Notwithstanding s. 50.01 (1m)
, "facility" means a nursing home or an intermediate care facility for the mentally retarded, which is not state-owned or state-operated, federally owned or federally operated or located outside the state.
"Intermediate care facility for the mentally retarded" has the meaning given under 42 USC 1396d
(c) and (d).
For the privilege of doing business in this state, there is imposed on all occupied, licensed beds of a facility, except occupied, licensed beds for which payment is made under 42 USC 1395
, an assessment that shall be deposited in the general fund and that is $100 per calendar month per occupied, licensed bed of an intermediate care facility for the mentally retarded and is $32 per calendar month per occupied, licensed bed of a nursing home. The assessment shall be on the average number of occupied, licensed beds of a facility for the calendar month previous to the month of assessment, based on an average daily midnight census computed and reported by the facility and verified by the department. Charged bed-hold days for any resident of a facility shall be included as one full day in the average daily midnight census. In determining the number of occupied, licensed beds, if the amount of the beds is other than a whole number the fractional part of the amount shall be disregarded unless it equals 50% or more of a whole number, in which case the amount shall be increased to the next whole number.
By the end of each month, each facility shall submit to the department the facility's occupied licensed bed count and the amount due under sub. (2)
for each occupied licensed bed of the facility for the month preceding the month during which the bed count and payment are being submitted. The department shall verify the bed count and, if necessary, make adjustments to the payment, notify the facility of changes in the bed count or payment and send the facility an invoice for the additional amount due or send the facility a refund.
The department shall levy, enforce and collect the assessment under this section and shall develop and distribute forms necessary for levying and collection.
The department shall promulgate rules that establish procedures and requirements for levying the assessment under this section.
An affected facility may contest an action by the department under this section by submitting a written request for a hearing to the department within 30 days after the date of the department's action.
Any order or determination made by the department under a hearing as specified in par. (a)
is subject to judicial review as prescribed under ch. 227
Hospital regulation and approval act. Sections 50.32
shall constitute the "Hospital Regulation and Approval Act".
History: 1975 c. 413
; Stats. 1975 s. 50.32.
"Critical access hospital" means a hospital that is designated by the department as meeting the requirements of 42 USC 1395i-4
(c) (2) (B) and is federally certified as meeting the requirements of 42 USC 1395i-4
"Governmental unit" means the state, any county, town, city, village, or other political subdivision or any combination thereof, department, division, board or other agency of any of the foregoing.
"Hospital" means any building, structure, institution or place devoted primarily to the maintenance and operation of facilities for the diagnosis, treatment of and medical or surgical care for 3 or more nonrelated individuals hereinafter designated patients, suffering from illness, disease, injury or disability, whether physical or mental, and including pregnancy and regularly making available at least clinical laboratory services, and diagnostic X-ray services and treatment facilities for surgery, or obstetrical care, or other definitive medical treatment.
"Hospital" may include, but not in limitation thereof by enumeration, related facilities such as outpatient facilities, nurses', interns' and residents' quarters, training facilities and central service facilities operated in connection with hospitals.
"Hospital" includes "special hospitals" or those hospital facilities that provide a limited type of medical or surgical care, including orthopedic hospitals, children's hospitals, critical access hospitals, mental hospitals, psychiatric hospitals or maternity hospitals.
History: 1975 c. 413
; Stats. 1975 s. 50.33; 1977 c. 83
s. 26 (4)
; 1979 c. 175
; 1983 a. 189
; 1997 a. 237
The purpose of ss. 50.32
is to provide for the development, establishment and enforcement of rules and standards for the construction, maintenance and operation of hospitals which, in the light of advancing knowledge, will promote safe and adequate care and treatment of patients in such hospitals.
History: 1975 c. 413
; Stats. 1975 s. 50.34.
Application and approval.
Application for approval to maintain a hospital shall be made to the department on forms provided by the department. On receipt of an application, the department shall, except as provided in s. 50.498
, issue a certificate of approval if the applicant and hospital facilities meet the requirements established by the department. Except as provided in s. 50.498
, this approval shall be in effect until, for just cause and in the manner herein prescribed, it is suspended or revoked. The certificate of approval may be issued only for the premises and persons or governmental unit named in the application and is not transferable or assignable. The department shall withhold, suspend or revoke approval for a failure to comply with s. 165.40 (6) (a) 1.
, but, except as provided in s. 50.498
, otherwise may not withhold, suspend or revoke approval unless for a substantial failure to comply with ss. 50.32
or the rules and standards adopted by the department after giving a reasonable notice, a fair hearing and a reasonable opportunity to comply. Failure by a hospital to comply with s. 50.36 (3m)
shall be considered to be a substantial failure to comply under this section.
History: 1975 c. 413
; Stats. 1975 s. 50.35; 1989 a. 37
; 1997 a. 93
Every 12 months, on a schedule determined by the department, an approved hospital shall submit an annual report in the form and containing the information that the department requires, including payment of the fee required under s. 50.135 (2) (a)
. If a complete annual report is not timely filed, the department shall issue a warning to the holder of the certificate for approval. The department may revoke approval for failure to timely and completely report within 60 days after the report date established under the schedule determined by the department.
History: 1997 a. 27
Rules and standards. 50.36(1)
The department shall promulgate, adopt, amend and enforce such rules and standards for hospitals for the construction, maintenance and operation of the hospitals deemed necessary to provide safe and adequate care and treatment of the patients in the hospitals and to protect the health and safety of the patients and employees; and nothing contained herein shall pertain to a person licensed to practice medicine and surgery or dentistry. The building codes and construction standards of the department of commerce shall apply to all hospitals and the department may adopt additional construction codes and standards for hospitals, provided they are not lower than the requirements of the department of commerce. Except for the construction codes and standards of the department of commerce and except as provided in s. 50.39 (3)
, the department shall be the sole agency to adopt and enforce rules and standards pertaining to hospitals.
The department shall conduct plan reviews of all capital construction and remodeling projects of hospitals to ensure that the plans comply with building code requirements under ch. 101
and with physical plant requirements under this chapter or under rules promulgated under this chapter.
The department shall promulgate rules that establish a fee schedule for its services in conducting the plan reviews under par. (a)
. The schedule established under these rules shall set fees for hospital plan reviews in amounts that are less than the sum of the amounts required on September 30, 1995, for fees under this subsection and for fees for examination of hospital plans under s. 101.19 (1) (a)
, 1993 stats.
The department shall promulgate rules that require that a hospital, before discharging a patient who is aged 65 or older or who has developmental disability or physical disability and whose disability or condition requires long-term care that is expected to last at least 90 days, refer the patient to the resource center under s. 46.283
. The rules shall specify that this requirement applies only if the secretary has certified under s. 46.281 (3)
that a resource center is available for the hospital and for specified groups of eligible individuals that include persons seeking admission to or patients of the hospital.
Any person licensed to practice medicine and surgery under subch. II of ch. 448
or podiatry under subch. IV of ch. 448
shall be afforded an equal opportunity to obtain hospital staff privileges and may not be denied hospital staff privileges solely for the reason that the person is an osteopathic physician and surgeon or a podiatrist. Each individual hospital shall retain the right to determine whether the applicant's training, experience and demonstrated competence is sufficient to justify the granting of hospital staff privileges or is sufficient to justify the granting of limited hospital staff privileges.
If, as a result of peer investigation or written notice thereof, a hospital staff member who is licensed by the medical examining board or podiatrists affiliated credentialing board, for any reasons that include the quality of or ability to practice, loses his or her hospital staff privileges, has his or her hospital staff privileges reduced or resigns from the hospital staff, the hospital shall so notify the medical examining board or podiatrists affiliated credentialing board, whichever is applicable, within 30 days after the loss, reduction or resignation takes effect. Temporary suspension due to incomplete records need not be reported.
If, as a result of peer investigation or written notice thereof, a hospital staff member who is licensed by the medical examining board or podiatrists affiliated credentialing board, for reasons that do not include the quality of or ability to practice, loses his or her hospital staff privileges for 30 days or more, has his or her hospital staff privileges reduced for 30 days or more or resigns from the hospital staff for 30 days or more, the hospital shall so notify the medical examining board or podiatrists affiliated credentialing board, whichever is applicable, within 30 days after the loss, reduction or resignation takes effect. Temporary suspension due to incomplete records need not be reported.
A hospital that admits patients for treatment of mental illness may grant to a psychologist who is listed or eligible to be listed in the national register of health services providers in psychology or who is certified by the American board of professional psychology an opportunity to obtain hospital staff privileges to admit, treat and discharge patients. Each hospital may determine whether the applicant's training, experience and demonstrated competence are sufficient to justify the granting of hospital staff privileges or of limited hospital staff privileges.
If a hospital grants a psychologist hospital staff privileges or limited hospital staff privileges under par. (b)
, the psychologist or the hospital shall, prior to or at the time of hospital admission of a patient, identify an appropriate physician with admitting privileges at the hospital who shall be responsible for the medical evaluation and medical management of the patient for the duration of his or her hospitalization.
The department shall require a hospital that is accredited as a hospital by a private accrediting organization to submit to the department a copy of the summary accreditation recommendation and may require the hospital to submit to the department copies of all correspondence sent or received on or after August 30, 1989, including survey results, between the hospital and the accrediting organization. Accreditation letters, reports and related correspondence submitted to the department, except those submitted by a county mental health complex under s. 51.08
, under this subsection are not subject to inspection, copying or receipt under s. 19.35 (1)
and may not be released by the department.
The department shall make or cause to be made such inspections and investigation, as are reasonably deemed necessary to obtain compliance with the rules and standards. It shall afford an opportunity for representatives of the hospitals to consult with members of the staff of the department concerning compliance and noncompliance with rules and standards.
A hospital owes a duty to its patients to exercise reasonable care in the selection of medical staff and in granting special privileges. Johnson v. Misericordia Community Hosp. 99 Wis. 2d 708
, 301 N.W.2d 156
Notification to accrediting organization.
The department shall notify a private accrediting organization that has accredited a hospital and the board of governors of the patients compensation fund under s. 619.04 (3)
if the department has done any of the following:
Suspended or revoked the hospital's approval under s. 50.35
Issued an order to the hospital.
Recommended to the federal health care financing administration that the hospital be decertified from the federal medicare program under 42 USC 1395
or the federal medicaid program under 42 USC 1396
for failure to meet a condition of participation under the program.
History: 1989 a. 37
Whoever violates rules promulgated under s. 50.36 (2) (c)
may be required to forfeit not more than $500 for each violation.
The department may directly assess forfeitures provided for under sub. (1)
. If the department determines that a forfeiture should be assessed for a particular violation, the department shall send a notice of assessment to the hospital. The notice shall specify the amount of the forfeiture assessed, the violation and the statute or rule alleged to have been violated, and shall inform the hospital of the right to a hearing under sub. (3)
A hospital may contest an assessment of a forfeiture by sending, within 10 days after receipt of notice under sub. (2)
, a written request for a hearing under s. 227.44
to the division of hearings and appeals created under s. 15.103 (1)
. The administrator of the division may designate a hearing examiner to preside over the case and recommend a decision to the administrator under s. 227.46
. The decision of the administrator of the division shall be the final administrative decision. The division shall commence the hearing within 30 days after receipt of the request for a hearing and shall issue a final decision within 15 days after the close of the hearing. Proceedings before the division are governed by ch. 227
. In any petition for judicial review of a decision by the division, the party, other than the petitioner, who was in the proceeding before the division shall be the named respondent.
All forfeitures shall be paid to the department within 10 days after receipt of notice of assessment or, if the forfeiture is contested under sub. (3)
, within 10 days after receipt of the final decision after exhaustion of administrative review, unless the final decision is appealed and the order is stayed by court order. The department shall remit all forfeitures paid to the state treasurer for deposit in the school fund.
The attorney general may bring an action in the name of the state to collect any forfeiture imposed under this section if the forfeiture has not been paid following the exhaustion of all administrative and judicial reviews. The only issue to be contested in any such action shall be whether the forfeiture has been paid.
History: 1999 a. 9
Exemptions and enforcement. 50.39(1)
and the rules promulgated pertaining thereto shall apply to all facilities coming under the definition of a "hospital" which are not specifically exempt by ss. 50.32
The use of the title "hospital" to represent or identify any facility which does not meet the definition of a "hospital" as provided herein or is not subject to approval under ss. 50.32
is prohibited, except that institutions governed by s. 51.09
Facilities governed by ss. 45.365
, secured correctional facilities as defined in s. 938.02 (15m)
, correctional institutions governed by the department of corrections under s. 301.02
and the offices and clinics of persons licensed to treat the sick under chs. 446
are exempt from ss. 50.32
. Sections 50.32
do not abridge the rights of the medical examining board, physical therapists affiliated credentialing board, podiatrists affiliated credentialing board, dentistry examining board, pharmacy examining board, chiropractic examining board and board of nursing in carrying out their statutory duties and responsibilities.
All orders issued by the department pursuant to ss. 50.32
shall be enforced by the attorney general. The circuit court of Dane County shall have jurisdiction to enforce such orders by injunctional and other appropriate relief.
The department may, in the event of an emergency condition that imminently threatens the health or safety of patients of a hospital, suspend new admissions to all or a part of the hospital until such time as the department decides that the hospital has removed or corrected the causes or deficiencies creating the emergency.
Immediately upon the suspension of new admissions under par. (a)
, the department shall notify the hospital in writing. Notice of the suspension shall include a clear and concise statement of the causes or deficiencies creating the emergency condition on which the suspension is based and notice of the opportunity for a hearing on the suspension or on recision of the suspension under s. 227.44
. If the hospital desires to contest the suspension, it shall provide written notice to the department of a request for a hearing within 10 days after receipt of the notice of suspension. If the hospital desires to contest failure by the department to rescind the suspension, it shall provide written notice to the department of a request for a hearing.
In addition to any other remedies provided by law, any person suffering a pecuniary loss because of a violation of s. 50.36 (3) (a)
may bring a civil action in any court of competent jurisdiction to recover the amount of the pecuniary loss, together with costs and disbursements, including reasonable attorney fees.
Licensing and regulation of home health agencies. 50.49(1)(1)
As used in this section, unless a different meaning appears from the context:
"Home health agency" means an organization that:
Primarily provides skilled nursing and other therapeutic services;
Has policies established by a professional group including at least one physician and at least one registered nurse to govern services, and provides for supervision of these services by a physician or a registered nurse; and
"Home health services" means the following items and services that are furnished to an individual, who is under the care of a physician, by a home health agency or by others under arrangements made by the home health agency, that are under a plan for furnishing those items and services to the individual that is established and periodically reviewed by a physician and that are, except as provided in subd. 6.
, provided on a visiting basis in a place of residence used as the individual's home:
Part-time or intermittent nursing care provided by or under the supervision of a registered professional nurse;
Physical or occupational therapy or speech-language pathology;
Medical social services under the direction of a physician;
Medical supplies, other than drugs and biologicals, and the use of medical appliances, while under such a plan;
In the case of a home health agency which is affiliated or under common control with a hospital, medical services provided by an intern or resident-in-training of such hospital, under an approved teaching program of such hospital; and
Any of the foregoing items and services which are provided on an outpatient basis, under arrangements made by the home health agency, at a hospital or extended care facility, or at a rehabilitation center which meets such standards as may be prescribed by rule, and the furnishing of which involves the use of equipment of such a nature that the items and services cannot readily be made available to the individual in such place of residence, or which are furnished at such facility while the individual is there to receive any such item or service, but not including transportation of the individual in connection with any such item or service.
"Patient" means individuals cared for or treated by home health agencies.