AB1146: Bill Text

AB1146,7,7 49.45 (6m) (m) By January 1, 2006, 2007, 2008, and 2009, the department shall submit a report to the chief clerk of each house of the legislature, for distribution to the legislature under s. 13.172 (2), that shall include all of the following:

AB1146,7,8 1. For the preceding calendar year for each facility:

AB1146,7,10 a. The staff turnover rate for registered nurses, licensed practical nurses, and nurse's assistants employed by the facility.

AB1146,7,16 b. The average hourly wage and fringe benefit costs, including specific unemployment compensation and worker's compensation costs, for registered nurses, licensed practical nurses, nurse's assistants, dietary staff, housekeeping staff, and laundry staff employed by the facility and the average hourly cost for nonemployee purchased services, if any, of registered nurses, licensed practical nurses, and nurse's assistants.

AB1146,7,20 c. Total revenues and expenses, total net income after taxes, expenses for each of the facility's cost centers under par. (am), the medical assistance reimbursement rate and method of calculation, the number of patient beds, and the number of patient days.

AB1146,7,22 d. Total cost of recruiting, screening, educating, and training the nursing staff of the facility.

AB1146,8,2 e. Any correlation that may be shown between the number of notices of violations for class "A," "B," or "C" violations a facility received under s. 50.04, if any, and the frequency with which the facility used nonemployee purchased services of registered nurses, licensed practical nurses, or nurse's assistants.

AB1146,8,5 2. Recommendations of the department for incentives for facilities to reduce reliance on nonemployee purchased services of registered nurses, licensed practical nurses, or nurse's assistants.

AB1146, s. 13 Section 13. 50.02 (2) (bn) of the statutes is amended to read:

AB1146,8,9 50.02 (2) (bn) The department may, by rule, increase the minimum hours of nursing home care per day staffing standards that are specified in s. 50.04 (2) (d) 1. to 3. (e).

AB1146, s. 14 Section 14. 50.034 (3) (e) of the statutes is created to read:

AB1146,8,14 50.034 (3) (e) Post in a conspicuous location in the residential care apartment complex a notice, provided by the board on aging and long-term care, of the name, address, and telephone number of the Long-Term Care Ombudsman Program under s. 16.009 (2) (b).

AB1146, s. 15 Section 15. 50.034 (9) of the statutes is created to read:

AB1146,8,17 50.034 (9) Assessment on occupied apartments. (a) In this subsection, "complex" means a certified or registered residential care apartment complex.

AB1146,8,20 (b) For the privilege of doing business in this state, there is imposed on all occupied apartments of a complex an annual assessment that shall be credited to the appropriation account under s. 20.432 (1) (gt) and that is $12 per apartment.

AB1146,9,2 (c) By July 1 annually, a complex shall submit to the department the amount due under par. (b) for each occupied apartment of the complex for the preceding June. The department shall verify the number of apartments of a complex and, if necessary, make adjustments to the payment, notify the complex of changes in the payment owing, and send the complex an invoice for the additional amount due or send the complex a refund.

AB1146,9,5 (d) Sections 77.59 (1) to (5), (6) (intro.), (a), and (c), and (7) to (10), 77.60 (1) to (7), (9), and (10), 77.61 (9) and (12) to (14), and 77.62, as they apply to the taxes under subch. III of ch. 77, apply to the assessment under this subsection.

AB1146,9,8 (e) 1. The department shall enforce and collect the assessment under this subsection and shall develop and distribute forms necessary for levying and collection.

AB1146,9,10 2. The department shall promulgate rules that establish procedures and requirements for levying the assessment under this subsection.

AB1146,9,13 (f) 1. An affected complex may contest an action by the department under this subsection by submitting a written request for a hearing to the department within 30 days after the date of the department's action.

AB1146,9,15 2. An order or determination made by the department under a hearing as specified in subd. 1. is subject to judicial review as prescribed under ch. 227.

AB1146, s. 16 Section 16. 50.04 (2) (d) of the statutes is repealed.

AB1146, s. 17 Section 17. 50.04 (2) (e) of the statutes is created to read:

AB1146,9,18 50.04 (2) (e) 1. In this paragraph:

AB1146,9,20 a. "Afternoon work shift" means the 8-hour work shift that begins immediately after the morning shift.

AB1146,9,22 b. "Certified nurse's assistant" means a nurse's assistant who meets the requirements specified under 42 USC 1296r (b) (5) (A) to (E).

AB1146,9,24 c. "Evening work shift" means the 8-hour work shift that begins immediately after the afternoon work shift.

AB1146,10,2 d. "Morning work shift" means the first 8-hour work shift that begins after midnight.

AB1146,10,11 2. The department shall promulgate rules that specify minimum staffing standards that are based on ratios between the number of registered nurses on duty in a nursing home per morning work shift, afternoon work shift, or evening work shift and the number of residents of the nursing home, between the number of licensed practical nurses on duty in a nursing home per morning work shift, afternoon work shift, or evening work shift and the number of residents of the nursing home, and between the number of certified nurse's assistants on duty in a nursing home per morning work shift, afternoon work shift, or evening work shift and the number of residents of the nursing home.

AB1146,10,15 3. By July 1, 2007, the department shall convert the minimum staffing requirements specified in s. 50.04 (2) (d), 2005 stats., to the minimum staffing standards specified in subd. 2., shall provide training to staff on enforcement of the standards, and shall assist nursing homes in implementing the standards.

AB1146,10,19 4. By July 1, 2007, a nursing home, other than a nursing home that primarily serves the developmentally disabled, shall have on duty the number of registered nurses, licensed practical nurses, and certified nurse's assistants necessary to satisfy the minimum staffing standards developed by the department under subd. 2.

AB1146,11,2 5. A registered nurse, licensed practical nurse, or certified nurse's assistant who while on duty provides primarily support services, including food preparation, housekeeping, laundry, or maintenance services, may not be counted for purposes of calculating the minimum staffing ratios under subd. 2. A registered nurse who is employed as a director of nursing, as an assistant director of nursing, or as the charge nurse required under par. (b), may not be counted for purposes of calculating the minimum staffing requirements under subd. 2. while he or she is performing the duties of a director of nursing, assistant director of nursing, or charge nurse.

AB1146,11,11 6. By January 1, 2009, after first referring to the most recent national research on nursing home staffing and consulting with representatives of the nursing home industry, labor unions that represent nursing home employees, advocates for elderly and disabled persons, recognized experts with experience in long-term care reimbursement, economists, the attorney general, the federal centers for medicare and medicaid services, and other interested parties, the department shall submit a report to the governor, and to the chief clerk of each house of the legislature for distribution to the legislature under s. 13.172 (2). The report shall contain all of the following recommendations:

AB1146,11,13 a. Proposed methods by which nursing homes are able more effectively to recruit and retain caregivers.

AB1146,11,17 b. Proposed revised minimum nursing home staffing ratios that minimize additional state costs, maximize access to care, facilitate care of the highest quality, and take into account the levels of care for physical or mental conditions that nursing home residents require.

AB1146,11,22 c. A proposed revised nursing home medical assistance reimbursement methodology that more effectively promotes resident care of high quality, advances wages and benefits for nursing home workers, supports nursing home provider compliance with applicable state statutes and rules and federal statutes and regulations, and encourages administrative efficiency.

AB1146, s. 18 Section 18. 50.065 (2) (am) 2g. of the statutes is created to read:

AB1146,11,25 50.065 (2) (am) 2g. Information maintained by the department of corrections in the registry of sex offenders under s. 301.45 (2).

AB1146, s. 19 Section 19. 50.065 (2) (am) 2r. of the statutes is created to read:

AB1146,12,4 50.065 (2) (am) 2r. Information on persons convicted of crimes as specified under the circuit court automation information system maintained by the Wisconsin court system on its Internet site.

AB1146, s. 20 Section 20. 50.065 (2) (b) 1g. of the statutes is created to read:

AB1146,12,7 50.065 (2) (b) 1g. Information maintained by the department of corrections in the registry of sex offenders under s. 301.45 (2).

AB1146, s. 21 Section 21. 50.065 (2) (b) 2r. of the statutes is created to read:

AB1146,12,11 50.065 (2) (b) 2r. Information on persons convicted of crimes as specified under the circuit court automation information system maintained by the Wisconsin court system on its Internet site.

AB1146, s. 22 Section 22. 50.09 (title) of the statutes is amended to read:

AB1146,12,13 50.09 (title) Rights of residents in certain facilities and complexes.

AB1146, s. 23 Section 23. 50.09 (1) of the statutes is renumbered 50.09 (1m), and 50.09 (1m) (intro.), (b), (c), (e), (f) 1. and 3., (g), (j) (intro.) and 2. (intro.) and a. and (L), as renumbered, are amended to read:

AB1146,12,19 50.09 (1m) Residents' rights. (intro.) Every resident in a nursing home or community-based residential facility or a complex shall, except as provided in sub. (5), have the right to:

AB1146,12,24 (b) Present grievances on the resident's own behalf or others to the facility's staff or administrator of the facility or complex, to public officials or to any other person without justifiable fear of reprisal, and to join with other residents or individuals within or outside of the facility or complex to work for improvements in resident care.

AB1146,13,8 (c) Manage the resident's own financial affairs, including any personal allowances under federal or state programs, unless the resident delegates, in writing, such this responsibility to the facility or complex and the facility or complex accepts the responsibility, or unless the resident delegates to someone else of the resident's choosing and that person accepts the responsibility. The resident shall receive, upon written request by the resident or guardian, a written monthly account of any financial transactions made by the facility or complex under such a delegation of responsibility.

AB1146,13,12 (e) Be treated with courtesy, respect and full recognition of the resident's dignity and individuality, by all employees of the facility or complex and licensed, certified, or registered providers of health care and pharmacists with whom the resident comes in contact.

AB1146,13,16 (f) 1. Privacy for visits by spouse. If both spouses are residents of the same facility or complex, they shall be permitted to share a room or apartment unless medically contraindicated as documented by the resident's physician in the resident's medical record.

AB1146,13,20 3. Confidentiality of health and personal records, and the right to approve or refuse their release to any individual outside the facility or complex, except in the case of the resident's transfer to another facility or complex or as required by law or 3rd-party payment contracts and except as provided in s. 146.82 (2) and (3).

AB1146,13,22 (g) Not to be required to perform services for the facility or complex that are not included for therapeutic purposes in the resident's plan of care.

AB1146,14,5 (j) (intro.) Be transferred or discharged, and be given reasonable advance notice of any planned transfer or discharge, and an explanation of the need for and alternatives to the transfer or discharge. The facility or complex to which the resident is to be transferred must have accepted the resident for transfer, except in a medical emergency or if the transfer or discharge is for nonpayment of charges following a reasonable opportunity to pay a deficiency. No person may be involuntarily discharged for nonpayment under this paragraph if the person meets all of the following conditions:

AB1146,14,8 2. (intro.) The funding of his or her care in the nursing home or community-based residential facility under s. 49.45 (6m) is reduced or terminated because of one of the following:

AB1146,14,10 a. He or she requires a level or type of care which that is not provided by the nursing home or community-based residential facility.

AB1146,14,12 (L) Receive adequate and appropriate care within the capacity of the facility or complex.

AB1146, s. 24 Section 24. 50.09 (1g) of the statutes is created to read:

AB1146,14,15 50.09 (1g) In this section, "complex" means a residential care apartment complex.

AB1146, s. 25 Section 25. 50.09 (2), (4) and (5) of the statutes are amended to read:

AB1146,14,20 50.09 (2) The department, in establishing standards for nursing homes and community-based residential facilities and complexes may establish, by rule, rights in addition to those specified in sub. (1) (1m) for residents in such the facilities or complexes.

AB1146,15,4 (4) Each facility or complex shall make available a copy of the rights and responsibilities established under this section and the facility's rules of the facility or complex to each resident and each resident's legal representative, if any, at or prior to the time of admission to the facility or complex, to each person who is a resident of the facility or complex, and to each member of the facility's staff of the facility or complex. The rights, responsibilities, and rules shall be posted in a prominent place in each facility or complex. Each facility or complex shall prepare a written plan and provide appropriate staff training to implement each resident's rights established under this section.

AB1146,15,8 (5) Rights established under this section shall not, except as determined by the department of corrections, be applicable to residents in such facilities or complexes, if the resident is in the legal custody of the department of corrections and is a correctional client in such a facility or complex.

AB1146, s. 26 Section 26. 50.09 (6) (a), (b) and (d) of the statutes are amended to read:

AB1146,15,13 50.09 (6) (a) Each facility or complex shall establish a system of reviewing complaints and allegations of violations of residents' rights established under this section. The facility or complex shall designate a specific individual who, for the purposes of effectuating this section, shall report to the administrator.

AB1146,15,21 (b) Allegations of violations of such rights by persons licensed, certified, or registered under chs. 441, 446 to 450, 455, and 456 shall be promptly reported by the facility or complex to the appropriate licensing, examining, or affiliated credentialing board and to the person against whom the allegation has been made. Any employee of the facility or complex and any person licensed, certified, or registered under chs. 441, 446 to 450, 455, and 456 may also report such allegations to the board. Such The board may make further investigation and take such disciplinary action, within the board's statutory authority, as the case requires.

AB1146,16,2 (d) The facility or complex shall attach a statement, which summarizes complaints or allegations of violations of rights established under this section, to the report required under s. 50.03 (4) (c) 1. or 2. The statement shall contain the date of the complaint or allegation, the name of the persons involved, the disposition of the matter, and the date of disposition. The department shall consider the statement in reviewing the report.

AB1146, s. 9102 Section 9102. Nonstatutory provisions; aging and long-term care board.

AB1146,16,8 (1) Residential care apartment complex activities. The authorized FTE positions for the board on aging and long-term care are increased by 1.0 PR position on July 1, 2006, to be funded from the appropriation account under section 20.432 (1) (gt) of the statutes, as created by this act, for the purpose of performing long-term care ombudsman activities in residential care apartment complexes.

AB1146, s. 9121 Section 9121. Nonstatutory provisions; health and family services.

AB1146,16,14 (1) Nursing home staffing standards; rules. The department of health and family services shall submit in proposed form the rules required under section 50.02 (2) (e) of the statutes, as created by this act, to the legislative council staff under section 227.15 (1) of the statutes no later than the first day of the 13th month beginning after the effective date of this subsection.

AB1146,16,19 (2) Nursing home staffing standards; report. By January 1, 2007, the department of health and family services shall report to the legislature in the manner provided under section 13.172 (3) of the statutes and to the governor concerning the status of the department's compliance with the requirements of section 50.04 (2) (e) 3. of the statutes, as created by this act.

AB1146,16,20 (3) Assessments on residential care apartment complexes; rules.

AB1146,17,2 (a) The department of health and family services shall submit in proposed form the rules required under section 50.034 (9) (e) 2. of the statutes, as created by this act, to the legislative council staff under section 227.15 (1) of the statutes no later than the first day of the 4th month beginning after the effective date of this paragraph.

AB1146,17,12 (b) Using the procedure under section 227.24 of the statutes, the department of health and family services may promulgate rules required under section 50.034 (9) (e) 2. of the statutes, as created by this act, for the period before the effective date of the rules submitted under paragraph (a ), but not to exceed the period authorized under section 227.24 (1) (c) and (2) of the statutes. Notwithstanding section 227.24 (1) (a), (2) (b), and (3) of the statutes, the department is not required to provide evidence that promulgating a rule under this paragraph as an emergency rule is necessary for the preservation of the public peace, health, safety, or welfare and is not required to provide a finding of emergency for a rule promulgated under this paragraph.

AB1146,17,23 (4) Proposal for nursing home quality improvement grant program. By the first day of the 7th month beginning after the effective date of this subsection, the department of health and family services shall submit to the legislature in the manner provided under section 13.172 (2) of the statutes a proposal for legislation to create a program to provide grants to nursing homes for quality-of-care improvement projects. In creating the proposal, the department of health and family services shall consult with advocates for residents of nursing homes, employees of or contractors for services with nursing homes or representatives of the employees or contractors, nursing home administrators, and experts in long-term care issues. Funding for the proposal required under this subsection must be generated within the nursing home industry and may not include general purpose revenues.

AB1146, s. 9321 Section 9321. Initial applicability; health and family services.

AB1146,18,3 (1) Assessments on residential care apartment complexes. The treatment of section 50.034 (9) of the statutes first applies to an assessment due from a residential care apartment complex for June 2006.

AB1146, s. 9421 Section 9421. Effective dates; health and family services. This act takes effect on the day after publication, except as follows:

AB1146,18,7 (1) Nursing home staffing standards. The treatment of sections 50.02 (2) (bn) and 50.04 (2) (d) of the statutes takes effect on July 1, 2007.

AB1146,18,10 (2) Residential care apartment complexes. The treatment of sections 16.009 (1) (em) 7., 20.432 (1) (gt), 50.034 (3) (e) and (9), 50.09 (title), 50.09 (1), (1g), (2), (4), (5), and (6) (a), (b), and (d) of the statutes takes effect on June 1, 2006.

AB1146,18,11 (End)