DHS 89.29(3)(a)(a) Reasons.
A residential care apartment complex may terminate its contract with a tenant when any of the following conditions apply:
Except as provided under par. (b)
, the tenant's needs cannot be met at the level of service which facilities are required to make available to tenants under s. DHS 89.23 (2)
Except as provided under par. (b)
, the time required to provide supportive, personal and nursing services to the tenant exceeds 28 hours per week.
Except as provided under par. (b)
, the tenant's condition requires the immediate availability of a nurse 24 hours a day.
The tenant is adjudicated incompetent under ch. 54, Stats.
, has an activated power of attorney for health care under ch. 155, Stats.
, or has been found to be incapable of recognizing danger, summoning assistance, expressing need or making care decisions by 2 physicians or by one physician and one licensed psychologist who have personally examined the tenant and signed a statement specifying that the person is incapable.
The tenant's behavior or condition poses an immediate threat to the health or safety of self or others. Mere old age, eccentricity or physical disability, either singly or together, are insufficient to constitute a threat to self or others.
The tenant refuses to cooperate in an examination by a physician or licensed psychologist of his or her own choosing to determine his or her health or mental status for the purpose of establishing appropriateness for retention or termination.
The tenant's fees have not been paid, provided the tenant and the tenant's designated representative, where appropriate, were notified and given reasonable opportunity to pay any deficiency.
The tenant refuses to enter into a negotiated risk agreement or refuses to revise the risk agreement when there is a documented and significant medical reason for doing so.
The presence of any condition identified as grounds for termination in the service agreement, provided that these grounds are not inconsistent with requirements contained in subds. 1.
(b) Supplemental services as an alternative to termination.
A residential care apartment complex shall not terminate its contract with a tenant for a reason under par. (a) 1.
if the tenant arranges for the needed services from another provider consistent with s. DHS 89.24 (2) (b)
and any unmet needs or disputes regarding potentially unsafe situations are documented in a risk agreement.
Except as provided under subd. 2.
, a residential care apartment complex shall provide 30 days advance notice of termination to the tenant and the tenant's designated representative, if any. If there is no designated representative, the facility shall notify the county department of social or human services under s. 46.21
Notice of termination shall include the grounds for termination and information about how to file a grievance consistent with the termination and grievance policies and procedures contained in the service agreement.
The 30-day notice period required for termination may include the period covered by a notice of nonpayment of fees and opportunity to pay any deficiency as required under par. (a) 7.
, provided that notice of termination is included with the notice of non-payment of fees.
No 30-day notice is required in an emergency. In this subdivision, "emergency" means an immediate and documented threat to the health or safety of the tenant or of others in the facility.
(d) Failure to meet requirements of this chapter.
If the requirements of this chapter are violated by either the facility or the tenant, the party which is not in violation may terminate the contract on 30 days written notice without financial penalty.
DHS 89.29 History
Cr. Register, February, 1997, No. 494
, eff. 3-1-97; am. Register, November, 1998, No. 515
, eff. 12-1-98; corrections in (1) (a), (2) (b) 2. and (3) (a) 4. made under s. 13.93 (2m) (b) 7., Stats., Register October 2007 No. 622
; correction in (1m) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635
; correction in (2) (b) 2. made under s. 13.92 (4) (b) 7., Stats., Register July 2011 No. 667
Variance for demonstration projects in family care pilots. DHS 89.295(1)(1)
In this section, "variance" means permission to meet a requirement of this subchapter by an alternative means.
The purpose of a variance granted under this section is to demonstrate efficient ways of delivering and assuring the quality of supportive, personal and nursing services in conjunction with delivery of the family care benefit as defined in s. 46.2805 (4)
The department may grant a variance to a requirement of this subchapter when it is demonstrated to the satisfaction of the department that granting the variance is consistent with the purpose of the demonstration and will not jeopardize the health, safety, welfare or rights of any resident in the residential care apartment complex. The department may place a time limit and conditions on the variance.
A request for variance shall be submitted to the department in writing and shall include all of the following:
The efficiencies and quality assurance approaches to be demonstrated through the variance.
Identification of each requirement from which the variance is requested.
A description of the alternative means by which the facility will meet the intent of the requirements to be varied.
A plan for meeting the care needs and ensuring the health, safety and welfare of tenants.
An agreement to provide information to and to cooperate with the department in monitoring and evaluating the quality and cost effectiveness of the demonstration.
A letter of support for the variance from the care management organization as defined in s. 46.2805 (1)
, Stats., serving the area where the facility is located.
Documentation that the facility has a contract with a care management organization, as defined in s. 46.2805 (1)
, Stats., for services to its enrollees.
DHS 89.295 History
Cr. Register, October, 2000, No. 538
, eff. 11-1-00.
The provisions of this subchapter apply to all registered and certified residential care apartment complexes.
Facility policies and procedures.
A residential care apartment complex shall establish written policies regarding tenant rights. Facility policies shall be consistent with and include all of the rights contained in this subchapter.
Explanation of tenant rights.
A residential care apartment complex shall explain and provide copies of the tenant rights under this subchapter and of any related facility policies and procedures to the tenant and to his or her designated representative before the service agreement or any other written agreement between the tenant and the facility is signed. A copy of the rights and related policies shall be posted in a public place in the facility where they will be visible to tenants, visitors and staff.
Rights of tenants.
A tenant of a residential care apartment complex shall have all the rights listed in this section. These rights in no way limit or restrict any other rights of the individual under the U.S. Constitution, civil rights legislation or any other applicable statute, rule or regulation. Tenant rights are all of the following:
(1) Courtesy and respect.
To be treated with courtesy, respect and full recognition of the tenant's dignity and individuality by all employees of the facility and all employees of service providers under contract to the facility.
To have privacy in his or her independent apartment and when receiving supportive, personal or nursing services.
To make reasonable decisions relating to activities, daily routines, use of personal space, how to spend one's time and other aspects of life in the residential care apartment complex.
(4) Management of financial affairs.
To manage his or her own financial affairs unless the tenant delegates, in writing, responsibility for financial management to someone of the tenant's choosing or the tenant is adjudicated incompetent, in which case the guardian shall be responsible.
(5) Service choice.
To choose which services are included in the service agreement, including the right to refuse services provided that the refusal would not endanger the health or safety of the other tenants.
(6) Choice of health care providers.
To the facility's noninterference with the tenant's choice of his or her physician and providers of other medical, mental health and pharmaceutical services. A tenant shall not be required to use medical, mental health or pharmaceutical providers who are employed by or affiliated with the facility or to whom the tenant is referred by facility staff. A tenant's choice of providers of supportive, personal and nursing services from providers other than the residential care apartment complex is subject to the requirements of s. DHS 89.24 (2) (b)
(7) Furnishings and possessions.
To furnish his or her independent apartment and to maintain personal possessions as space permits as long as the tenant does not unreasonably interfere with the other tenants' choices or endanger the health or safety of the other tenants.
To receive visitors, meet with groups or participate in activities of the tenant's choice, including organizing and participating in tenant or family councils or groups provided that the health or safety of the other tenants is not endangered.
To receive and send sealed, unopened mail, including packages. The residential care apartment complex shall give mail to tenants on the day it is received or as soon as possible thereafter.
To have a private telephone properly installed in his or her independent apartment.
No tenant may be required to engage in any religious activity.
(12) Confidentiality of records.
To have his or her medical, personal and financial records kept confidential consistent with all applicable federal and state statutes, rules and regulations. For the purposes of registration, certification and administration, staff of the residential care apartment complex, the department, and any county department or aging unit designated to administer the medicaid waiver for those tenants whose services are paid for under s. 46.27 (11)
, Stats., shall have access to a tenant's records without the tenant's consent, but may not disclose the information except as permitted by law.
(13) Access to records.
A tenant or tenant's designated representative may inspect, copy and challenge the accuracy of the tenant's records.
(14) Disclosure of personal information.
To have necessary discussion by facility employees regarding one's physical, mental or medical condition, services, payment sources and other personal affairs conducted discreetly, and to not have facility employees, staff or any service provider under contract with the facility indiscreetly disclosing personal information about oneself to other tenants.
(15) Receipt of services.
To receive services consistent with the service agreement and risk agreement.
Except as provided for in the service agreement or risk agreement, to have the facility not interfere with the tenant's ability to manage his or her own medications or, when the facility is managing the medications, to receive all prescribed medications in the dosage and at the intervals prescribed by the tenant's physician and to refuse a medication unless there is a court order.
(17) Safe environment.
To a safe environment in which to live.
(18) Freedom from abuse.
To be free from physical, sexual or emotional abuse, neglect or financial exploitation or misappropriation of property by the facility, its staff or any service provider under contract with the facility.
A residential care apartment complex shall have a written grievance procedure and shall provide a copy to each tenant and tenant's designated representative, where applicable. Tenants of a residential care apartment complex may file complaints with the department. The grievance procedure shall include information about how to file a complaint with the department.
DHS 89.35 Note
Note: Complaints may be filed with the Department by writing or phoning the Bureau of Quality Assurance, Division of Disability and Elder Services, P.O. Box 7851, Madison, WI 53707, (608) 266-0120.
Any person assigned by the residential care apartment complex to investigate the facts associated with a grievance shall not have had any involvement in the issues leading to the grievance.
The residential care apartment complex shall provide a written summary of the grievance, findings, conclusions and any action taken as a result of the grievance to the tenant, the tenant's designated representative, if any, and, for tenants whose services are funded under s. 46.27 (11)
, Stats., the county department or aging unit designated to administer the medical assistance waiver.
Tenants of a residential care apartment complex may file complaints with the department. The department shall maintain a record of all complaints.
Coercion and retaliation prohibited.
Any form of coercion to discourage or prevent a tenant or the tenant's guardian or designated representative from exercising any of the rights under this subchapter or from filing a grievance or complaint is prohibited. Any form of retaliation against a tenant for exercising his or her rights or filing a grievance or complaint, or against an employee or service provider who assists a tenant in exercising his or her rights or filing a grievance or complaint, is prohibited.
The provisions of this subchapter apply to a facility which is applying to the department for registration as a residential care apartment complex or which is registered by the department as a residential care apartment complex.
Information requirements, application procedure and form.
An applicant shall submit a completed application form to the department to initiate the registration process. The application shall be on a form supplied by the department that is signed and dated by the applicant and shall include assurances that the applicant meets the definition and all the requirements for a residential care apartment complex contained in this chapter as well as all applicable federal, state and local statutes, ordinances, rules and regulations.
DHS 89.42 Note
Note: To obtain a copy of the application form, contact the Bureau of Quality Assurance, Division of Disability and Elder Services, P.O. Box 7851, Madison, WI 53707. Phone: (608) 266-0120.
The department shall issue a statement of registration upon receipt of a completed application and assurances.
Registration shall be issued only for the residential care apartment complex location, owner and operator identified in the application form and is not transferable to any other residential care apartment complex, owner or operator.
The department may, without notice to the facility, visit the facility at any time to determine if the facility meets the requirements of this chapter. The owner or operator shall be able to verify compliance with this chapter and shall provide the department access to the residential care apartment complex and its staff, tenants and records.
A registered residential care apartment complex shall notify tenants that, for registered facilities, the department does not routinely inspect facilities or verify compliance with the requirements for residential care apartment complexes and does not enforce contractual obligations under the service or risk agreements.
Termination and revocation. DHS 89.44(1)
A residential care apartment complex's registration terminates whenever any of the following occurs:
A residential care apartment complex shall immediately report to the department any change which would invalidate its registration under sub. (1)
The department may revoke the registration of a residential care apartment complex which fails to comply with one or more of the requirements of this chapter. In the event of revocation, the department shall provide the residential care apartment complex with prior written notice of the proposed action, the reasons for the action and notice of the opportunity for appeal under s. DHS 89.45
A residential care apartment complex shall immediately notify all tenants and tenants' designated representatives, where appropriate, of any notice of revocation and the reasons for the revocation.
No person may engage in any form of coercion to prevent a tenant, employee or service provider from filing a complaint about a residential care apartment complex or any form of retaliation against a tenant, employee or service provider for filing a complaint.