The Advocate - October 2020 Residents' Rights Month Week 3

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October 2020

Note from the State Long-Term Care Ombudsman


October is the month dedicated to resident rights. One of the most fundamental rights enjoyed by citizens of the United States is voting. Lyndon B. Johnson is quoted as saying, “A man without a vote is a man without protection.” I would change that saying slightly to state, a person without a vote is a person without protection. Next month is the opportunity for nursing facilities all over the State of Iowa to protect the voting rights of all Iowans currently living in long-term care. I understand that this has been a tough past few months, especially in the sphere of those living and working in long-term care. I also understand that for staff at nursing facilities the idea of having to fit one additional task into their workday may be overwhelming. But, ensuring that residents of long-term care are able to vote if they choose to is too important not to be accomplished. Residents of long-term care do not lose the right to vote just by virtue of the fact they are residing in long-term care. So please make sure that your staff is educated and able to facilitate voting by residents.


Last week, the Iowa Department of Inspections and Appeals shared with the State Long-Term Care Ombudsman guidance that Iowa’s Secretary of State provided to each county auditor’s office. This guidance is in regard to how to facilitate voting for those Iowans currently residing in health care facilities. I am attaching that information in full:






CDC guidance suggests that all Health Care Facilities (HCF) close to all outside guests, and HCFs—which include hospitals and dementia-specific assisted living programs—in Iowa are following that guidance. In most HCFs, only essential HCF staff are allowed to enter these facilities. Therefore, county auditors are unable to send in bi-partisan teams to assist residents with absentee voting.



Absentee voting in HCFs are covered in Iowa Code Section 53.22.



HCF residents are required to request a ballot in order to receive one. You may send an absentee request form directly to each HCF resident or send a bundle of forms to the designated staff of the HCF as you have done in the past. They too are under a lot of stress and may not have time to deliver forms to patients.

REMEMBER: HCF residents do not need to provide an ID Number on their absentee ballot request form.



Instead of sending a bi-partisan team to the facility, the County Auditor now will mail absentee ballots directly to HCF residents who request them. A voter can choose any individual to assist them if needed.

Attached are two documents that must be provided to anyone who is going to assist an HCF resident with voting an absentee ballot. Notice to Person Giving Assistance explains what a person can and cannot do to assist the voter, and the Affidavit of Voter Requesting Assistance must be completed and returned with the absentee ballot. Provide copies of these documents to the HCF and include them in the absentee ballot package you send to any HCF resident.

Any voter admitted to an HCF after the absentee ballot request deadline (Saturday, October 24) can request and receive an absentee ballot. That includes on election day, November 3.



Contact the administrator of each HCF within your county to let them know of the temporary change in the HCF voting process for the November 3, 2020 General Election.


Notice to Person Giving Assistance

Due to the COVID-19 pandemic, County Auditors are unable to send bi-partisan teams to assist Health Care Facility residents with absentee voting. Therefore, you have been selected by a resident of your health care facility to lend assistance in marking their mailed absentee ballot.

As a person selected to assist a voter you are subject to rules set out in Iowa Code section 49.90.

  • You must mark the ballot as directed by the voter.
  • You cannot give any information to anyone about the choices the voter

Failure to follow these rules may lead to a criminal charge of Election Misconduct.

  • If a voter requests assistance from you, first give the voter an Affidavit of Voter Requesting Assistance to complete. You may assist the voter with completing it. The form MUST be returned with the voted
  • Next, read the directions included with the mailed absentee ballot either with or to the
  • You may read the ballot to the voter and/or mark the ballot as the voter directs.
  • You may not lead or coax a voter to make certain choices. Discussions with the voter regarding which candidates to choose cannot occur once the ballot has been
  • If the voter does not express their choice on every office or section it is acceptable to leave offices or sections of the ballot blank. A voter must be able to make a clear, conscious selection in order for you to mark the
  • If you make a mistake, mark the ballot spoiled, and contact the County Auditor for a new
  • Only the voter, or an individual in the presence and at the direction of the voter, may sign the Absentee Ballot Affidavit Envelope. The voter may use a stamp of their
  • Finally, package and return the absentee ballot according to the directions provided by the County

You CAN answer questions about how to mark the ballot.

  • Do I have to vote for all of the offices?
    • The answer is, “No, you do not have to vote on each ”
  • If a race is a vote for two (or more), do I have to vote for all of them?
    • The answer is, “No, you can vote for just ”
  • Do I have to fill in the target or bubble all the way?
    • The answer is, “Yes, you need to fully darken the target.”

 You CAN NOT answer questions about what to mark on the ballot.

  • Who is the incumbent?
  • Which are the judges that voted….?
  • Is this going to raise taxes?

Which campaign ad said ….?

Voting Information 2020



Group Activities

As you know, last month CMS came out with revised guidance on visitation in nursing facilities in QSO-20-39-NH. In addition to visitation, the guidance also addressed communal activities and dining. Group activities can be held with social distancing, hand hygiene and use of face coverings. Specifically the guidance states, “For example, book clubs, crafts, movies, exercise, and bingo are all activities that can be facilitated with alterations to adhere to the guidelines for preventing transmission.” The QSO can be found on our website. We encourage all facilities to actively facilitate group activities for residents. A great place to start may be to arrange movie matinee spooktaculars featuring Halloween themed movies.

News & Resources

On Friday, October 16, 2020 Governor Reynolds issued a proclamation extending the disaster emergency in the State of Iowa until 11:59 pm on November 15, 2020.


COVID-19 Moment of Silence

The afternoon of Thursday, October 8, the Office of the State Long-Term Care Ombudsman observed a moment of silence for the residents and caregivers that have lost their lives due to COVID-19.

Resident/Tenant Rights

The facility must not impose a charge against the personal funds of a resident for any item or service for which payment is made under Medicaid or Medicare (except for applicable deductible and coinsurance amounts).

These items include the following: hair hygiene supplies, comb, brush, bath soap, disinfecting soaps or specialized cleansing agents when indicated to treat special skin problems or to fight infection, razor, shaving cream, toothbrush, toothpaste, denture adhesive, denture cleaner, dental floss, moisturizing lotion, tissues, cotton balls, cotton swabs, deodorant, incontinence care and supplies, sanitary napkins and related supplies, towels, washcloths, hospital gowns, over the counter drugs, hair and nail hygiene services, bathing assistance, and basic personal laundry.


Services included in Medicare or Medicaid payment are the following: nursing services as required, food and nutrition services, activities program, room/bed maintenance services, medically-related social services and hospice services.

§ 483.10 Residents Rights (f) Self-Determination (11) (i)(A)-(G)   

Resident_Tenant Health Safety Welfare


Residents and tenants get excited when they have something to look forward to especially when dining and a new program Wow Wednesdays is a way to do that. Residents and tenants look forward to the Wow Wednesday food item with enthusiasm as they may try something they have never had previously. This article showcases the process and what type of items might pique interest of those residents and tenants.

One way to brighten someone's day is to receive flowers. The Friends for Flowers project is a volunteer group in North Carolina that collects and revives plants and flowers to re-distribute to residents in the nursing facilities in this article.


Technology in Facilities

In The Advocate - July 2020 newsletter this office mentioned new technology using an LED UV-C sanitizing cabinet. One facility in Iowa is benefiting from similar technology. Sioux Center Health is using UV-C robots in the facility to sanitize. For more information view the article.


This device, Aladin assists in predicting falls before they happen in this article.

Volunteer Ombudsman Program or 515-971-6294 "We are your Voice for Choice-Iowa Volunteer Ombudsman Program"


VOP Statewide Conference Call

This month's statewide call will be held on Wednesday, November 18 at 10:00 am. If you do view a recording of a previously recorded statewide conference call be sure to email to receive one hour of continuing education credit.

Events & Educational Opportunities


COVID-19 Update & Residents Rights Advocacy During the Pandemic

Not eligible for VOP CEUs

Oct 20 (12 pm)

More Information | Register


When Ageism Meets the Other Isms: Recognizing and Respecting the Diversity of Older People Webinar series presented by Iowa Abuse in Later Life Coordinated Community Response Team

Not eligible for VOP CEUs

Oct 22 (9 - 10:30 am) moderated by Jill Fulitano-Avery,  Executive Officer Office of Persons with Disabilities, Native American Affairs, and Deaf Services -  Iowa Department of Human Rights

Nov 5 (9 - 10:30 am) Topic not released at time of publication

via Zoom meeting
More Information | Register