DHS 124.21(5)
(5) Rehabilitation record. A record shall be maintained for each patient who receives rehabilitation services. This record shall be part of the patient's medical record.
DHS 124.21 History
History: Cr.
Register, January, 1988, No. 385, eff. 2-1-88.
DHS 124.22(1)
(1)
Direction. If respiratory care services are offered by the hospital, the service shall be under the direction of a qualified physician.
DHS 124.22(2)
(2) Policies and procedures. Respiratory care services shall be provided in accordance with written policies and procedures approved by the medical staff. The policies and procedures shall address at minimum:
DHS 124.22(2)(b)
(b) Management of adverse reactions to respiratory care services;
DHS 124.22(2)(c)
(c) Administration of medications in accordance with physicians' orders;
DHS 124.22(2)(d)
(d) The personnel who may perform specific procedures, under what circumstances and under what degree of supervision;
DHS 124.22(2)(f)
(f) Procurement, handling, storage and dispensing of therapeutic gases.
DHS 124.22(3)
(3) Personnel. Only qualified respiratory therapists, respiratory therapy technicians and other hospital personnel designated by the medical staff in writing may provide respiratory care procedures.
DHS 124.22(4)
(4) Physician's orders. Respiratory care services shall be provided in accordance with the orders of a physician. Oral orders given by a physician shall be transcribed into the medical record by the staff person authorized to take the orders.
DHS 124.22(5)
(5) Respiratory services record. A record shall be maintained for each patient who receives respiratory services. This record shall be part of the patient's medical record.
DHS 124.22 History
History: Cr.
Register, January, 1988, No. 385, eff. 2-1-88.
DHS 124.23(1)
(1)
Direction. If outpatient services are offered by the hospital, the service shall be under the direction of a qualified member of the medical staff.
DHS 124.23(2)
(2) Written policies and procedures. The hospital shall have written policies and procedures relating to staffing and functions of the service and medical records.
DHS 124.23(3)(a)(a) The outpatient service shall be organized into sections or clinics, the number of which shall depend on the size and the degree of departmentalization of the medical staff, the available facilities and the needs of the patients for whom the service accepts responsibility.
DHS 124.23(3)(b)
(b) The outpatient service shall have cooperative arrangements with appropriate community agencies in regard to services provided by the outpatient service and the needs of the patients.
DHS 124.23(3)(c)
(c) Outpatient clinics shall be integrated with corresponding inpatient services.
DHS 124.23(3)(d)
(d) On their initial visit to the service, patients shall receive an appropriate health assessment with follow-up as indicated.
DHS 124.23(4)(a)(a) The outpatient service shall have the professional and nonprofessional personnel needed to adequately meet the needs of the outpatient population.
DHS 124.23(4)(b)
(b) A registered nurse shall be responsible for the nursing care of the service.
DHS 124.23(5)(a)(a) Facilities shall be provided to ensure that the outpatient service is operated efficiently and to protect the health and safety of the patients.
DHS 124.23(5)(b)
(b) The number of examination and treatment rooms shall be adequate in relation to the volume and nature of work performed.
DHS 124.23(6)
(6) Outpatient record. A record shall be maintained for each patient who receives outpatient services. The record shall be maintained and correlated with inpatient and emergency medical records.
DHS 124.23 History
History: Cr.
Register, January, 1988, No. 385, eff. 2-1-88.
DHS 124.24(1)(1)
Emergency care. The hospital shall have written policies for caring for emergency cases, including policies for transferring a patient to an appropriate facility when the patient's medical status indicates the need for emergency care which the hospital cannot provide.
DHS 124.24(2)(a)1.
1. The emergency service shall be directed by personnel who are qualified by training and experience to direct the emergency service and shall be integrated with other services of the hospital.
DHS 124.24(2)(a)2.
2. The policies and procedures governing medical care provided in the emergency service shall be established by and are a continuing responsibility of the medical staff.
DHS 124.24(2)(a)3.
3. Emergency services shall be supervised by a member of the medical staff, and nursing functions shall be the responsibility of a registered nurse.
DHS 124.24(2)(a)4.
4. The hospital's emergency services shall be coordinated with the community's disaster plan, if there is one.
DHS 124.24(2)(b)1.1. The emergency service shall be provided with the facilities, equipment, drugs, supplies and space needed for prompt diagnosis and emergency treatment.
DHS 124.24(2)(b)2.
2. Facilities for the emergency service shall be separate and independent of the operating room.
DHS 124.24(2)(b)3.
3. The location of the emergency service shall be in close proximity to an exterior entrance of the hospital.
DHS 124.24(2)(c)1.1. There shall be sufficient medical and nursing personnel available for the emergency service at all times. All medical and nursing personnel assigned to emergency services shall be trained in cardiopulmonary resuscitation before beginning work.
DHS 124.24(2)(c)2.
2. The medical staff shall ensure that qualified members of the medical staff are regularly available at all times for the emergency service, either on duty or on call, and that a physician is responsible for all patients who arrive for treatment in the emergency service.
DHS 124.24(2)(c)3.
3. If unable to reach the patient within 15 minutes, the physician shall provide specific instructions to the emergency staff on duty if emergency measures are necessary. These instructions may take the form of protocols approved by the medical staff or standing orders.
DHS 124.24(2)(c)4.
4. A sufficient number of nurses qualified by training and experience to work in emergency services shall be available to deal with the number and severity of emergency service cases.
DHS 124.24(2)(d)1.1. Adequate medical records to permit continuity of care after provision of emergency services shall be maintained on all patients. The emergency room patient record shall contain:
DHS 124.24(2)(d)1.i.
i. Appropriate time notations, including time of the patient's arrival, time of physician notification, time of treatments, including administration of medications, and time of patient discharge or transfer from the service.
DHS 124.24(2)(d)2.
2. Where appropriate, medical records of the emergency service shall be integrated with those of the inpatient and outpatient services.
DHS 124.24(2)(e)
(e) Emergency services committee. An emergency services committee composed of physicians, registered nurses and other appropriate hospital staff shall review emergency services and medical records for appropriateness of patient care on at least a quarterly basis. The committee shall make appropriate recommendations to the medical staff and hospital administrative staff based on its findings.
DHS 124.24(3)(a)(a) In this subsection, "victim" means a female who alleges or for whom it is alleged that she suffered sexual assault and who, as a result of the sexual assault, presents as a patient at a hospital that provides emergency services.
DHS 124.24(3)(b)
(b) The department may directly assess a forfeiture for each violation of a requirement under s.
50.375 (2) or
(3), Stats., for care of a victim by a hospital that provides emergency services. The department may assess the forfeitures as follows:
DHS 124.24 Note
Note: Section
50.375 (2), Stats., requires a hospital that provides emergency services to a victim to 1) provide to the victim medically and factually accurate and unbiased written and oral information about emergency contraception and its use and efficacy; 2) orally inform the victim of
her option to receive emergency contraception at the hospital,
her option to report the sexual assault to a law enforcement agency,
and any available options for her to receive an examination to gather evidence regarding the sexual assault; and 3) except as specified in s.
50.375 (4), Stats., immediately provide to the victim upon her request emergency contraception, in accordance with instructions approved by the federal food and drug administration. If the medication is taken in more than one dosage, the hospital shall provide all subsequent dosages to the victim for later self administration.
DHS 124.24 Note
Note: Section
50.375 (3), Stats., requires a hospital that provides emergency care to ensure that each hospital employee who provides care to a victim has available medically and factually accurate and unbiased information about emergency contraception.
DHS 124.24(3)(c)
(c) 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
par. (d) pursuant to s.
50.377 (3), Stats.
DHS 124.24(3)(d)
(d) Pursuant to s.
50.377 (4), Stats., all forfeitures shall be paid to the department within 10 days after receipt of a notice of assessment or, if the forfeiture is contested under
par. (e), 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.
DHS 124.24(3)(e)
(e) Pursuant to s.
50.377 (3), Stats., a hospital may contest an assessment of a forfeiture by the department under
par. (b) by sending, within 10 days after receipt of notice under
par. (c), a written request for a hearing under s.
227.44, Stats., to the division of hearings and appeals. 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, Stats. 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.
DHS 124.24 History
History: Cr.
Register, January, 1988, No. 385, eff. 2-1-88;
CR 09-089: cr. (3)
Register March 2010 No. 651, eff. 4-1-10.
DHS 124.25(1)
(1)
Organized service. If the hospital has an organized social work service, that service shall have written policies and procedures. If the hospital does not have an organized social work service, the services of a consultant having the qualifications set out in
sub. (2) (a) shall be secured on a contractual basis. The services performed and recommendations made by the consultant shall be documented in writing.
DHS 124.25(2)(a)(a) Direction. The social work service shall be directed by a social worker who has:
DHS 124.25(2)(a)1.
1. A master's degree in social work from a graduate school of social work accredited by the council on social work education, and one year of social work experience in a health care setting; or
DHS 124.25(2)(a)2.
2. A bachelor's degree in social work, sociology or psychology, meets the national association of social workers standards of membership and has one year of social work experience in a health care setting.
DHS 124.25(2)(b)
(b) Staff. The social work service staff, in addition to the director, may include social workers, case workers and social work assistants at various levels of social work training and experience.
DHS 124.25(2)(c)
(c) Numbers of staff. There shall be a sufficient number of social work service staff to carry out the purpose and functions of the service.
DHS 124.25(3)
(3) Integration of the service. The social work service shall be integrated with other services of the hospital, as follows:
DHS 124.25(3)(a)
(a) Staff shall participate, as appropriate, in ward rounds, medical staff seminars, nursing staff conferences and in conferences with individual physicians and nurses concerned with the care of a particular patient and the patient's family;
DHS 124.25(3)(b)
(b) Staff shall inform appropriate administrative and professional personnel of the hospital about community programs and developments which may affect the hospital's social work program; and
DHS 124.25(3)(c)
(c) Staff shall participate in appropriate continuing education and orientation programs for nurses, medical students, interns, residents, physicians and hospital administrative staff, as well as inservice training programs for staff of the service.
DHS 124.25(4)(a)(a) Social work service activities shall address the social service needs of patients, their families and others designated by the patient as these relate to the health care and health of the patients.
DHS 124.25(4)(b)
(b) When appropriate, planning for patient care shall include assessment by the social work staff of the need to provide services to patients, their families and others designated by the patient in order to help them adjust to illness and to plan for needed post-hospital care.
DHS 124.25(5)(a)(a) Social work staff shall record their notes on intervention on behalf of a patient, the patient's family and others designated by the patient in the patient's permanent medical record.
