S-3081

   Amend House File 309, as passed by the House, as follows:
   1.  Page 1, before line 1 by inserting: 
   <Section 1.  Section 135C.16, subsection 1, Code 2025, is amended to read as follows:
   1.  In addition to the inspections required by sections 135C.9 and 135C.38, the department shall make or cause to be made such further unannounced inspections as it deems necessary to adequately enforce this chapter. At On average, at least one general unannounced inspection shall be conducted for each health care facility within a thirty-month twelve-month period, not to exceed a period of fifteen months. The inspector shall show identification to the person in charge of the facility and state that an inspection is to be made before beginning the inspection. An employee of the department who gives unauthorized advance notice of an inspection made or planned to be made under this subsection or section 135C.38 shall be disciplined as determined by the director, except that if the employee is employed pursuant to the merit system provisions of chapter 8A, subchapter IV, the discipline shall not exceed the discipline authorized pursuant to that subchapter.
   Sec. ___.  Section 135C.36, subsection 1, Code 2025, is amended to read as follows:
   1.  A class I violation is one which presents an imminent danger or a substantial probability of resultant death or physical harm to the residents of the facility in which the violation occurs. A physical condition or one or more practices in a facility may constitute a class I violation. A class I violation shall be abated or eliminated immediately unless the department determines that a stated period of time, specified in the citation issued under section 135C.40, is required to correct the violation. A licensee is subject to a penalty of not less than two five thousand nor more than ten thousand dollars for each class I violation for which the licensee’s facility is cited.
   Sec. ___.  Section 135C.36, Code 2025, is amended by adding the following new subsection:
   NEW SUBSECTION.  1A.  A class I violation includes any confirmed instance of a facility retaliating against a resident or employee for filing a complaint or otherwise cooperating with the department or the office of long-term care ombudsman.
   Sec. ___.  Section 135C.38, subsection 1, paragraph a, Code 2025, is amended to read as follows:
   a.  Upon receipt of a complaint made in accordance with section 135C.37, the department shall make a preliminary review of the complaint. Unless the department concludes that the complaint is intended to harass a facility or a licensee or is without reasonable basis, the department shall make or cause to be made an on-site inspection of the health care facility which is the subject of the complaint within the time period determined pursuant to the following guidelines, which period shall commence on the date of receipt of the complaint:
   (1)  For nursing facilities, an on-site inspection shall be initiated as follows:
   (a)  Within two one working days day for a complaint determined by the department to be an alleged immediate jeopardy situation.
   (b)  Within ten five working days for a complaint determined by the department to be an alleged high-level, nonimmediate jeopardy situation.
   (c)  Within forty-five calendar days for a complaint determined by the department to be an alleged nonimmediate jeopardy situation, other than a high-level situation.
   (2)  For all other types of health care facilities, an on-site inspection shall be initiated as follows:
   (a)  Within two one working days day for a complaint determined by the department to be an alleged immediate jeopardy situation.
   (b)  Within twenty five working days for a complaint determined by the department to be an alleged high-level, nonimmediate jeopardy situation.
   (c)  Within forty-five calendar days for a complaint determined by the department to be an alleged nonimmediate jeopardy situation, other than a high-level situation.>
   2.  Page 1, after line 14 by inserting: 
   <Sec. ___.  Section 135C.44, Code 2025, is amended to read as follows:
   135C.44  Treble Additional fines for repeated violations.
   The penalties authorized by section 135C.36 shall be trebled quadrupled for a second or subsequent class I or violation and tripled for a second or subsequent class II violation occurring within any twelve-month period if a citation was issued for the same class I or class II violation occurring within that period and a penalty was assessed therefor for the violation.
   Sec. ___.  DEPARTMENT OF INSPECTIONS, APPEALS, AND LICENSING —— NURSING FACILITY INSPECTORS AND ASSISTED LIVING PROGRAM MONITORS.
   1.  There is appropriated from the general fund of the state to the department of inspections, appeals, and licensing for the fiscal year beginning July 1, 2025, and ending June 30, 2026, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
   To employ additional nursing facility inspectors and assisted living program monitors to perform additional safety inspections, including salaries, support, maintenance, miscellaneous purposes, and for not more than the following full-time equivalent positions:
   ...................................................................... $    600,000

   ............................................................... FTEs            30

   2.  Moneys appropriated in this section of this Act shall be in addition to moneys received from federal matching funds.>
   3.  Title page, by striking lines 1 through 3 and inserting <An Act relating to health care facilities, providing penalties, and making an appropriation.>
   4.  By renumbering as necessary.

______________________________
JANICE WEINER