SB436,121,115
50.01
(3) (intro.) "Nursing home" means a place
which provides 24-hour
6services including board and room to 3 or more unrelated residents who where 5 or
7more persons who are not related to the operator or administrator reside, receive care
8or treatment and, because of their mental or physical condition
require nursing care
9or personal care in excess of 7 hours a week, require access to 24-hour nursing
10services, including limited nursing care, intermediate level nursing care and skilled
11nursing services. "Nursing home" does not include any of the following:
SB436, s. 221
12Section
221. 50.01 (4m) of the statutes is amended to read:
SB436,121,1513
50.01
(4m) "Operator" means any person licensed or required to be licensed
14under s. 50.03 (1)
or a person who operates an adult family home that is licensed
15under s. 50.033 (1m) (b).
SB436, s. 222
16Section
222. 50.01 (4o) of the statutes is amended to read:
SB436,121,1817
50.01
(4o) "Personal care" means assistance with the activities of daily living,
18such as eating, dressing, bathing and ambulation
, but does not include nursing care.
SB436, s. 223
19Section
223. 50.01 (5) of the statutes is repealed.
SB436, s. 224
20Section
224. 50.01 (6) of the statutes is amended to read:
SB436,121,2321
50.01
(6) "Resident" means a person
who is cared for or treated in
any and is
22not discharged from a nursing home
or ,community-based residential facility
or
23adult family home, irrespective of how admitted.
SB436, s. 225
24Section
225. 50.01 (6v) of the statutes is created to read:
SB436,122,2
150.01
(6v) "Skilled nursing services" means those services, to which all of the
2following apply, that are provided to a resident under a physician's orders:
SB436,122,53
(a) The services require the skills of and are provided directly by or under the
4supervision of a person whose licensed, registered, certified or permitted scope of
5practice is at least equivalent to that of a licensed practical nurse.
SB436,122,66
(b) Any of the following circumstances exist:
SB436,122,97
1. The inherent complexity of a service prescribed for a resident is such that
8it can be safely and effectively performed only by or under the supervision of
9registered nurses or licensed practical nurses.
SB436,122,1210
2. The full recovery or medical improvement of the resident is not possible, but
11the services are needed to prevent, to the extent possible, deterioration of the
12resident's condition or to sustain current capacities of the resident.
SB436,122,1613
3. Because of special medical complications, performing or supervising a
14service that is generally unskilled or observing the resident necessitates the use of
15a person whose licensed, registered, certified or permitted scope of practice is at least
16equivalent to that of a licensed practical nurse.
SB436, s. 226
17Section
226. 50.035 (10) of the statutes is created to read:
SB436,122,2118
50.035
(10) Exceptions to care limitations. (a)
Notwithstanding the
19limitations on the type of care that may be required by and provided to residents
20under s. 50.01 (1g) (intro.), the following care may be provided in a community-based
21residential facility under the following circumstances:
SB436,123,222
1. Subject to par. (b), a community-based residential facility may provide more
23than 3 hours of nursing care per week or care above intermediate level nursing care
24for not more than 30 days to a resident who does not have a terminal illness but who
1has a temporary condition that requires the care, if all of the following conditions
2apply:
SB436,123,43
a. The resident is otherwise appropriate for the level of care that is limited in
4a community-based residential facility under s. 50.01 (1g) (intro.).
SB436,123,65
b. The services necessary to treat the resident's condition are available in the
6community-based residential facility.
SB436,123,137
2. Subject to par. (b) and if a community-based residential facility has obtained
8a waiver from the department or has requested such a waiver from the department
9and the decision is pending, the community-based residential facility may provide
10more than 3 hours of nursing care per week or care above intermediate level nursing
11care for more than 30 days to a resident who does not have a terminal illness but who
12has a stable or long-term condition that requires the care, if all of the following
13conditions apply:
SB436,123,1514
a. The resident is otherwise appropriate for the level of care that is limited in
15a community-based residential facility under s. 50.01 (1g) (intro.).
SB436,123,1716
b. The services necessary to treat the resident's condition are available in the
17community-based residential facility.
SB436,123,2018
c. The community-based residential facility has obtained a waiver from the
19department under this subdivision or has requested such a waiver from the
20department and the decision is pending.
SB436,123,2321
3. A community-based residential facility may provide more than 3 hours of
22nursing care per week or care above intermediate level nursing care to a resident who
23has a terminal illness and requires the care, under the following conditions:
SB436,123,2524
a. If the resident's primary care provider is a licensed hospice or a licensed home
25health agency.
SB436,124,4
1b. If the resident's primary care provider is not a licensed hospice or a licensed
2home health agency, but the community-based residential facility has obtained a
3waiver of the requirement under subd. 3. a. from the department or has requested
4such a waiver and the department's decision is pending.
SB436,124,95
(b) A community-based residential facility may not have a total of more than
64 residents or 10% of the facility's licensed capacity, whichever is greater, who qualify
7for care under par. (a) 1. or 2. unless the facility has obtained a waiver from the
8department of the limitation of this paragraph or has requested such a waiver and
9the department's decision is pending.
SB436,124,1110
(c) The department may grant a waiver of the limitation under par. (a) 2. or 3.
11a. or (b).
SB436, s. 227
12Section
227. 50.065 (1) (am) of the statutes is created to read:
SB436,124,1413
50.065
(1) (am) "Certificate of approval" means a certificate of approval issued
14under s. 50.35.
SB436,124,1817
50.065
(1) (b) "Client" means a person who receives
direct care or treatment 18services from an entity.
SB436,124,2521
50.065
(1) (c) (intro.) "Entity" means a facility, organization or service that is
22regulated, licensed or certified by or registered with the department
to provide direct
23care or treatment services to clients. "Entity" includes
a hospital, a personal care
24worker agency and a supportive home care service agency. "Entity" does not include
25any of the following:
SB436,125,53
50.065
(1) (c) 3. A person certified as a medical assistance provider, as defined
4in s. 49.43 (10), who is not otherwise
regulated
approved under s. 50.065 (1) (cm),
5licensed or certified by or registered with the department.
SB436, s. 232
8Section
232. 50.065 (1) (c) 6. of the statutes is created to read:
SB436,125,99
50.065
(1) (c) 6. A public health dispensary established under s. 252.10.
SB436, s. 233
10Section
233. 50.065 (1) (cm) of the statutes is created to read:
SB436,125,1211
50.065
(1) (cm) "Hospital" means a facility approved as a hospital under s.
1250.35.
SB436,125,1915
50.065
(2) (a) (intro.) Notwithstanding s. 111.335, and except as provided in
16sub. (5), the department may not license
, certify, issue a certificate of approval to or
17register a person to operate an entity or continue the license
, certification, certificate
18of approval or registration of a person to operate an entity if the department knows
19or should have known any of the following:
SB436,125,2522
50.065
(2) (am) (intro.)
The Subject to subd. 5. and par. (bd), the department
23shall obtain all of the following with respect to a person specified under par. (a)
24(intro.)
and a person specified under par. (ag) (intro.) who is a nonclient resident or
25prospective nonclient resident of an entity:
SB436, s. 236
1Section
236. 50.065 (2) (am) 5. of the statutes is created to read:
SB436,126,122
50.065
(2) (am) 5. Information maintained by the department under this
3section regarding any denial to the person of a license, certification, certificate of
4approval or registration or of a continuation of a license, certification, certificate of
5approval or registration to operate an entity for a reason specified in par. (a) 1. to 5.
6and regarding any denial to the person of employment at, a contract with or
7permission to reside at an entity for a reason specified in par. (ag) 1. to 5. If the
8information obtained under this subdivision indicates that the person has been
9denied a license, certification, certificate of approval or registration, continuation of
10a license, certification, certificate of approval or registration, a contract, employment
11or permission to reside as described in this subdivision, the department need not
12obtain the information specified in subds. 1. to 4.
SB436,126,1815
50.065
(2) (b) 1. (intro.) Subject to subds.
1. e. and 2. and
3. par. (bd), every
16entity shall obtain all of the following with respect to a person specified under par.
17(ag) (intro.)
who is an employe or contractor or a prospective employe or contractor
18of the entity:
SB436, s. 238
19Section
238. 50.065 (2) (b) 1. e. of the statutes is created to read:
SB436,127,520
50.065
(2) (b) 1. e. Information maintained by the department under this
21section regarding any denial to the person of a license, certification, certificate of
22approval or registration or of a continuation of a license, certification, certificate of
23approval or registration to operate an entity for a reason specified in par. (a) 1. to 5.
24and regarding any denial to the person of employment at, a contract with or
25permission to reside at an entity for a reason specified in par. (ag) 1. to 5. If the
1information obtained under this subd. 1. e. indicates that the person has been denied
2a license, certification, certificate of approval or registration, continuation of a
3license, certification, certificate of approval or registration, a contract, employment
4or permission to reside as described in this subd. 1. e., the entity need not obtain the
5information specified in subd. 1. a. to d.
SB436,127,198
50.065
(2) (bd)
Subdivision 1. does not apply Notwithstanding pars. (am) and
9(b) 1., the department is not required to obtain the information specified in par. (am)
101. to 5., and an entity is not required to obtain the information specified in par. (b)
111. a. to e., with respect to a person under 18 years of age whose background
12information form under sub. (6) (am) indicates that the person is not ineligible to be
13employed, contracted with or permitted to reside at
the an entity for a reason
14specified in par. (ag) 1. to 5. and with respect to whom the
department or entity
15otherwise has no reason to believe that the person is ineligible to be employed,
16contracted with or permitted to reside at
the an entity for any of those reasons.
This
17paragraph does not preclude the department from obtaining, at its discretion, the
18information specified in par. (am) 1. to 5. with respect to a person described in this
19paragraph who is a nonclient resident or a prospective nonclient resident of an entity.
SB436,128,822
50.065
(2) (bg) If an entity takes an action specified in par. (ag) (intro.) with
23respect to
a person an employe, prospective employe, contractor or prospective
24contractor for whom, within the last 4 years, the information required under par. (b)
251. a. to c.
and e. has already been obtained, either by another entity or by a temporary
1employment agency, the entity may obtain the information required under par. (b)
21. a. to c.
and e. from that other entity or temporary employment agency, which shall
3provide the information, if possible, to the entity. If an entity cannot obtain the
4information required under par. (b) 1. a. to c.
and e. from another entity or from a
5temporary employment agency
or if an entity has reasonable grounds to believe that
6any information obtained from another entity or from a temporary employment
7agency is no longer accurate, the entity shall obtain that information from the
8sources specified in par. (b) 1. a. to c
and e.
SB436,128,2311
50.065
(2) (c) If the background information form completed by a person under
12sub. (6) (am) indicates that the person is not ineligible to be employed
, or contracted
13with
or permitted to reside at an entity for a reason specified in par. (ag) 1. to 5., an
14entity may employ or contract with the person
or permit the person to reside at the
15entity for not more than 60 days pending the receipt of the information sought under
16par. (b) 1.
If the background information form completed by a person under sub. (6)
17(am) indicates that the person is not ineligible to be permitted to reside at an entity
18for a reason specified in par. (ag) 1. to 5. and if an entity otherwise has no reason to
19believe that the person is ineligible to be permitted to reside at an entity for any of
20those reasons, the entity may permit the person to reside at the entity for not more
21than 60 days pending receipt of the information sought under par. (am). An entity
22shall provide supervision for a person who is employed or contracted with or
23permitted to reside as permitted under this paragraph.
SB436,129,5
150.065
(3) (a) Every 4 years or at any time within that period that the
2department considers appropriate, the department shall request the information
3specified in sub. (2) (am) 1. to 4. for all persons who are licensed to operate an entity
4and for all persons specified in par. (ag) (intro.) who are nonclient residents of an
5entity.
SB436,129,118
50.065
(3) (b) Every 4 years or at any other time within that period that an
9entity considers appropriate, the entity shall request the information specified in
10sub. (2) (b) 1. a. to d. for all persons specified in sub. (2) (ag) (intro.)
who are employes
11or contractors of the entity.
SB436,129,1814
50.065
(3m) Notwithstanding subs. (2) (b) 1. and (3) (b), if the department
15obtains the information required under sub. (2) (am) or (3) (a) with respect to a person
16specified in sub. (2) (a) (intro.) and that person is also an employe, contractor or
17nonclient resident of the entity, the entity is not required to obtain the information
18specified in sub. (2) (b) 1. or (3) (b) with respect to that person.
SB436,130,521
50.065
(5) (intro.) The department may license
, certify, issue a certificate of
22approval to or register to operate an entity a person who otherwise may not be
23licensed
, certified, issued a certificate of approval or registered for a reason specified
24in sub. (2) (a) 1. to 5., and an entity may employ, contract with or permit to reside at
25the entity a person who otherwise may not be employed, contracted with or permitted
1to reside at the entity for a reason specified in sub. (2) (ag) 1. to 5., if the person
2demonstrates to the department by clear and convincing evidence and in accordance
3with procedures established by the department by rule that he or she has been
4rehabilitated. No person who has been convicted of any of the following offenses may
5be permitted to demonstrate that he or she has been rehabilitated:
SB436, s. 246
6Section
246. 50.065 (5) (f) of the statutes is created to read:
SB436,130,87
50.065
(5) (f) An offense that is included in the list established by the
8department by rule promulgated under sub. (7) (am).
SB436,130,1811
50.065
(5m) Notwithstanding s. 111.335, the department may refuse to license
,
12certify or register, or issue a certificate of approval to, a person to operate an entity,
13and an entity may refuse to employ, contract with or permit to reside at the entity
14a person specified in sub. (2) (ag) (intro.), if the person has been convicted of an
15offense that the department has not defined as a "serious crime" by rule promulgated
16under sub. (7) (a), or specified in the list established by rule under sub. (7) (b), but
17that is, in the estimation of the department or entity, substantially related to the care
18of a client.
SB436,130,2421
50.065
(6) (a) The department shall require any person who applies for
22issuance or continuation of a license
, certification, certificate of approval or
23registration to operate an entity to complete a background information form that is
24provided by the department.
SB436,131,93
50.065
(6) (b) For persons specified under par. (a) who are
regulated, licensed
,
4issued a certificate of approval or certified by, or registered with, the department, for
5person specified in par. (am) 2., and for other persons specified by the department by
6rule, the entity shall send the background information form to the department. For
7all other persons specified in par. (a) and for persons specified under par. (am) 1., the
8entity shall maintain the background information form on file for inspection by the
9department.
SB436,131,2212
50.065
(7) (a) Establish by rule a definition of "serious crime" for the purpose
13of this section. The definition shall include only crimes or acts that are substantially
14related to the care of a client
, shall include those crimes or acts that are included in
15the list established under par. (am), shall include the offenses specified in sub. (5) (a)
16to (e) and shall include classes of crimes or acts involving abuse or neglect of a client
17for which
no a person who has committed any of those crimes or acts may be
18permitted to demonstrate under sub. (5) that he or she has been rehabilitated.
The
19definition may also include other crimes or acts that do not involve abuse or neglect
20of a client but that are substantially related to the care of a client for which no person
21who committed any of those crimes or acts may be permitted to demonstrate under
22sub. (5) that he or she has been rehabilitated.
SB436, s. 251
23Section
251. 50.065 (7) (am) of the statutes is created to read:
SB436,132,724
50.065
(7) (am) Establish by rule a list of crimes or acts, in addition to those
25offenses specified in sub. (5) (a) to (e), involving the abuse or neglect of a client for
1which no person who has committed any of those crimes or acts may be permitted to
2demonstrate under sub. (5) that he or she has been rehabilitated. The list may also
3include other crimes or acts, in addition to those offenses specified in sub. (5) (a) to
4(e), that do not involve the abuse or neglect of a client, but that are substantially
5related to the care of a client, for which no person who has committed any of those
6crimes or acts may be permitted to demonstrate under sub. (5) that he or she has been
7rehabilitated.
SB436, s. 252
8Section
252. 50.33 (1) of the statutes is renumbered 50.33 (1r).
SB436, s. 253
9Section
253. 50.33 (1g) of the statutes is created to read:
SB436,132,1210
50.33
(1g) "Critical access hospital" means a hospital that is designated by the
11department as meeting the requirements of
42 USC 1395i-4 (c) (2) (B) and is
12federally certified as meeting the requirements of
42 USC 1395i-4 (e).
SB436, s. 254
13Section
254. 50.33 (2) (c) of the statutes is amended to read:
SB436,132,1814
50.33
(2) (c) "Hospital" includes "special hospitals" or those hospital facilities
15providing primarily one that provide a limited type of medical or surgical care
such
16as, but not in limitation thereof,
including orthopedic hospitals, children's hospitals,
17critical access hospitals, mental hospitals, psychiatric hospitals or maternity
18hospitals.
SB436, s. 255
19Section
255. 50.35 of the statutes is amended to read:
SB436,133,8
2050.35 Application and approval. Application for approval to maintain a
21hospital shall be made to the department on forms provided by the department. On
22receipt of an application, the department shall
, except as provided in s. 50.498, issue
23a certificate of approval if the applicant and hospital facilities meet the requirements
24established by the department.
This Except as provided in s. 50.498, this approval
25shall be in effect until, for just cause and in the manner herein prescribed, it is
1suspended or revoked. The certificate of approval may be issued only for the
2premises and persons or governmental unit named in the application and is not
3transferable or assignable.
The Except as provided in s. 50.498, the department may
4not withhold, suspend or revoke approval unless for a substantial failure to comply
5with ss. 50.32 to 50.39 or the rules and standards adopted by the department after
6giving a reasonable notice, a fair hearing and a reasonable opportunity to comply.
7Failure by a hospital to comply with s. 50.36 (3m) shall be considered to be a
8substantial failure to comply under this section.
SB436,133,1611
50.49
(6) (a)
The Except as provided in s. 50.498, the department shall issue
12a home health agency license if the applicant is fit and qualified, and if the home
13health agency meets the requirements established by this section. The department,
14or its designated representatives, shall make such inspections and investigations as
15are necessary to determine the conditions existing in each case and file written
16reports. Each licensee shall annually file a report with the department.
SB436,133,2019
50.49
(6) (b) A home health agency license is valid until suspended or revoked
,
20except as provided in s. 50.498.