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Program Notification to the Department

Assisted living programs are required to notify the Department of Inspections, Appeals and Licensing (DIAL) within 24 hours, or the next business day of incidents identified below according to 481-67.4. These incidents include:

  • An accident which causes major injury with major injury being defined as:  
    • Resulting in death,
    • Admission to a higher level of care (such as a hospital) for more than observation, or
    • Requires consultation with an attending physician, designee, or extender who determines, in writing on a form designated by the department, that an injury is a “major injury” based on the circumstances of the accident, the previous functional ability of the tenant, and the tenant’s prognosis.
    • Accidents are not reportable if:
      • An ambulatory tenant who falls when neither the program nor its employees have culpability related to the fall, even if the tenant sustains a major injury,
      • A spontaneous fracture, or
      • A hairline fracture.
      • When the building sustains damage due to a natural or other disaster.
      • When there is an act that causes major injury to a tenant or when a program has knowledge of a pattern of acts committed by the same tenant on another tenant that results in any physical injury. A pattern is defined as two or more times within a 30-day period.
      • When a tenant elopes from a program.
      • When a tenant attempts suicide, regardless of injury.
      • When a fire occurs in a program and the fire requires the notification of emergency services, requires full or partial evacuation of the program, or causes physical injury to a tenant.
      • When a defect or failure occurs in the fire sprinkler or fire alarm system for more than 4 hours in a 24-hour period (in addition to requirements to notify the state fire marshal).
      • Additional reporting requirements as outlined in Iowa Code 235B and 235E for dependent adult abuse.

A copy of the Major Injury Determination form can be located here.

Insufficiencies are not commonly cited under this rule; however, it is an important reminder of events that may require a report to DIAL. These reports must be made in the most expeditious means. Previous meetings with DIAL representatives include a preference that these reports be completed by logging into your program webpage on the DIA Health Facility Database.