Assisted Living Partners
Assisted Living Partners

Striving to Enhance Life for Those Residing or Working in Assisted Living Facilities in Iowa.

RULE CLARIFICATION - LPN can no longer complete an initial assessment!!

Linda Kellen, ALP Bureau Chief reported that there is a discrepancy between the DIA Chapter 69 rules and the Iowa Board of Nursing's Scope of Practice.  The rule at 481-69.22(1) states, "A program shall evaluate each prospective tenant's functional, cognitive and health status prior to the tenant's signing the occupancy agreement and taking occupancy of a dwelling  unit in order to determine the tenant's eligibility for the program, including whether the services needed are available. The cognitive evaluation shall utilize a scored, objective tool. When the score from the cognitive evaluation indicates moderate cognitive decline and risk, the Global Deterioration Scale (GDS) shall be used at all subsequent intervals, if applicable.  If the tenant subsequently returns to the tenant's mildly cognitively impaired state, the program may discontinue the GDS and revert to a scored cognitive screening tool.  The evaluation shall be conducted by a health care professional, a human service professional, or a licensed practical nurse via nurse delegation."

The Iowa Board of Nursing Scope of Practice 655-6.2(5) states "The registered nurse shall recognize and understand the legal implications of accountability.  Accountability includes but need not be limited to the following:

a. Performing or supervising those activities and functionals which require the knowledge and skill level currently ascribed to the registered nurse and seeking assistance when activities and functions that are beyond the licensee's scope of preparation."

Linda stated that in clarification with the Board of Nursing, the RN is NOT ABLE to delegate the initial assessment to an LPN.  Linda stated that this clarification will be effective immediately.



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