DHS 83.19(6)(6) Recognizing and responding to resident changes of condition. DHS 83.19 HistoryHistory: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09. DHS 83.20DHS 83.20 Department-approved training. DHS 83.20(1)(a)(a) Training for standard precautions, fire safety, first aid and choking, and medication administration and management shall be approved by the department or designee and shall be provided by trainers approved by the department or designee. Approvals for training plans and trainers for standard precautions, fire safety, first aid and choking, and medication administration and management issued before April 1, 2009, shall expire April 1, 2010. DHS 83.20(1)(b)(b) The CBRF shall maintain documentation of the training in par. (a), including the trainer approval number, the name of the employee, training topic and the date training was completed. DHS 83.20(2)(a)(a) Standard precautions. All employees who may be occupationally exposed to blood, body fluids or other moist body substances, including mucous membranes, non-intact skin, secretions, and excretions except sweat, whether or not they contain visible blood shall successfully complete training in standard precautions before the employee assumes any responsibilities that may expose the employee to such material. DHS 83.20(2)(b)(b) Fire safety. Within 90 days after starting employment, all employees shall successfully complete training in fire safety. DHS 83.20(2)(c)(c) First aid and choking. Within 90 days after starting employment, all employees shall successfully complete training in first aid and procedures to alleviate choking. DHS 83.20(2)(d)(d) Medication administration and management. Any employee who manages, administers or assists residents with prescribed or over-the-counter medications shall complete training in medication administration and management prior to assuming these job duties. DHS 83.20 HistoryHistory: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09. DHS 83.21DHS 83.21 All employee training. The CBRF shall provide, obtain or otherwise ensure adequate training for all employees in all of the following: DHS 83.21(1)(1) Resident rights. Training shall include general rights of residents including rights as specified under s. DHS 83.32 (3). Training shall be provided as applicable under ss. 50.09 and 51.61 and chs. 54, 55, and 304, Stats., and ch. DHS 94, depending on the legal status of the resident or service the resident is receiving. Specific training topics shall include house rules, coercion, retaliation, confidentiality, restraints, self-determination, and the CBRF’s complaint and grievance procedures. Residents’ rights training shall be completed within 90 days after starting employment. DHS 83.21(2)(a)(a) Training shall be specific to the client group served and shall include the physical, social and mental health needs of the client group. Specific training topics shall include, as applicable: characteristics of the client group served, activities, safety risks, environmental considerations, disease processes, communication skills, nutritional needs, and vocational abilities. Client group specific training shall be completed within 90 days after starting employment. DHS 83.21(2)(b)(b) In a CBRF serving more than one client group, employees shall receive training for each client group. DHS 83.21(3)(3) Recognizing, preventing, managing and responding to challenging behaviors. Specific training topics shall include, as applicable: elopement, aggressive behaviors, destruction of property, suicide prevention, self-injurious behavior, resident supervision, and changes in condition. Challenging behaviors training shall be completed within 90 days after starting employment. DHS 83.21 HistoryHistory: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; correction in (1) made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637. DHS 83.22DHS 83.22 Task specific training. The CBRF shall provide, obtain or otherwise ensure adequate training for employees performing job duties in all of the following: DHS 83.22(1)(1) Assessment of residents. All employees responsible for resident assessment shall successfully complete training in the assessment of residents prior to assuming these job duties. Specific training topics shall include: assessment methodology, assessment of changes in condition, sources of assessment information, and documentation of the assessment. DHS 83.22(2)(2) Individual service plan development. All employees responsible for service plan development shall successfully complete training in individual service plan development prior to assuming these job duties. Specific training topics shall include: identification of the resident’s needs and desired outcomes, development of goals and interventions, service plan evaluation and review of progress. DHS 83.22(3)(3) Provision of personal care. All employees responsible for providing assistance with activities of daily living shall successfully complete training prior to assuming these job duties. Specific training topics shall include, as appropriate: bathing, eating, dressing, oral hygiene, nail and foot care, toileting and incontinence care, positioning and body alignment, and mobility and transferring. DHS 83.22(4)(4) Dietary training. All employees performing dietary duties shall complete dietary training within 90 days after assuming these job duties. Specific training topics shall include: determining nutritional needs, menu planning, food preparation and food sanitation. DHS 83.22 HistoryHistory: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09. DHS 83.23DHS 83.23 Employee supervision. Until an employee has completed all required training, the employee shall be directly supervised by the administrator or by qualified resident care staff. DHS 83.23 HistoryHistory: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09. DHS 83.24(1)(1) Exemptions for completed training. Employees who have completed department-approved training in standard precautions, fire safety, first aid and choking, and medication administration and management prior to or on April 1, 2009, or who receive such training within one year after April 1, 2009, shall be exempt from the training specified under s. DHS 83.20 (2). DHS 83.24(3)(3) Exemptions from standard precautions training. Except as stated in subs. (1) and (2), the following individuals are exempt from training in standard precautions: DHS 83.24(3)(b)(b) Employees who can provide documentation that they have had training from a regulated health care entity in the practice of standard precautions within the previous year. DHS 83.24(3)(c)(c) A nurse aide certified after 1999 and in good standing on the Wisconsin Nurse Aide Registry. DHS 83.24(4)(4) Exemptions from fire safety training. Except as stated under sub. (1), firefighters are exempt from training in fire safety. DHS 83.24(5)(5) Exemptions from first aid and choking training. Except as stated in subs. (1) and (2), the following individuals are exempt from training in first aid and choking: DHS 83.24(5)(b)(b) Student nurses who have successfully completed related training. DHS 83.24(6)(6) Exemptions from medication administration and management training. Except as stated under subs. (1) and (2), the following individuals are exempt from medication administration and management training: DHS 83.24(6)(a)(a) Nurse aides who have completed a medication aide training program and are in good standing on the Wisconsin Nurse Aide Registry. DHS 83.24(6)(b)(b) Student nurses currently enrolled in a nursing program that has successfully completed a medication administration course. DHS 83.24(6)(c)(c) Other licensed health care persons whose licensure and scope of practice allows medication administration. DHS 83.24 NoteNote: See ch. DHS 129 for medication aide training standards. DHS 83.24(7)(7) Exemptions from client group training, resident rights training, and challenging behavior training. Except as specified under subs. (1) and (2), all of the following individuals are exempt from client group training, resident rights training and challenging behavior training: DHS 83.24(7)(c)(c) Employees with a degree in social work, psychology or a similar human services field. DHS 83.24(7)(d)(d) Student nurses who have successfully completed related courses. DHS 83.24(7)(e)(e) A nurse aide in good standing on the Wisconsin Nurse Aide Registry. DHS 83.24(8)(8) Exemption from provision of personal care training. A nurse aide in good standing on the Wisconsin Nurse Aide Registry is exempt from provision of personal care training. DHS 83.24(9)(9) Exemptions from assessment and individual service plan development training. Except under subs. (1) and (2), the following individuals are exempt from assessment and individual service plan development training: DHS 83.24(9)(c)(c) Employees with a degree in social work, psychology or a similar human services field. DHS 83.24(9)(d)(d) Student nurses who have successfully completed related courses. DHS 83.24(10)(10) Exemptions from dietary training. Except under subs. (1) and (2), the following individuals are exempt from training in determining dietary needs, menu planning, food preparation and sanitation: DHS 83.24(10)(c)(c) Employees who have completed an associate in applied science degree in culinary arts. DHS 83.24 HistoryHistory: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; correction in (7) (b), (9) (b) made under s. 13.92 (4) (b) 7., Stats., Register December 2011 No. 672; CR 23-046: am. (3) (a) Register April 2024 No. 820, eff. 5-1-24. DHS 83.25DHS 83.25 Continuing education. The administrator and resident care staff shall receive at least 15 hours per calendar year of continuing education beginning with the first full calendar year of employment. Continuing education shall be relevant to the job responsibilities and shall include, at a minimum, all of the following: DHS 83.25(5)(5) Prevention and reporting of abuse, neglect and misappropriation. DHS 83.25(6)(6) Fire safety and emergency procedures, including first aid. DHS 83.25 HistoryHistory: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09. DHS 83.26(1)(1) The CBRF shall maintain documentation of all employee training under s. DHS 83.21 and task specific training under s. DHS 83.22 and shall include the name of the employee, the name of the instructor, the dates of training, a description of the course content, and the length of the training. DHS 83.26(2)(2) Employee orientation and hours of continuing education shall be documented in the employee’s file. DHS 83.26 HistoryHistory: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09. DHS 83.27DHS 83.27 Limitations on admissions and retentions. DHS 83.27(1)(a)(a) No CBRF may have more residents, including respite care residents, than the maximum bed capacity on its license. DHS 83.27(1)(b)(b) The CBRF may not have more than 4 residents, or 10% of the licensed capacity, whichever is greater, who need more than 3 hours of nursing care per week or care above intermediate level nursing care for not more than 30 days unless the facility has obtained a waiver from the department or the department has received a request for a waiver from the CBRF and the department’s decision is pending. DHS 83.27(2)(2) Admission and retention limitations. A CBRF may not admit or retain any of the following persons: DHS 83.27(2)(a)(a) A person who has an ambulatory or cognitive status that is not compatible with the license classification under s. DHS 83.04 (2). DHS 83.27(2)(b)(b) A person who is destructive of property or self, or who is physically or mentally abusive to others, unless the CBRF has sufficient resources to care for such an individual and is able to protect the resident and others. DHS 83.27(2)(c)(c) A person who has physical, mental, psychiatric or social needs that are not compatible with the client group as described in the CBRF’s program statement. DHS 83.27(2)(d)(d) A person who needs more than 3 hours of nursing care per week except for a temporary condition needing more than 3 hours of nursing care per week for no more than 30 days. If the CBRF requests a waiver or variance, the department may grant a waiver or variance to this requirement, as described under s. DHS 83.03, if the following conditions are met: DHS 83.27(2)(d)1.1. The resident’s clinical condition is stable and predictable, does not change rapidly, and medical orders are unlikely to involve frequent changes or complex modifications and the resident’s clinical condition is one that may be treatable, or the resident has a long-term condition needing more than 3 hours of nursing care per week for more than 30 days. DHS 83.27(2)(d)2.2. The resident is otherwise appropriate for the level of care provided in the CBRF. DHS 83.27(2)(d)3.3. The services needed to treat the resident’s condition are available in the CBRF. DHS 83.27(2)(e)(e) A person whose condition requires 24-hour supervision by a registered nurse or licensed practical nurse.
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Chs. DHS 30-100; Community Services
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