481—58.11(135C) Personnel.
	58.11(1) General qualifications.
	a. 	No person with a current record of habitual alcohol intoxication or addiction to the use of drugs shall serve in a managerial role of a nursing facility. (II)
	b. 	No person under the influence of alcohol or intoxicating drugs shall be permitted to provide services in a nursing facility. (II)
	c. 	No person shall be allowed to provide services in a facility if the person has a disease:
	(1)	Which is transmissible through required workplace contact, (I, II, III)
	(2)	Which presents a significant risk of infecting others, (I, II, III)
	(3)	Which presents a substantial possibility of harming others, and (I, II, III)
	(4)	For which no reasonable accommodation can eliminate the risk. (I, II, III)
Refer to guidelines issued by the Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, to determine (1), (2), (3) and (4).
	d. 	Individuals with either physical or mental disabilities may be employed for specific duties, but only if that disability is unrelated to that individual’s ability to perform the duties of the job. (III)
	e. 	Persons employed in all departments, except the nursing department of a nursing facility, shall be qualified through formal training or through prior experience to perform the type of work for which they have been employed. Prior experience means at least 240 hours of full-time employment in a field related to their duties. Persons may be hired in laundry, housekeeping, activities and dietary without experience or training if the facility institutes a formal in-service training program to fit the job description in question and documents such as having taken place within 30 days after the initial hiring of such untrained employees. (III)
	f. 	The health services supervisor shall be a qualified nurse as defined in these regulations. (II)
	g. 	There shall be an organized ongoing in-service educational and training program planned in advance for all personnel in all departments. (II, III)
	h. 	Nurse aides may be utilized in accordance with the requirements in 441—subrule 81.13(19) and rule 441—81.16(249A). Nurse aides who have received training other than the Iowa state-approved program must pass a competency evaluation approved by the department of inspections and appeals in accordance with 441—subrule 81.13(19) and rule 441—81.16(249A). Evidence of prior formal training must be presented to the facility or institution conducting the challenge examination before the examination is given. The approved facility or institution, following department of inspections and appeals guidelines, shall make the determination of who is qualified to take the examination. Documentation of the challenge examinations administered shall be maintained.
	58.11(2) Nursing supervision and staffing.
	a. 	Where only part-time nurses are employed, one nurse shall be designated health service supervisor. (III)
	b. 	A qualified nurse shall be employed to relieve the supervising nurses, including charge nurses, on holidays, vacation, sick leave, days off, absences or emergencies. Pertinent information for contacting such relief person shall be readily available to nurses. (III)
	c. 	When the health service supervisor serves as the administrator of a facility 50 beds and over, a qualified nurse must be employed to relieve the health service supervisor of nursing responsibilities. (III)
	d. 	The department may establish on an individual facility basis the numbers and qualifications of the staff required in the facility using as its criteria the services being offered and the needs of the residents. (III)
	e. 	A nursing facility of 75 beds or more shall have a qualified nurse on duty 24 hours per day, seven days a week. (II, III)
	f. 	In facilities under 75 beds, if the health service supervisor is a licensed practical nurse, the facility shall employ a registered nurse, for at least four hours each week for consultation, who must be on duty at the same time as the health service supervisor. (II, III)
	(1)	This shall be an on-site consultation and documentation shall be made of the visit. (III)
	(2)	The registered nurse-consultant shall have responsibilities clearly outlined in a written agreement with the facility. (III)
	(3)	Consultation shall include but not be limited to the following: counseling the health service supervisor in the management of the health services; (III) reviewing and evaluating the health services in determining that the needs of the residents are met; (II, III) conducting a review of medications at least monthly if the facility does not employ a registered nurse part-time. (II, III)
	g. 	Facilities with 75 or more beds must employ a health service supervisor who is a registered nurse. (II)
	h. 	There shall be at least two people who shall be capable of rendering nursing service, awake, dressed, and on duty at all times. (II)
	i. 	Physician’s and other qualified health care practitioner’s orders shall be implemented by qualified personnel. (II, III)
	58.11(3) Employee criminal record checks, child abuse checks and dependent adult abuse checks and employment of individuals who have committed a crime or have a founded abuse. The facility shall comply with the requirements found in Iowa Code section 135C.33  and rule 481—50.9(135C) related to completion of criminal record checks, child abuse checks, and dependent adult abuse checks and to employment of individuals who have committed a crime or have a founded abuse. (I, II, III)
[ARC 0903C, IAB 8/7/13, effective 9/11/13; ARC 5421C, IAB 2/10/21, effective 3/17/21; ARC 7033C, IAB 5/31/23, effective 7/5/23]