135C.23  Express requirements for admission or residence.
  No individual shall be admitted to or permitted to remain in a health care facility as a resident, except in accordance with the requirements of this section.
  1.  Each resident shall be covered by a contract executed at the time of admission or prior thereto by the resident, or the resident’s legal representative, and the health care facility, except as otherwise provided by subsection 5 with respect to residents admitted at public expense to a county care facility operated under chapter 347B. Each party to the contract shall be entitled to a duplicate original thereof, and the health care facility shall keep on file all contracts which it has with residents and shall not destroy or otherwise dispose of any such contract for at least one year after its expiration. Each such contract shall expressly set forth:
  a.  The terms of the contract.
  b.  The services and accommodations to be provided by the health care facility and the rates or charges therefor.
  c.  Specific descriptions of any duties and obligations of the parties in addition to those required by operation of law.
  d.  Any other matters deemed appropriate by the parties to the contract. No contract or any provision thereof shall be drawn or construed so as to relieve any health care facility of any requirement or obligation imposed upon it by this chapter or any standards or rules in force pursuant to this chapter, nor contain any disclaimer of responsibility for injury to the resident, or to relatives or other persons visiting the resident, which occurs on the premises of the facility or, with respect to injury to the resident, which occurs while the resident is under the supervision of any employee of the facility whether on or off the premises of the facility.
  2.  a.  A health care facility shall not knowingly admit or retain a resident:
  (1)  Who is dangerous to the resident or other residents.
  (2)  Who is in an acute stage of alcoholism, drug addiction, or mental illness.
  (3)  Whose condition or conduct is such that the resident would be unduly disturbing to other residents.
  (4)  Who is in need of medical procedures, as determined by a physician, or services which cannot be or are not being carried out in the facility.
  b.  This section does not prohibit the admission of a patient with a history of dangerous or disturbing behavior to an intermediate care facility for persons with mental illness, intermediate care facility for persons with an intellectual disability, nursing facility, or county care facility when the intermediate care facility for persons with mental illness, intermediate care facility for persons with an intellectual disability, nursing facility, or county care facility has a program which has received prior approval from the department to properly care for and manage the patient. An intermediate care facility for persons with mental illness, intermediate care facility for persons with an intellectual disability, nursing facility, or county care facility is required to transfer or discharge a resident with dangerous or disturbing behavior when the intermediate care facility for persons with mental illness, intermediate care facility for persons with an intellectual disability, nursing facility, or county care facility cannot control the resident’s dangerous or disturbing behavior. The department, in coordination with the state mental health and disability services commission created in section 225C.5, shall adopt rules pursuant to chapter 17A for programs to be required in intermediate care facilities for persons with mental illness, intermediate care facilities for persons with an intellectual disability, nursing facilities, and county care facilities that admit patients or have residents with histories of dangerous or disturbing behavior.
  c.  The denial of admission of a person to a health care facility shall not be based upon the patient’s condition, which is the existence of a specific disease in the patient, but the decision to accept or deny admission of a patient with a specific disease shall be based solely upon the ability of the health care facility to provide the level of care required by the patient.
  3.  Except in emergencies, a resident who is not essentially capable of managing the resident’s own affairs shall not be transferred out of a health care facility or discharged for any reason without prior notification to the next of kin, legal representative, or agency acting on the resident’s behalf. When such next of kin, legal representative, or agency cannot be reached or refuses to cooperate, proper arrangements shall be made by the facility for the welfare of the resident before the resident’s transfer or discharge.
  4.  No owner, administrator, employee, or representative of a health care facility shall pay any commission, bonus, or gratuity in any form whatsoever, directly or indirectly, to any person for residents referred to such facility, nor accept any commission, bonus, or gratuity in any form whatsoever, directly or indirectly, for professional or other services or supplies purchased by the facility or by any resident, or by any third party on behalf of any resident, of the facility.
  5.  Each county which maintains a county care facility under chapter 347B shall develop a statement in lieu of, and setting forth substantially the same items as, the contracts required of other health care facilities by subsection 1. The statement must be approved by the county board of supervisors and by the department. When so approved, the statement shall be considered in force with respect to each resident of the county care facility.
[C71, 73, 75, 77, 79, 81, §135C.23]
83 Acts, ch 76, §1
; 87 Acts, ch 190, §1
; 88 Acts, ch 1234, §9
; 90 Acts, ch 1039, §9
; 94 Acts, ch 1170, §23
; 96 Acts, ch 1129, §113
; 2004 Acts, ch 1090, §1
; 2009 Acts, ch 41, §263
; 2010 Acts, ch 1031, §389
; 2012 Acts, ch 1019, §17