Amendment ASA-AB150

AB150-ASA,1033,15 2. The department shall promulgate rules that establish a fee schedule for its services under subd. 1. in conducting the plan reviews. The schedule established under these rules shall set fees for nursing home plan reviews in amounts that are less than the sum of the amounts required on September 30, 1995, for fees under this paragraph and for fees for examination of nursing home plans under s. 101.19 (1) (a), 1993 stats.

AB150-ASA, s. 3227 Section 3227. 50.03 (4) (a) 1. b. of the statutes is amended to read:

AB150-ASA,1034,9 50.03 (4) (a) 1. b. Except as provided in sub. (4m) (b), the department shall issue a license for a community-based residential facility if it finds the applicant to be fit and qualified, if it finds that the community-based residential facility meets the requirements established by this subchapter and if the community-based residential facility has paid the license fee under s. 140.85 (2) (a) 50.037 (2) (a). In determining whether to issue a license for a community-based residential facility, the department may consider any action by the applicant or by an employe of the applicant that constitutes a substantial failure by the applicant or employe to protect and promote the health, safety or welfare of a resident. The department may deny licensure to or not renew licensure for any person who conducted, maintained, operated or permitted to be maintained or operated a community-based residential facility for which licensure was revoked. The department, or its designee, shall make such inspections and investigations as are necessary to determine the conditions existing in each case and shall file written reports. Before renewing the license of any community-based residential facility, the department shall consider all complaints filed under sub. (2) (f) during the current license period and the disposition of each. The department shall promulgate rules defining "fit and qualified" for the purposes of this subd. 1. b.

AB150-ASA, s. 3228 Section 3228. 50.03 (4) (c) of the statutes is renumbered 50.03 (4) (c) 1. and amended to read:

AB150-ASA,1034,24 50.03 (4) (c) 1. Unless sooner revoked or suspended, a community-based residential facility license shall be is valid for one year. Unless sooner revoked or suspended, a nursing home license is valid for one year, but may be issued to a new licensee for less than one year to coincide with the date of federal medical assistance certification as a skilled nursing facility or intermediate care facility 24 months. At least 120 days but not more than 150 30 days prior to license expiration, the applicant shall submit an annual a biennial report and application for renewal of the license in such the form and containing such the information as that the department requires. If the report and application are approved, the license shall be renewed for an additional one-year 24-month period. If the application for renewal and a complete annual report are not timely filed, the department shall issue a warning to the licensee. Failure to make application for renewal within 30 days there after may be after receipt of the warning is grounds for nonrenewal of the license.

AB150-ASA, s. 3229 Section 3229. 50.03 (4) (c) 2. of the statutes is created to read:

AB150-ASA,1035,11 50.03 (4) (c) 2. Unless sooner revoked or suspended, a nursing home license is valid for 12 months, but may be issued to a new licensee for less than 12 months to coincide with the date of federal medical assistance certification as a skilled nursing facility or intermediate care facility. At least 120 days but not more than 150 days prior to license expiration, the applicant shall submit an annual report and application for renewal of the license in the form and containing the information that the department requires. If the report and application are approved, the license shall be renewed for an additional 12-month period. If the application for renewal and a complete annual report are not timely filed, the department shall issue a warning to the licensee. Failure to make application for renewal within 30 days after receipt of the warning is grounds for nonrenewal of the license.

AB150-ASA, s. 3230 Section 3230. 50.03 (5g) (c) (intro.) of the statutes is amended to read:

AB150-ASA,1035,21 50.03 (5g) (c) (intro.) If the department provides to a community-based residential facility written notice of the grounds for a sanction or penalty, an explanation of the types of sanctions or penalties that the department may impose under this subsection and an explanation of the process for appealing a sanction or penalty imposed under this subsection, the department may impose any of the following against a licensee or other person who violates the applicable provisions of this section or rules promulgated under the applicable provisions of this section or who fails to comply with an order issued under par. (b) by the time specified in the order:

AB150-ASA, s. 3231 Section 3231. 50.03 (5g) (c) 1. a. of the statutes is amended to read:

AB150-ASA,1036,3 50.03 (5g) (c) 1. a. Within the limits specified in this subdivision, the department may, by rule, set daily forfeiture amounts and payment deadlines based on the size and type of community-based residential facility and the seriousness of the violation. As part of the order, the The department may set daily forfeiture amounts that increase periodically within the statutory limits if there is continued failure to comply with an order issued under par. (b).

AB150-ASA, s. 3231m Section 3231m. 50.03 (5g) (c) 1. c. of the statutes is amended to read:

AB150-ASA,1036,11 50.03 (5g) (c) 1. c. All forfeitures shall be paid to the department within 10 days after receipt of notice of assessment or, if the forfeiture is contested under par. (f), 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 under s. 50.03 (11). The department shall remit all forfeitures paid under this subdivision to the state treasurer secretary of administration for deposit in the school fund.

AB150-ASA, s. 3232 Section 3232. 50.03 (14) (b) of the statutes is amended to read:

AB150-ASA,1036,20 50.03 (14) (b) The county departments of the county in which the facility is located that are responsible for providing services under s. 46.215 (1) (L), 46.22 (1) (b) 7. a. 1. c., 51.42 or 51.437 shall participate in the development and implementation of individual relocation plans. Any county department of another county shall participate in the development and implementation of individual relocation plans in place of the county departments of the county in which the facility is located, if the county department accepts responsibility for the resident or is delegated responsibility for the resident by the department or by a court.

AB150-ASA, s. 3233 Section 3233. 50.033 (2) of the statutes is amended to read:

AB150-ASA,1037,5 50.033 (2) Regulation. Standards for operation of licensed adult family homes and procedures for application for licensure, monitoring, inspection, revocation and appeal of revocation shall be under rules promulgated by the department under s. 50.02 (2) (am) 2. Licensure shall be for a term not to exceed 12 24 months from the date of issuance and is not transferable. The biennial licensure fee for a licensed adult family home is $75. The fee is payable to the county department under s. 46.215, 46.22, 46.23, 51.42 or 51.437, if the county department licenses the adult family home under sub. (1m) (b), and is payable to the department if the department licenses the adult family home under sub. (1m) (b).

AB150-ASA, s. 3234b Section 3234b. 50.034 of the statutes is created to read:

AB150-ASA,1037,16 50.034 Assisted living facilities. (1) Certification or registration required. (a) No person may operate an assisted living facility that provides living space for residents who are clients under s. 46.27 (11) or 46.277 and publicly funded services as a home health agency or under contract with a county department under s. 46.215, 46.22, 46.23, 51.42 or 51.437 that is a home health agency unless the assisted living facility is certified by the department under this section. The department may charge a fee, in an amount determined by the department, for certification under this paragraph. The amount of any fee charged by the department for certification of an assisted living facility need not be promulgated as a rule under ch. 227.

AB150-ASA,1037,19 (b) No person may operate an assisted living facility that is not certified as required under par. (a) unless the assisted living facility is registered by the department.

AB150-ASA,1037,22 (2) Rules. The department shall promulgate all of the following rules for the regulation of certified assisted living facilities and for the registration of assisted living facilities under this section:

AB150-ASA,1037,24 (a) Defining the term "kitchen, including a stove" for purposes of the definition of "assisted living facility" under s. 50.01 (1d).

AB150-ASA,1037,25 (b) Establishing standards for operation of certified assisted living facilities.

AB150-ASA,1038,3 (c) Establishing minimum information requirements for registration and registration application procedures and forms for assisted living facilities that are not certified.

AB150-ASA,1038,4 (d) Establishing procedures for monitoring certified assisted living facilities.

AB150-ASA,1038,7 (e) Establishing intermediate sanctions and penalties for and standards and procedures for imposing intermediate sanctions or penalties on certified assisted living facilities and for appeals of intermediate sanctions or penalties.

AB150-ASA,1038,9 (f) Establishing standards and procedures for appeals of revocations of certification or refusal to issue or renew certification.

AB150-ASA,1038,11 (3) Requirements for operation. A certified or registered assisted living facility shall do all of the following:

AB150-ASA,1038,15 (a) Establish, with each resident of the assisted living facility, a mutually agreed-upon written service agreement that identifies the services to be provided to the resident, based on a comprehensive assessment of the resident's needs and preferences that is conducted by one of the following:

AB150-ASA,1038,17 1. For residents for whom services are reimbursable under s. 46.27 (11), by the county department or aging unit designated under s. 46.27 (3) (b) in the county.

AB150-ASA,1038,19 2. For residents for whom services are reimbursable under s. 46.277, by the county department under s. 46.277 (4) (a) in the county.

AB150-ASA,1038,21 3. For residents who have private or 3rd-party funding, by the assisted living facility.

AB150-ASA,1038,23 (b) Establish a schedule of fees for services to residents of the assisted living facility.

AB150-ASA,1039,3 (c) Provide or ensure the provision of services that are sufficient and qualified to meet the needs identified in a resident's service agreement under par. (a), to meet unscheduled care needs and to provide emergency assistance 24 hours a day.

AB150-ASA,1039,6 (d) Establish, with each resident of the assisted living facility, a signed, negotiated risk agreement that identifies situations that could put the resident at risk and for which the resident understands and accepts responsibility.

AB150-ASA,1039,10 (4) Limitation on number of assisted living facility units. (a) The maximum number of individual units of assisted living facilities that the department may certify or register for operation is 1,500 units, which may be implemented only as follows:

AB150-ASA,1039,11 1. In fiscal year 1996-97, not more than a total of 600 units.

AB150-ASA,1039,12 2. In fiscal year 1997-98, not more than a total, in the aggregate, of 900 units.

AB150-ASA,1039,14 3. In fiscal year 1998-99 and thereafter, not more than a total, in the aggregate, of 1,500 units.

AB150-ASA,1039,18 (b) An assisted living facility may not be newly constructed and a nursing home or a community-based residential facility may not convert a separate area of its total area to an assisted living facility unless the department first approves the construction or conversion.

AB150-ASA,1039,23 (c) If the department receives in a fiscal year applications for certification or registration of assisted living facilities that exceed the maximum number of individual units that may be registered or certified, as specified in par. (a), the department may select applications for approval, within the maximum limits specified, based on all of the following criteria:

AB150-ASA,1039,24 1. The geographical distribution of the state's population of elderly persons.

AB150-ASA,1040,2 2. Whether or not the assisted living facility proposes to serve both publicly funded residents and residents who pay privately for services.

AB150-ASA,1040,3 3. Whether or not a closure of nursing home beds would result.

AB150-ASA,1040,5 4. Whether or not certification or registration of the assisted living facility would alleviate a shortage of long-term care facilities in the area.

AB150-ASA,1040,9 (d) The department may charge an application fee of $300 to any facility applying for certification or registration as an assisted living facility under par. (c). The amounts of fees received under this paragraph shall be credited to the appropriation under s. 20.435 (1) (gn).

AB150-ASA,1040,14 (5) Use of name prohibited. An entity that does not meet the definition under s. 50.01 (1d) may not designate itself as an "assisted living facility" or use the word "assisted living facility" to represent or tend to represent the entity as an assisted living facility or services provided by the entity as services provided by an assisted living facility.

AB150-ASA,1040,19 (6) Funding. Funding for supportive, personal or nursing services that a person who resides in an assisted living facility receives, other than private or 3rd-party funding, may be provided only under s. 46.27 (11) (c) 7. or 46.277 (5) (e), unless the provider of the services is a certified medical assistance provider under s. 49.45 (3) (a).

AB150-ASA,1041,3 (7) Revocation of certification. Certification for an assisted living facility may be revoked because of the substantial and intentional violation of this section or of rules promulgated by the department under sub. (2) or because of failure to meet the minimum requirements for certification. The operator of the certified assisted living facility shall be given written notice of any revocation of certification and the grounds for the revocation. Any assisted living facility certification applicant or operator of a certified assisted living facility may, if aggrieved by the failure to issue or renew the certification or by revocation of certification, appeal under the procedures specified by the department by rule under sub. (2).

AB150-ASA, s. 3235 Section 3235. 50.035 (2) (a) 3. of the statutes is amended to read:

AB150-ASA,1041,9 50.035 (2) (a) 3. The department or the department of industry, labor and human relations development may waive the requirement under subd. 1. or 2. for a community-based residential facility that has a smoke detection or sprinkler system in place that is at least as effective for fire protection as the type of system required under the relevant subdivision.

AB150-ASA, s. 3236 Section 3236. 50.035 (2) (b) (intro.) of the statutes is amended to read:

AB150-ASA,1041,14 50.035 (2) (b) (intro.) No facility may install a smoke detection system that fails to receive the approval of the department or of the department of industry, labor and human relations development. At least one smoke detector shall be located at each of the following locations:

AB150-ASA, s. 3237 Section 3237. 50.035 (7) of the statutes is created to read:

AB150-ASA,1041,22 50.035 (7) Statement of financial condition required. (a) No community-based residential facility may initially admit as a resident an individual who applies for admission to the facility and who intends to pay for residence in the facility from private funds, unless the individual provides certain financial information to the community-based residential facility. From this information, the community-based residential facility shall prepare and provide to the individual a statement of financial condition to which all of the following apply:

AB150-ASA,1041,23 1. The statement is pertinent to the individual.

AB150-ASA,1042,3 2. The statement estimates a date, if any, by which the individual's assets and other private funding sources would be depleted if the individual resides continuously in the community-based residential facility.

AB150-ASA,1042,6 3. The statement indicates that public funding may not be available when the individual's assets and other private funding sources, if any, are depleted and specifies options that may be available to the individual at that time.

AB150-ASA,1042,10 (b) The individual shall waive his or her right to confidentiality for the information provided under par. (a), to the administrator of the community-based residential facility, to the preparer of the statement of financial condition and, if par. (c) applies, to the county department under s. 46.215 or 46.22.

AB150-ASA,1042,14 (c) If the date estimated under par. (a) 2. is less than 24 months after the date of the individual's statement of financial condition, the community-based residential facility shall provide the statement to the county department under s. 46.215 or 46.22.

AB150-ASA, s. 3238m Section 3238m. 50.037 (2) (a) of the statutes is amended to read:

AB150-ASA,1042,18 50.037 (2) (a) The annual biennial fee for a community-based residential facility is $75 $170, plus an annual fee of $10 $22 per resident, based on the number of residents that the facility is licensed to serve.

AB150-ASA, s. 3239 Section 3239. 50.037 (2) (c) of the statutes is amended to read:

AB150-ASA,1043,2 50.037 (2) (c) A community-based residential facility that wishes to renew a license issued under s. 50.03 (4) (a) 1. b. and that fails to submit the annual biennial fee prior to the renewal date of the license, or a new community-based residential facility subject to this section that fails to submit the annual biennial fee by 30 days prior to the opening of the new community-based residential facility, shall pay an additional fee of $10 per day for every day after the deadline that the facility does not pay the fee.

AB150-ASA, s. 3240 Section 3240. 50.037 (3) of the statutes is amended to read:

AB150-ASA,1043,7 50.037 (3) Exemption. Community-based residential facilities where the total monthly charges for each resident do not exceed the monthly state supplemental payment rate under s. 49.177 (3s) 49.77 (3s) that is in effect at the time the fee under sub. (2) is assessed are exempt from this section.

AB150-ASA, s. 3240m Section 3240m. 50.04 (4) (e) 1. of the statutes is amended to read:

AB150-ASA,1044,9 50.04 (4) (e) 1. If a nursing home desires to contest any department action under this subsection or under federal law requiring the department, as the designated medical assistance agency, to notify the nursing home of deficiencies under federal regulations and report those deficiencies to the appropriate federal agency, it shall send a written request for a hearing under s. 227.44 to the division of hearings and appeals created under s. 15.103 (1) within 10 days of receipt of notice of the contested action. Department action that is subject to a hearing under this subsection includes imposition service of a notice of a deficiency under federal regulations violation of this subchapter or rules promulgated under this subchapter, a notation in the report under sub. (3) (b), imposition of a plan of correction and rejection of a nursing home's plan of correction, but does not include a correction order. Upon the request of the nursing home, the division shall grant a stay of the hearing under this paragraph until the department assesses a forfeiture, so that its hearing under this paragraph is consolidated with the forfeiture appeal hearing held under sub. (5) (e). All agency action under this subsection arising out of a violation, deficiency or rejection and imposition of a plan of correction shall be the subject of a single hearing. Unless a stay is granted under this paragraph, the division shall commence the hearing within 30 days of the request for hearing, within 30 days of the department's acceptance of a nursing home's plan of correction or within 30 days of the department's imposition of a plan of correction, whichever is later. If the department initiates decertification of a nursing home under federal regulations, a hearing on federal deficiencies that are the subject of that decertification may be held if informal reconsideration has been completed. The division shall send notice to the nursing home in conformance with s. 227.44. Issues litigated at the hearing may not be relitigated at subsequent hearings under this paragraph arising out of the same violation or deficiency.

AB150-ASA, s. 3240p Section 3240p. 50.04 (5) (f) of the statutes is amended to read:

AB150-ASA,1044,17 50.04 (5) (f) Forfeitures paid within 10 days. All forfeitures shall be paid to the department within 10 days of receipt of notice of assessment or, if the forfeiture is contested under par. (e), within 10 days of receipt of the final decision after exhaustion of administrative review, unless the final decision is appealed and the order is stayed by court order under s. 50.03 (11). The department shall remit all forfeitures paid to the state treasurer secretary of administration for deposit in the school fund.

AB150-ASA, s. 3240y Section 3240y. 50.05 (3) of the statutes is amended to read:

AB150-ASA,1045,2 50.05 (3) Monitor. In any situation described in sub. (2), the department may place a person to act as monitor in the facility. The monitor shall observe operation of the facility, assist the facility by advising it on how to comply with state regulations, and shall submit a written report periodically to the department on the operation of the facility. The department may require payment by the operator or controlling person of the facility for the costs of placement of a person to act as monitor in the facility, if, subsequently, a court appoints a receiver for the facility under sub. (4).

AB150-ASA, s. 3241d Section 3241d. 50.05 (10) of the statutes is amended to read:

AB150-ASA,1045,13 50.05 (10) Contingency fund. If funds collected under subs. (3), (7) and (8) are insufficient to meet the expenses of performing the powers and duties conferred on the receiver by this section, or if there are insufficient funds on hand to meet those expenses, the department may draw from the supplemental funds fund created under s. 20.435 (1) (dm) and (6) (dm) to pay those the expenses associated with the placement of a monitor, if any, in a nursing home and the receivership of a nursing home. Operating funds collected under this section and not applied to the expenses of the placement of a monitor, if any, and the receivership, except for the amount of a security, if any is required under sub. (14m), shall be used to reimburse the fund for advances made under this section.

AB150-ASA, s. 3241f Section 3241f. 50.05 (11) of the statutes is amended to read:

AB150-ASA,1045,17 50.05 (11) (title) Compensation of monitor or receiver. The court shall set the compensation of a person placed as a monitor, if any, and of the receiver, which will be considered a necessary expense expenses of a receivership.

AB150-ASA, s. 3241h Section 3241h. 50.05 (14m) of the statutes is amended to read:

AB150-ASA,1046,5 50.05 (14m) Bond upon termination; reappointment. If the court terminates a receivership under sub. (14) and the department grants a license for the facility to the same applicant under which the facility was licensed immediately prior to appointment of a receiver under sub. (4) or (5), the court may require that person to post a bond for a period of not less than 120 days in an amount fixed by the court as security for maintaining compliance with this subchapter and the rules promulgated under this subchapter. If the court, after notice to the parties in the receivership proceeding and after a hearing, finds that the standards for appointment under sub. (4) are met, the court may reappoint the receiver. If the court reappoints the receiver, the receiver may use the security, if any has been required under this subsection, in addition to funds under subs. (7), (8) and (10), for purposes of payment of the placement of a monitor, if any, and for the receivership.

AB150-ASA, s. 3241j Section 3241j. 50.05 (15) (a) of the statutes is amended to read:

AB150-ASA,1046,10 50.05 (15) (a) Within 30 days after termination, the receiver shall give the court a complete accounting of all property of which the receiver has taken possession, of all funds collected under this section and of the expenses of the monitor, if any is placed in a nursing home, and the receivership.

AB150-ASA, s. 3241L Section 3241L. 50.05 (15) (b) of the statutes is amended to read:

AB150-ASA,1046,24 50.05 (15) (b) If the operating funds collected by the receiver under subs. (7) and (8) exceed the reasonable expenses of the placement of a monitor in a nursing home, if any, and of the receivership, the court shall order payment of the surplus to the operator or controlling person, after reimbursement of funds drawn from the contingency fund under sub. (10). If the operating funds are insufficient to cover the reasonable expenses of the placement of a monitor in a nursing home, if any, and of the receivership, the operator or controlling person shall be liable for the deficiency. The operator or controlling person may apply to the court to determine the reasonableness of any expense of the placement of a monitor in a nursing home, if any, and of the receivership. The operator or controlling person shall not be responsible for expenses in excess of what the court finds to be reasonable. Payment recovered from the operator or controlling person shall be used to reimburse the contingency fund for amounts drawn by the receiver under sub. (10).

AB150-ASA, s. 3243 Section 3243. 50.135 (1) of the statutes is amended to read:

AB150-ASA,1047,5 50.135 (1) Definition. In this section, "inpatient health care facility" means any hospital, nursing home, county home, county mental hospital, tuberculosis sanatorium or other place licensed or approved by the department under ss. 49.14, 49.16, 49.171, 49.70, 49.71, 49.72, 50.02, 50.03, 50.35, 51.08, 51.09, 58.06, 252.073 and 252.076, but does not include community-based residential facilities.

AB150-ASA, s. 3244 Section 3244. 50.135 (2) (c) of the statutes is amended to read:

AB150-ASA,1047,10 50.135 (2) (c) The fees collected under par. (a) shall be credited to the appropriation under s. 20.435 (1) (gm) for health planning and cost containment activities and to the appropriation under s. 20.488 (1) (g) licensing, review and certifying activities.

AB150-ASA, s. 3245 Section 3245. 50.36 (1) of the statutes is amended to read:

AB150-ASA,1047,25 50.36 (1) The department shall promulgate, adopt, amend and enforce such rules and standards for hospitals for the construction, maintenance and operation of the hospitals deemed necessary to provide safe and adequate care and treatment of the patients in the hospitals and to protect the health and safety of the patients and employes; and nothing contained herein shall pertain to a person licensed to practice medicine and surgery or dentistry. The building codes and construction standards of the department of industry, labor and human relations development shall apply to all hospitals and the department may adopt additional construction codes and standards for hospitals, provided they are not lower than the requirements of the department of industry, labor and human relations development. Except for the construction codes and standards of the department of industry, labor and human relations development and except as provided in s. 50.39 (3), the department shall be the sole agency to adopt and enforce rules and standards pertaining to hospitals.

AB150-ASA, s. 3246 Section 3246. 50.36 (2) of the statutes is renumbered 50.36 (2) (a) and amended to read: