information, including names, mailing address (with city, state and ZIP code), contact person's name (if owner is a business or entity and not a person), phone number, and email address;
- Managing entity information (if applicable), including names, mailing address (with city, state and ZIP code), contact person's name (if owner is a business or entity and not a person), phone number, and email address.
How much does registration cost?
Registration is $500 for each health care employment agency office location operating in Iowa. If you register via the online form, please include the submission number with your check when you mail it to DIA. If you register via fax, please include the date you sent your fax when you mail your check.
Please mail your check to:
Iowa Department of Inspections and Appeals
Health Facilities Division
Lucas State Office Building, 3rd Floor
321 East 12th St.
Des Moines, Iowa 50309-0083
In addition to registration, each health care employment agency is required to:
- Adhere to all requirements under Iowa Code Section 135Q.2(2);
- Submit quarterly reports to DIA;
- Verify that its employees comply with all applicable state and federal requirements;
- Maintain documentation regarding each agency worker's compliance with minimum licensing, certification, training, health requirements, and continuing education standards as described in Iowa Administrative Code 481-55.3(1);
- Report to the Iowa Direct Care Worker Registry completed work assignments of the agency worker (if the worker is a certified nurse aide, or CNA) sufficient to maintain an active status on the registry, per state and federal requirements.
Please note this is not an all-inclusive list of requirements. For additional details, please see Iowa Administrative Code 481-55.
In accordance with Rule 55.5(3), the first quarterly report expected by DIA should contain data required by that rule for the period from Jan. 1, 2023, through March 31, 2023, and shall be submitted no later than April 15, 2023. Additional information will be distributed at a later date to registered health care employment agencies regarding the method by which such data should be submitted to DIA.
- First quarter reports (Jan. 1-March 31) are due annually no later than April 15;
- Second quarter reports (April 1-June 30) are due annually no later than July 15;
- Third quarter reports (July 1-Sept. 30) are due annually no later than Oct. 15;
- Fourth quarter reports (Oct. 1-Dec. 31) are due annually no later than Jan. 15.
Until such time as the department's database can accept electronic reports of hours for CNAs from health care employment agencies, each health care employment agency will need to provide to DIA a job description and an attestation letter on company letterhead to registry staff showing that a CNA working for their agency has performed at least eight hours of paid, nursing or nursing-related duties. The agency must provide enough details to show that the CNA has met the long-term care employment guidelines.
Please note that a CNA cannot report their own hours to the registry, nor can the CNA provide a letter verifying employment from the employment agency to DIA directly.
Letters can be emailed to DCW@dia.iowa.gov, faxed to 515.281.6259, or mailed to:
Iowa Direct Care Worker Registry
c/o Iowa Dept. of Inspections and Appeals
Lucas State Office Building, 3rd Floor
321 East Locust St.
Des Moines, Iowa 50319-0083
Please visit the Iowa Direct Care Worker Registry page on the DIA website for additional registry information.