(2) Multiple units.
Multiple units of a licensed agency shall be separately licensed if the department determines that the units, because of the volume of services provided or the distance between them and the central office, cannot adequately share supervision and administration of services with the central office. If a branch agency is not separately licensed from a parent agency, the parent agency shall be deemed to be in violation of this chapter if the branch is in violation.
Application for a license to operate a home health agency shall be made on a form provided by the department, shall be accompanied by a nonrefundable fee of $300, and shall include at least the following information:
For all incorporated applicants, the date and the state of incorporation, a copy of the articles of incorporation, tax status and, if a foreign corporation, evidence of authority to do business in Wisconsin;
The name, principal business address and the percentage of ownership interest of all officers, directors, stockholders owning 10% or more of stock, members, partners, and all other persons having authority or responsibility for the operation of the agency;
Proof of sufficient financial responsibility as may be necessary to operate the agency for at least 90 days;
A description of the nature, type and scope of service to be provided, including geographic area to be served;
Name, identification and qualifications of the administrator; and
The department may use any of the following information to determine that a home health agency applicant or owner is fit and qualified:
Any adverse action against a home health agency applicant or owner by a licensing agency of any state that resulted in denial, suspension, injunction, or revocation of a health care agency or health care facility license.
Any adverse action initiated by a state or federal agency based on non-compliance that resulted in civil money penalties, termination of a provider agreement, suspension of payments, or the appointment of temporary management of the facility.
Any conviction of the applicant for a crime involving neglect or abuse of patients or of the elderly or involving assaultive behavior or wanton disregard for the health or safety of others, or any act of abuse under ss. 940.285
Any conviction of a home health agency applicant or owner for a crime related to the delivery of health care services or items, or for providing health care without a license.
Any conviction of a home health agency applicant or owner for a crime involving a controlled substance under ch. 961, Stats.
Any conviction of a home health agency applicant or owner for a crime involving a sexual offense.
Any prior financial failure of a home health agency applicant or owner that resulted in bankruptcy or in the closing of a health care agency or health care facility or the relocation or discharge of a health care agency's or health care facility's patients.
Any unsatisfied judgment against a home health agency applicant or owner or any debts that are at least 90 days past due.
DHS 133.03 Note
To obtain a copy of the license application form, send your request to the Division of Quality Assurance, P.O. Box 2969, Madison, Wisconsin 53701-2969. The street address is 1 W. Wilson Street in Madison. The e-mail address is:
. The completed application form should be sent to the same office.
Following receipt of a complete application for a new license or for a license change when there has been a change in the ownership of a home health agency, the department shall investigate the application to determine the applicant's ability to comply with this chapter.
Within 90 days after receiving a complete application, the department shall either approve the application and issue a license or deny the application, unless either of the following applies:
The applicant or agency is temporarily unable to conform to all the rules in this chapter.
If subd. 1. a.
applies, the department may, within the 90-day period in subd. 1.
, issue a provisional license for a term of 90 days. The department may, upon the agency's request, renew that license for additional 90-day terms not to exceed one year from the original issuance date of the provisional license.
During the provisional period specified in subd. 2.
, the home health agency shall actively serve at least 10 patients requiring skilled nursing care or other therapeutic services in Wisconsin. At least seven of the 10 patients shall be actively receiving skilled nursing services when the home health agency submits a written request for an on-site licensure survey. At least 3 patients shall be receiving skilled nursing services at the time of the on-site licensure survey.
The department may not charge an additional fee for the original regular license issued to a home health agency that has not had a provisional license.
After the department issues an initial regular license, the department may not charge the home health agency an additional licensing fee until the annual, continuing license fee is due. The fee shall be 0.25% of patient fee revenue of the home health agency based on the agency's financial information submitted to the department in the form prescribed by the department, with a maximum fee of $2,500 and a minimum fee of $500.
(5) Licensure term.
A home health agency regular license is valid indefinitely unless suspended, revoked or voluntarily surrendered.
DHS 133.03(6)(a)(a) Changes requiring notice.
The licensee shall, within 10 days, notify the department in writing of any changes in the services provided and any appointment or change of the administrator.
(b) Changes requiring new application.
A new application under sub. (3)
shall be submitted to the department within 10 working days when any of the following changes has occurred:
The corporate licensee has transferred 50% or more of the issued stock to another party or other parties;
The licensee has transferred ownership of 50% or more of the assets to another party or other parties;
There has been change in partners or partnership interests of 50% or greater in terms of capital or share of profits; or
(7) Denial or revocation.
If at any time the department determines that there has been a substantial failure to comply with the requirements of this chapter, or that the license fee has not been paid, or that the information required by the department for licensure is not provided, it shall deny or revoke the license after providing notice to the licensee.
An applicant or home health agency may appeal the following department actions:
If a home health agency wants to contest a department action specified in par. (a)
, it shall file a written request for a hearing under s. 227.44
, Stats., with the department of administration's division of hearings and appeals within 10 days of receipt of notice of the contested action.
DHS 133.03 Note
Note: The mailing address of the Division of Hearing and Appeals is: P.O. Box 7875, Madison, WI 53707-7875. The facsimile transmission number is 608-267-2744. The hearing request may be delivered in person to the Division of Hearings and Appeals at: 5005 University Avenue, Suite 201, Madison, WI.
Every 12 months, on a schedule determined by the department, a licensed home health agency shall submit to the department an annual report in the form and containing the information that the department requires, including payment of the fee required under s. 50.49 (2) (b)
, Stats., and sub. (4) (d)
. If a complete annual report is not timely filed, the department shall issue a warning to the licensee. If a licensed home health agency that has not filed a timely report fails to submit a complete report to the department within 60 days after the date established under the schedule determined by the department, the department may revoke the license.
DHS 133.03 History
Cr. Register, May, 1984, No. 341
, eff. 6-1-84; reprinted to correct printing error in (3) (e), Register, September, 1984, No. 345
; r. and recr. (4) and (5), Register, November, 1985, No. 359
, eff. 12-1-85; correction in (4) (b) made under s. 13.93 (2m) (b) 7., Stats., Register, August, 1995, No. 476
; am. (6) (b), Register, October, 1995, No. 478
, eff. 11-1-95; r. and recr. (5), r. (6), renum. (7) to (9) to be (6) to (8), cr. (9), Register, August, 2000, No. 536
, eff. 9-1-00; r. and recr. (3) (h), (4) (b), (c), (8), cr. (4) (d), am. (9), Register, April, 2001, No. 544
, eff. 5-1-01; correction in (8) (a) 2. was made under s. 13.93 (2m) (b) 7., Stats., Register August 2001 No. 548
; CR 03-033
: am. (8) (b) Register December 2003 No. 576
, eff. 1-1-04; CR 07-060
: am. (4) (b) 3. and (5), cr. (3) (i) Register November 2007 No. 623
, eff. 12-1-07.
The department may make any inspections and investigations it considers necessary, including review of clinical and administrative records, subject only to restrictions of law.
The department may investigate any complaints received by it concerning the operation or services of a home health agency.
DHS 133.04 Note
Note: A complaint may be filed by writing the Bureau of Health Services, Division of Quality Assurance, P.O. Box 2969, Madison, Wisconsin 53701-2969 or by calling the Wisconsin Home Health Hotline toll free at 1-800-642-6552.
(3) Patient visits.
The department may contact patients of a home health agency as part of an inspection or investigation. A licensee shall provide the department a list of names, addresses and other identifying information of current and past patients as may be requested. The department may select the names of the patients to be visited and may visit these patients with their approval.
Statement of deficiency.
Upon determining that a home health agency is in violation of any requirement of this chapter, the department shall promptly serve a statement of deficiency upon the administrator or other designated representative of the home health agency. The statement of deficiency shall specify the rule violated and state the facts that constitute the violation.
Within 10 working days of receipt of the statement of deficiency, the home health agency shall submit a plan of correction to the department for approval detailing how the agency will correct the violation or how the agency has corrected the violation. The department may require that a plan of correction be submitted for approval within a shorter specified time for violations the department determines may be harmful to the health, safety, welfare, or rights of patients.
The department may require the home health agency to modify the proposed plan of correction before the department approves the plan of correction.
The department may require a licensee to implement and comply with a plan of correction that is developed by the department.
The department shall verify that the home health agency has completed the plan of correction submitted or imposed in par. (b)
The department may impose any of the following penalties for a violation of a requirement of this chapter:
Suspend admissions of new patients until the department has verified that the home health agency has completed the plan of correction under par. (b)
(5) Interference with inspections.
Any interference with or refusal to allow any inspection or investigation under this chapter shall be grounds for denial or revocation of the license.
(6) Waivers or variances.
Upon application of a home health agency, the department may waive or vary any provision of this chapter if it finds that the waiver or variance will not adversely affect the health, safety or welfare of any patient.
DHS 133.04 History
Cr. Register, May, 1984, No. 341
, eff. 6-1-84; r. and recr. (4), Register, April, 2001, No. 544
, eff. 5-1-01.
Each home health agency shall have a governing body which shall:
Adopt governing policies in the form of by-laws, charter, written policies or other official means;
Provide for a qualified substitute administrator to act in absence of the administrator.
The home health agency shall establish an advisory group of at least one practicing physician and one registered nurse and appropriate representation from other professional disciplines. A majority of the members shall be persons who are neither owners nor employees of the agency.
Review annually and make recommendations to the governing body concerning the agency's scope of services offered, admission and discharge policies, medical supervision and plans of care, emergency care, clinical records, personnel qualifications, and program evaluation;
Meet at least annually to advise the agency on professional issues, participate in the evaluation of the agency's program and assist the agency in maintaining liaison with other health care providers in a community information program; and
DHS 133.05 History
Cr. Register, May, 1984, No. 341
, eff. 6-1-84; CR 07-060
: am. (2) (b) 1., Register November 2007 No. 623
, eff. 12-1-07.
The home health agency shall be administered by an administrator who shall be a licensed physician, a registered nurse, or a person who has had training and experience in health care administration and at least one year of supervisory or administrative experience in home health care or related health programs.
(2) Duties of the administrator.
The administrator shall:
Be knowledgeable about this chapter, and shall take all reasonable steps to ensure compliance of the agency with the requirements of this chapter;
Administer the entire home health services of the agency; and
Cooperate with the department in investigating compliance with this chapter.
(3) Personnel policies.
The agency shall prepare in writing and review annually the following policies:
A system for recruitment, orientation and continuing training of staff; and
A plan for the evaluation of staff in the performance of duties.