481—65.9 (135C) Personnel.
	 65.9(1) The personnel policies and procedures shall include the following requirements:
	  a.   	 Written job descriptions for all employees or agreements for all consultants, which include duties and responsibilities, education, experience, or other requirements, and supervisory relationships; (III)
	  b.   	 Annual performance evaluations of all employees and consultants which are dated and signed by the employee or consultant and the supervisor; (III)
	  c.   	 Personnel records which are current, accurate, complete and confidential to the extent allowed by law. The record shall contain documentation of how the employee’s or consultant’s education and experience are relevant to the position for which they were hired; (III)
	  d.   	 Roles, responsibilities, and limitation of student interns and volunteers; (III)
	  e.   	 An orientation program for all newly hired employees and consultants which includes introduction to facility personnel policies and procedures and a discussion of the safety plan. Subparagraphs 65.9(1)“f”(3), (5) and (9) shall be included; (II, III)
	  f.   	 A plan for a continuing education program with a minimum of 12 in-service programs per year. There shall be a written, individualized staff development plan implemented for each employee. The plan shall take into consideration the duties of the employee and the needs of the facility identified in the résumé of care. The plan shall ensure that each employee has the opportunity to develop and enhance skills and to broaden and increase knowledge needed to provide effective resident care including, but not limited to:
	 (1) 	 First aid; (II, III)
	 (2) 	 Human needs and behavior; (II, III)
	 (3) 	 Problems and needs of persons with mental illness; for example, diagnosis and treatment, suicide assessment and prevention; (II, III)
	 (4) 	 Medication; (II, III)
	 (5) 	 Crisis intervention; for example, use of restraints and seclusion; (II)
	 (6) 	 Delivery of services in accordance with the principles of normalization; (III)
	 (7) 	 Infection control and wellness; (III)
	 (8) 	 Fire safety, disaster, and tornado preparation; (II, III) and
	 (9) 	 Resident rights. (II, III)
	  g.   	 Equal opportunity and affirmative action employment practices; (III)
	  h.   	 Procedures to be used when disciplining an employee; (III) and
	  i.   	 Appropriate dress and personal hygiene for staff and residents. (III)
	 65.9(2) There shall be written personnel policies for each facility. Personnel policies shall include the following requirements:
	  a.   	 Employees shall have a physical examination before employment and at least every four years after beginning employment. (III)
	  b.   	 Screening and testing for tuberculosis shall be conducted pursuant to 481—Chapter 59. (I, II, III)
	  c.   	 No one shall 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; (I, II, III)
	 (4) 	 For which no reasonable accommodation can eliminate the risk. (I, II, III)
Refer to Guideline for Infection Control in Hospital Personnel, 1998, Centers for Disease Control, U.S. Department of Health and Human Services, to determine (1), (2), (3) and (4).
	  d.   	 There shall be written policies for emergency medical care for employees in case of sudden illness or accident. These policies shall include the administrative individuals to be contacted. (III)
	  e.   	 Health certificates for all employees shall be available for review by the department. (III)
	 65.9(3) Staffing. The facility shall establish, subject to approval of the department, the numbers and qualifications of the staff required in an ICF/PMI using as its criteria the services being offered as indicated on the résumé of care and as required for implementation of individual program plans. (II, III)
	  a.   	 Direct care staff. Direct care staff shall be present in the facility unless all residents are involved in activities away from the facility. The policies and procedures shall provide for an on-call staff person to be available when residents and staff are absent from the facility. (II, III)
	 (1) 	 The on-call staff person shall be designated in writing. (II, III)
	 (2) 	 Residents or another responsible person shall be informed of how to contact the on-call person. (II, III)
The staffing plan shall ensure that at least one qualified direct care staff person is on duty to carry out and implement the individual program plans. (II, III)
	  b.   	 Qualified mental health professional. The ICF/PMI shall, by direct employment or contract, provide for sufficient services of a qualified mental health professional to attain or maintain the highest practicable mental and psychosocial well-being of each resident. Attainment shall be determined by resident assessment and individual plans of care. (I, II, III) Responsibilities of the QMHP shall include, but not be limited to:
	 (1) 	 Approval of each resident’s individual program plan; (II, III)
	 (2) 	 Monitoring the implementation of each resident’s individual program plan, including periodic personal contact; (II, III) and
	 (3) 	 Participation on each resident’s interdisciplinary team. (II, III)
	  c.   	 Nursing staff. Each facility shall have sufficient nursing staff to provide nursing and related services to attain or maintain the highest practical physical, mental and psychosocial well-being of each resident. Attainment shall be determined by resident assessments and individual plans of care.
	 (1) 	 The director of nursing (DON) shall be a registered nurse who is employed by the facility at least 40 hours per week. This person shall have two years’ experience in direct care or supervision of people with mental illness. (II, III)
	 (2) 	 The facility shall provide 24-hour service by licensed nurses, including at least one registered nurse on the day tour of duty, seven days a week. (II, III)
	 (3) 	 If the DON has other institutional responsibilities, a qualified registered nurse shall serve as the DON’s assistant so there is the equivalent of a full-time nursing supervisor on duty. (II, III)
	 (4) 	 The department shall 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 as indicated on the résumé of care and as required for implementation of individual program plans. (II, III)
	 (5) 	 The DON shall not serve as charge nurse in a facility with an average daily total occupancy of 60 or more residents. (II, III)
	 (6) 	 A waivered licensed practical nurse shall not be allowed as a charge nurse on any shift. (II, III)
	 (7) 	 There shall be at least two people capable of rendering nursing service awake, dressed, and on duty at all times. (II, III)
	  d.   	 Activity staff. Each ICF/PMI shall employ a recreational therapist, occupational therapist or activity coordinator to direct the activity program both inside and outside the facility in accordance with each resident’s individual program plan. (III)
Staff for the activity program shall be based on the needs of the residents being served as identified on the IPP. (III)
	 (1) 	 The activity program director shall attend workshops or educational programs which relate to activity programming. These shall total a minimum of ten contact hours per year. (III)
	 (2) 	 Personnel coverage shall be provided when the activity program director is absent during scheduled activities. (III)
	 (3) 	 The activity program director shall have access to all information about residents necessary to carry out the program. (III)
	  e.   	 Responsibilities of the activity program director shall include:
	 (1) 	 Coordinating all activities, including volunteer or auxiliary activities and religious services; (III)
	 (2) 	 Ensuring that all records required are kept; (III)
	 (3) 	 Coordinating the activity program with all other services in the facility; (III) and
	 (4) 	 Participating in the in-service training program in the facility. This shall include attending as well as presenting sessions. (III)
	 65.9(4) Personnel record. A personnel record shall be kept for each employee. (III)
	  a.   	 The record shall include the employee’s:
	 (1) 	 Name and address, (III)
	 (2) 	 Social security number, (III)
	 (3) 	 Date of birth, (III)
	 (4) 	 Date of employment, (III)
	 (5) 	 References, (III)
	 (6) 	 Position in the facility, (III)
	 (7) 	 Job description, (III)
	 (8) 	 Documentation of experience and education, (III)
	 (9) 	 Staff development plan, (III)
	 (10) 	 Annual performance evaluation, (II, III)
	 (11) 	 Documentation of disciplinary action, (II, III)
	 (12) 	 Date and reason for discharge or resignation, (III) and
	 (13) 	 Current physical examination. (III)
	  b.   	 The personnel records shall be made available to the long-term care resident’s advocate/ombudsman of the department on aging in response to a complaint being investigated. (III)
	 65.9(5) 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 as amended by 2013 Iowa Acts, Senate File 347, 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)
This rule is intended to implement Iowa Code sections 135C.14(2) and 135C.14(6).
[ARC 0663C, IAB 4/3/13, effective 5/8/13; ARC 0903C, IAB 8/7/13, effective 9/11/13]