(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Sections 50.36 (2) (c) and 50.38, Stats., were repealed by 2007 Wis.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.
"Special care unit" means an organized health care service which combines specialized facilities and staff for the intensive care and management of patients in a crisis or potential crisis state. "Special care units" include coronary care, surgical intensive care, medical intensive care and burn units, but do not include post-obstetrical or post-surgical recovery units or neonatal intensive care units.
The hospital shall keep documentation of approvals on file in the hospital following all inspections by state and local authorities.
DHS 124.27 History
Cr. Register, January, 1988, No. 385
, eff. 2-1-88; emerg. cr. (5m), eff. 1-1-94; emerg. am. (4) (b), eff. 7-1-94; cr. (5m), Register, August, 1994, No. 464
, eff. 9-1-94; am. (4) (b), Register, January, 1995, No. 469
, eff. 2-1-95; emerg. renum. (4), (5), (6) to (10) to be DHS 124.28 to 124.36, r. (5m), eff. 7-1-96; renum. (4), (5), (6) to (10) to be DHS 124.28, 124.29, 124.32 to 124.36, r. (5m), Register, December, 1996, No. 492
, eff. 1-1-97.
The hospital shall provide fire protection adequate to ensure the safety of patients, staff and others on the hospital's premises. Necessary safeguards such as extinguishers, sprinkling and detection devices, fire and smoke barriers, and ventilation control barriers shall be installed to ensure rapid and effective fire and smoke control.
(2) Life safety code.
Facilities shall meet the applicable provisions of the 2000 edition of the Life Safety Code (LSC).
(3) Equivalent compliance.
An existing facility that does not meet all requirements of the applicable Life Safety Code may be considered in compliance with it if it achieves a passing score on the Fire Safety Evaluation System (FSES) developed by the U.S. department of commerce, national bureau of standards, to establish safety equivalencies under the Life Safety Code.
DHS 124.28 History
Emerg. renum. from DHS 124.27 (4), eff. 7-1-96; renum. from DHS 124.27 (4), Register, December, 1996, No. 492
, eff. 1-1-97; CR 04-040
: r. and recr. (2), r. (3), renum. (4) to be (3) Register November 2004 No. 587
, eff. 12-1-04; reprinted to restore dropped copy Register December 2004 No. 588
Plans for new construction or remodeling.
The hospital shall submit its plans and specifications for any new construction or remodeling to the department according to the following schedules:
One copy of preliminary or schematic plans shall be submitted to the department for review and approval;
One copy of final plans and specifications which are used for bidding purposes shall be submitted to the department for review and approval before construction is started;
If on-site construction above the foundation is not started within 12 months after the date of approval of the final plans and specifications, the approval under sub. (1)
shall be void and the plans and specifications shall be resubmitted for reconsideration of approval; and
Any changes in the approved final plans affecting the application of the requirements of this subchapter shall be shown on the approved final plans and shall be submitted to the department for approval before construction is undertaken. The department shall notify the hospital in writing of any conflict with this subchapter found in its review of modified plans and specifications.
DHS 124.29 Note
Note: Plan approval by the department of safety and professional services is also required for any new construction or remodeling of plumbing or private sewage systems, elevators or storage tanks.
DHS 124.29 Note
Note: Copies of the 1967, 1973 and 1981 Life Safety Codes and related codes can be obtained from the National Fire Protection Association, Battery March Park, Quincy, MA 02269. Copies are kept on file in the offices of the Division of Quality Assurance and the Legislative Reference Bureau.
DHS 124.29 Note
Note: The Department draws on the "Guidelines for Construction and Equipment of Hospitals and Medical Facilities", 1983/84 edition, published by the U.S. Department of Health and Human Services, for guidance in determining the adequacy of specific designs.
DHS 124.29 History
Emerg. renum. from DHS 124.27 (5), eff. 7-1-96; renum. from DHS 124.27 (5), Register, December, 1996, No. 492
, eff. 1-1-97.
Review for compliance with this chapter and the state building code. DHS 124.30(1)
The department shall review hospital construction and remodeling plans for compliance with this chapter and for compliance with the state commercial building code, chs. SPS 361
, with the exception of s. SPS 361.31 (3)
. Where chs. SPS 361
refer to the department of safety and professional services, those rules shall be deemed for purposes of review under this chapter to refer to the department of health services.
Before the start of any construction or remodeling project for a hospital, the plans for the construction or remodeling shall be submitted to the department, pursuant to s. DHS 124.29
, for review and approval by the department.