(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.
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.
The department may directly assess a forfeiture for each violation of a requirement under s. 50.375 (2)
, 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
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
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.
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)
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.
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
Cr. Register, January, 1988, No. 385
, eff. 2-1-88; CR 09-089
: cr. (3) Register March 2010 No. 651
, eff. 4-1-10.
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:
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
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.
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.
(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.
(3) Integration of the service.
The social work service shall be integrated with other services of the hospital, as follows:
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;
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
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.
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.
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.
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.
More detailed records of the interventions shall be kept by the service to meet the needs of students, training of staff, for research purposes, and to permit review by supervisors or consultants.
The facilities for social work staff shall provide privacy for interviews with patients, their family members and other persons designated by the patients.
DHS 124.25 History
Cr. Register, January, 1988, No. 385
, eff. 2-1-88.
Referral to aging and disability resource center required.
If the secretary of the department has certified that a resource center, as defined in s. DHS 10.13 (42)
, is available for the hospital under s. DHS 10.71
, the hospital shall refer patients to the aging and disability resource center as required under ss. 50.36 (2) (c) and 50.38
, Stats., and s. DHS 10.72
DHS 124.255 Note
Sections 50.36 (2) (c) and 50.38, Stats., were repealed by 2007 Wis. Act 20
DHS 124.255 History
Cr. Register, October, 2000, No. 538
, eff. 11-1-00; corrections made under s. 13.92 (4) (b) 7.
, Stats., Register January 2009 No. 637
Additional requirements for psychiatric hospitals. DHS 124.26(1)(1)
In this section, "psychiatric hospital" means a special hospital that primarily provides psychiatric care to inpatients and outpatients. It does not include a special hospital that primarily offers treatment for alcohol abuse and drug abuse patients.
(2) Additional medical record requirements.
The medical records maintained by a psychiatric hospital shall document the degree and intensity of the treatment provided to individuals who are furnished services in the facility. A patient's medical record shall contain:
The reason for treatment or chief complaint in the words of the patient as well as observations or concerns expressed by others;
The psychiatric evaluation, including a medical history containing a record of mental status and noting the onset of illness, the circumstances leading to admission, attitudes, behavior, an estimate of intellectual functions, memory functioning, orientation and an inventory of the patient's personality assets recorded in descriptive fashion;
Social service records, including reports of interviews with patients, family members and others and providing an assessment of home plans, family attitudes and community resource contacts as well as a social history;
A comprehensive treatment plan based on an inventory of the patient's strengths and disabilities, which shall include:
The documentation of all active therapeutic efforts and interventions;
Progress notes recorded at least weekly by the physician, nurse, social worker and staff from other appropriate disciplines involved in active treatment modalities, as indicated by the patient's condition; and
Recommendations from appropriate services concerning follow-up care; and
(3) Additional treatment plan and staffing requirements. DHS 124.26(3)(a)(a)
The hospital shall have enough staff with appropriate qualifications to carry out an active program of psychiatric treatment for individuals who are furnished services in the facility.
Staff shall plan, implement and revise, as indicated, a written, individualized treatment program for each patient based on:
The degree of psychological impairment and appropriate measures to be taken to relieve treatable distress and to compensate for nonreversible impairments;
Environmental and physical limitations required to safeguard the individual's health and safety with an appropriate plan of care; and
The treatment of psychiatric inpatients shall be under the supervision of a qualified physician who shall provide for an intensive treatment program.
If nonpsychiatric medical and surgical diagnostic and treatment services are not available within the facility, qualified consultants or attending physicians shall be immediately available if a patient should need this attention, or an adequate arrangement shall be in place for immediate transfer of the patient to a general hospital.
Nursing services shall be under the direct supervision of a registered nurse qualified to care for psychiatric patients and, by demonstrated competence, to participate in interdisciplinary formulation of individual treatment plans, to give skilled nursing care and therapy, and to direct, supervise and educate others who assist in implementing the nursing component of each patient's treatment plan.
Registered nurses and other nursing personnel shall participate in interdisciplinary meetings affecting the planning and implementation of nursing care plans for patients, including diagnostic conferences, treatment planning sessions and meetings held to consider alternative facilities and community resources.
Psychological services shall be under the supervision of a psychologist licensed under ch. 455, Stats.
There shall be enough psychologists, consultants and support personnel qualified to:
Participate in therapeutic interventions and in interdisciplinary conferences and meetings held to establish diagnoses, goals and treatment programs.
The number of social work staff qualified to carry out their duties shall be adequate for the hospital to meet the specific needs of individual patients and their families and develop community resources and for consultation to other staff and community agencies.
Participate in interdisciplinary conferences and meetings on formulation of a diagnosis and treatment planning, including identification and use of alternative forms of care and treatment.
The number of qualified therapists and therapist assistants shall be sufficient to provide needed therapeutic activities, including, when appropriate, occupational, recreational and physical therapy, to ensure that each patient receives appropriate treatment.
The total number of rehabilitation personnel, including consultants, shall be sufficient to permit appropriate representation and participation in interdisciplinary conferences and meetings, including diagnostic conferences, which affect the planning and implementation of activity and rehabilitation programs.
DHS 124.26 History
Cr. Register, January, 1988, No. 385
, eff. 2-1-88.
General requirements and definitions. DHS 124.27(1)(1)
The buildings of the hospital shall be constructed and maintained so that they are functional for diagnosis and treatment and for the delivery of hospital services appropriate to the needs of the community and with due regard for protecting the health and safety of the patients. The provisions of this section apply to all new, remodeled and existing construction unless otherwise noted.
"Existing construction" means a building which is in place or is being constructed with plans approved by the department prior to the effective date of this chapter.
"Full-term nursery" means an area in the hospital designated for the care of infants who are born following a full-term pregnancy and without complications, until discharged to a parent or other legally authorized person.
"Intermediate nursery" means an area in the hospital designated for the care of infants immediately following birth who require observation due to complications, and for the care of infants who require observation following placement in the critical care nursery, until discharged to a parent or other legally authorized person.
"Life Safety Code" means the National Fire Protection Association's (NFPA) Standard 101.
"New construction" means construction for the first time of any building or addition to an existing building, the plans for which are approved after February 1, 1988.
"Remodeling" means to make over or rebuild any portion of a building or structure and thereby modify its structural strength, fire hazard character, exits, heating and ventilating systems, electrical system or internal circulation, as previously approved by the department. Where exterior walls are in place but interior walls are not in place at the time of the effective date of this chapter, construction of interior walls shall be considered remodeling. "Remodeling" does not include repairs necessary for the maintenance of a building or structure.