ACC Aux Award 2 image001

Resident Handbook 2014

Afton Care Center

508 West Pearl Street

Afton, Iowa 50830

Phone: 641-347-8416

Fax: 641-347-5497

E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.




Welcome To

Afton Care Center

We are grateful for the opportunity to serve you and welcome to our care center. 

We offer a wide range of services and activities that we hope will bring comfort and variety to your life. To help acquaint you with these services, we have prepared this “Handbook” for you and your family. Please keep this handbook and refer to it anytime you have a question or want to share information with a visitor, your family, or a special friend. If you have any questions, please feel free to talk with me, the Director of Nursing Services, or the Social Worker. Our doors are always open to you and your family. 

Again welcome, 

Kristy Knutson, LNHA


Afton Care Center 








Admission Policy

It is the policy of Afton Care Center to admit only those residents whose needs can be met by the facility or met in cooperation with community resources or other providers. It is our policy to provide equal access to services to all residents without regard to race, color, national origin, disability, or age. Admission is not denied to people with communicable disease including but not limited to blood and body substance infections. Consultation with the State Department of Health will be conducted on a case-by-case basis with the welfare of potential residents, existing residents, and staff considered. The facility will not admit persons in need of services greater than can be provided by our facility. Afton Care Center will not conduct any procedures requiring surgery or the admission of anesthesia.

Admission Requirements

The resident must be admitted to the facility under the order of a physician licensed to practice in the state of Iowa. All residents must be seen by the physician once a month for the first three months of nursing home care and once every sixty days thereafter. The attending physician must furnish the facility with a recent history and physical of the resident, diagnosis to admit, course of treatment, and physician orders necessary concerning the safety of the resident.

All residents have extensive rights in this facility, accordingly to state and federal regulations. These rights will be discussed with you at the time of admission. Advanced Directives will also be discussed with you upon admission, and assistance is available, if needed, to initiate these directives. 






Business Office:

The Business Office will be open from 9:00 a.m. to 4:30 p.m., Monday through Friday. During this time we will be happy to help residents with check cashing, acquiring postage stamps, handling trust account transactions, and answering questions about other business matters.

Medicare & Insurance

The Afton Care Center is a skilled facility. This means we can admit residents who qualify for Medicare for their source of payment for a period of time. In order qualify for Medicare Part A, the resident must have spent three (3) midnights in the hospital prior to admission to the facility and have a physician order/certification stating the resident requires skilled care services. Medicare Part A will provide coverage for up to 100 days of skilled nursing care. Full coverage is provided for the first 20 days. After the 20th day, a co-payment is required. 

Medicare Part B therapy is also available at our facility if the physician provides an order for such therapy. If you have any questions about your insurance policies, please contact your insurance agent or the Social Worker. If you feel you may qualify for Medicare benefits, please visit with the Administrator, Social Worker, or Business Office Manager. 

Resident Trust Fund

Each resident may keep up to $50.00 in a resident trust fund. If you are interested in this service please see the Business Office Manager who can explain the policies and procedures.


If you have questions on resident rates please contact the Administrator or Business Office Manager for explanation.





Clothing & Personal Items

You or your family is responsible for providing all clothing. We encourage residents to dress in street clothes if possible. Please bring in at minimum seven (7) changes of clothing for resident.

We strive to protect and preserve the personal property of each resident. For this reason we require that clothing be labeled with permanent marker. Clothing items requiring dry cleaning are the responsibility of the resident or family members. We are always concerned with misplaced items and will do our best to find them.

All clothing items and all other personal items are listed on an inventory list when you are admitted. Please notify the Charge Nurse of any additional items brought into the facility and items taken out of the facility.


The Resident’s medical record including the Plan of Care is considered confidential information. Disciplinary action will be taken against any staff member who violates this confidentiality.

Electrical Appliances

Electrical appliances such as heat lamps, electric blankets, heating pads, and extension cords are prohibited by the order of the State Fire Marshall. If you have questions on other electrical appliances please contact the Administrator or Maintenance Director.


Gratuities are not necessary and staff is prohibited from accepting them. A “smile and thank you” are the best rewards.


Arrangements can be made with the Business Office or Activities Director to have the newspaper delivered to you. You are responsible for payment of the subscription. The facility does receive a daily Des Moines Register and a weekly Afton Star that are located at the nurse’s station for all to read. 


Some residents have dietary restrictions, which make it necessary to limit the amount and type of food they receive. For this reason, food items should not be taken to the resident’s room without first checking with the Charge Nurse. We ask that all food items be placed in covered containers and that items that need refrigeration be taken to the dietary kitchen to be served by the staff to the residents.

Personal Mail

Personal mail is delivered unopened daily except Sunday and holidays. Mail is usually delivered by 2 p.m. each day. Outgoing mail can be left in the “mailbox” by the nurse’s station. Outgoing mail is never censored. Postage stamps may be purchased in the Business Office during normal business hours. Arrangements can be made to provide assistance in reading and sending mail if needed.

Smoking & Alcohol

Afton Care Center is a “smoke free” facility. All residents will be

made aware of this policy upon admission. We discourage any resident from smoking however an outdoor area is provided where residents may smoke under certain circumstances. No alcohol is permitted in resident’s rooms unless they have a physician order stating such. All alcohol will be kept at the nurse’s station.


The facility will help arrange transportation for Medicaid residents to needed medical appointments. We encourage families of private pay residents to provide transportation and accompany residents to appointments whenever possible. 

Room Changes

No resident will be moved from one room to another without first notifying the family or responsible party that a move will be made. However, room changes to protect the safety or welfare of any resident may be made at any time without prior notice. The facility will work with the family to locate the resident in the room, which will best serve the physical and social needs of the resident.

Room Decorations

Since this is your home you are encouraged to bring such favorite items as pictures, lamps, small plants, etc. to brighten your room and make it more homelike. You are permitted to bring whatever personal furnishings you wish as long as they do not infringe upon the rights of your roommate (if you have one) or violate any fire safety regulations. We would like to remind you that throw rugs and extension cords are strictly prohibited per State Fire Marshall Office regulations.

Safety Precautions

We are concerned with the safety of our residents as well as their physical care and mental well-being. We utilize a “wanderguard system” to alert us when confused residents attempt to leave the building. Fire-fighting equipment and alarm systems are checked regularly to ensure proper working condition. Monthly fire drills are held and all residents are expected to comply with these drills. All staff is trained in case of emergencies.

Televisions & Computers

Residents are able to have televisions and personal computers in their rooms. All rooms have access to “wireless” capability for computers. All rooms have needed equipment to hook into our television antenna system. There is a large screen TV in our front living room area. We ask that you be respectful of activities in the area.

Visitors & Out of Facility Visits

Although there are no set visiting hours, relatives and friends are encouraged to visit anytime. Please be considerate of residents and their roommates during your visit, and please do not disrupt their schedules. Children are welcomed visitors, but it is best if they remain with an adult.

Upon request a private area can be arranged for family members, clergy, or other visitors.

Relatives of critically ill residents may visit at any time.

Your family may join you for a meal in the dining room. Arrangements should be made with the Business Office Manager or the nurse in charge, preferably no later than one hour before mealtime.






Activity Program

Planned activities are provided under the direction of a full time Activity Director. Special arrangements are made for evening and weekend activities. A variety of activities is offered to meet the spiritual, physical, emotional, and social needs of each resident. A monthly activity calendar is distributed to each resident and is available on our web site.


Beauticians visit the care center weekly to cut hair, set hair, and give permanents. These individuals are not employees of the facility, but are available for the resident’s convenience. Financial arrangements are the responsibility of each resident or responsible party.

Dental, Optical, and Hearing Services

The facility will help you make arrangements for these services, both routine and emergency needs.

Dietary Services

You will be provided with regular, well-prepared, nutritious meals as ordered by your physician. Therapeutic diets and modified diets are provided as ordered by your physician also. A consulting Dietitian is contracted by the facility to oversee all menus and diets. All residents are encouraged to eat in the dining room. We serve breakfast at 7:30 a.m., lunch at 11:30 a.m., and supper at 5:30 p.m. Supplemental snacks are available between meals and at bedtime.

Laundry Services

Laundry services are available every day for all washable items. Family may do resident’s laundry if requested.


Your room will be cleaned daily by one of the housekeeping staff. Seasonal cleaning such as drapery cleaning and window washing, etc. is provided on a regular schedule.

Closets and drawers are the responsibility of the resident or their family to keep clean and orderly. If the resident or family chooses not to clean, the facility’s housekeeping staff may periodically remove excess belongings in the presence of the resident or family.


The facility employees a full time Maintenance Director experienced in general maintenance and repairs. Residents should notify Maintenance Director, Charge Nurse, or housekeeping staff of needed repairs.

Medications & Pharmaceutical Services

When necessary, medications are secured from the pharmacy by the nursing staff. Residents may designate the pharmacy of their choice as long as the pharmacy will provide medications using the facility’s unit dose system. All medications administered are ordered by your physician. Each resident has the right to self-administer medications unless the facility staff has determined that the practice is unsafe for the resident.

Medications are billed directly to you. If you are covered under Medicare Part A, the cost of medications is included in your Medicare billing. If you are a Medicaid resident any medications not covered by your Part D drug plan or Medicaid will be billed to the facility, usually over the counter drugs.

If you plan to be out of the building during a medication pass the nursing department will make arrangements to send necessary medications with you or your responsible party.

We cannot accept medications from home or hospitals.

Nursing Services

We provide 24-hour nursing service and maintain the nursing hours per resident as required by state and federal regulations.

If a resident’s condition requires more care or has improved to require less care, the Administrator, Director of Nursing, and Care Plan Coordinator will evaluate the resident to determine if a different level of care would be appropriate. If the change in level of care necessitates a rate change we would notify the resident or responsible party. If a resident’s condition is such that we can no longer provide adequate care we would notify the resident, next of kin, and/or other appropriate community agencies in accordance with the Admission Agreement. 

Medical Director

The facility contracts with a local physician to serve as our Medical Director. The Medical Director is responsible for coordinating the medical care at the facility, as well as, implementing resident care policies. The Medical Director meets at least quarterly with the Quality Assurance Committee.

Physician Services

You must remain under the care of a qualified physician during your stay here. A local physician should be selected at the time of admission. All medications, treatments, and diets are subject to the physician’s direction. The facility will make provisions for emergency physician services, i.e., the facility Medical Director. 

Religious Services

Residents are not required to participate in any religious activities. The facility provides interdenominational services every Sunday with assistance of local clergy. Clergy are encouraged to make visits to their members.

Social Services

A qualified Social Worker is employed to help meet the medically related social needs of the residents. Families are also encouraged to utilize the services of the Social Worker about financial concerns, etc. In addition to assisting with any concerns the Social Worker is also knowledgeable about other resources in the community.

Therapy Services

The facility contracts with a licensed physical therapist, speech pathologist, and occupational therapist to provide evaluations and services to meet our resident’s needs. The therapists also provide training and consultation to the therapy aides and nursing staff. All restorative services are prescribed by your physicians and are carried out under medical direction. This service is directed toward assisting the resident achieve and maintain the highest level of selfcare and independence. Therapy includes such things as gait training, exercises, walking, stair climbing, teaching how to dress, swallow, etc.

Survey Results

Residents have the right to examine the results of our most recent state surveys. A copy is located near the main door.

Volunteer Services

Our Activity Director is in charge of volunteer services. We encourage family members and community members to be active in their local care center. Volunteers may be asked to do special duties for certain residents, share their talent, and help with group activities.


One way to exercise your rights as a resident is through the Resident Council. We hope you will take an active role in our Resident Council and attend the monthly meetings. The Resident Council is an organization of persons living in Afton Care Center whose purpose is to provide a means for residents to share concerns, problems, and ideas with other residents and staff. It also allows you and other residents the opportunity to participate in the affairs and decisions that influence your life each day while you are a resident here. The council is your voice at the care center and aims at responding to your needs and interests. 

The Resident Council operates independently, but in partnership with the Administrator and other staff. All residents automatically become members, but participation is voluntary.


Residents have the right to have information on their medical record explained to them by their physician or other licensed health professionals. If the physician determines this medically inadvisable, they may inform an appropriate person on the resident’s behalf. Resident records are only open to those persons directly involved with the care of the resident or those authorized by law, such as health care evaluators.

In order to provide continuity of care when a resident is being transferred to the care of another physician, pertinent information will be sent to the receiving facility or physician. The resident or responsible party will be asked to sign a form authorizing the release of records.


The resident has the right to be informed of their health status including but not limited to, their medical condition and the right to accept or refuse treatment. The residents have the right to make informed health care decisions including decisions regarding lifesustaining measures. The care center must act on physician orders; therefore, any agreements must be between the resident and their physician.






A new resident admission is usually started when a family member, responsible party, hospital discharge planner, or physician’s office contacts Afton Care Center. After the initial contact our Director of Nursing will arrange a meeting to get to know the prospective resident and gather information such as a current medication list, the current physician, a medical history, etc. If we feel we can meet the needs of the potential resident we then need to complete a PASSR (Preadmission Screening and Resident Review) to meet federal and state guidelines. If the potential resident will be coming from a hospital the hospital will provide this documentation. If the potential resident will be coming from another care facility we will request that care center provide us with a copy of the PASSR they have. Once we have this needed documentation we will contact the physician to get an admission order and will work with the potential resident and family/responsible party to schedule a date/time when the resident will be admitted to our facility. 

On the day the resident is admitted the resident or family member/responsible party will need to provide us with copies of or the resident’s social security card, Medicare card, Medicaid card (if applicable), supplemental insurance cards, living will documents and Durable Power of Attorney documents (if the resident has either of these in place).

On the day the resident is admitted please bring a minimum of 7 changes of clothing, including socks and undergarments. You should also remember to bring sweaters, coat, hats, and shoes. Personal items such as combs, hairbrushes, make-up, hearing aids, glasses, dentures, canes or walker should also be brought if needed by the resident. We also encourage you to bring items such as a favorite chair, pictures, etc. to make the resident feel at home as much as possible. Please do not bring electric heating pads and extension cords, as they are not allowed per State Fire Marshall regulations.