DHS 127.03(5)(a)1.1. If the department approves an application following its review under
sub. (4), the department shall issue either a provisional license under
par. (c) or a regular license within the time period for the applicable type of review under
sub. (4) (b), provided that the applicant pays the license fee under
sub. (3).
DHS 127.03(5)(a)2.
2. The license shall bear the name and address of the rural medical center and the name and address of the applicant and identify the types of health care services that the center is licensed to provide.
DHS 127.03(5)(a)3.
3. The license shall state any applicable conditions and restrictions, including maximum bed capacity and the level of care that may be provided, and any other limitations that the department finds necessary and appropriate.
DHS 127.03(5)(a)4.
4. A license shall be issued exclusively for the rural medical center applicant named in the application and may not be transferred or assigned. A licensee shall fully comply with all requirements and restrictions of the license. When there is a change in the ownership of the rural medical center, the new operator shall submit a new application to the department.
DHS 127.03(5)(a)5.
5. Rural medical center licensees shall surrender to the department all single-service licenses or other approvals held for the types of health care services identified in the rural medical center license.
DHS 127.03(5)(b)
(b)
Regular license. A regular license is valid until it is suspended or revoked.
DHS 127.03(5)(c)1.1. If an approved applicant is not currently licensed by the department or certified by the federal government to provide one or more of the health care services that the applicant seeks to provide as a rural medical center, the department shall issue the applicant a provisional license.
DHS 127.03(5)(c)3.
3. A rural medical center with a provisional license shall submit an application for a regular license to the department so that it is received by the department at least 45 calendar days before expiration of the provisional license. If an application for a regular license is not received by that date, the provisional license shall lapse as of the date of its expiration. If the department does not make a favorable determination under
sub. (4) on the application for a regular license, the department may not issue a regular license. Expiration of a rural medical center's provisional license does not affect other licenses, approvals or certifications maintained by the entity.
DHS 127.03(6)(a)1.1. The licensee shall notify the department in writing of any changes that affect the continuing accuracy and completeness of the information required under
sub. (2) (a). If the rural medical center provides nursing home services, any change in ownership shall be reported to the department in writing at least 30 calendar days prior to the change.
DHS 127.03(6)(a)2.
2. The licensee shall notify the department in writing of any changes in the administrator of the nursing home service within 2 business days of the change.
DHS 127.03(6)(a)3.
3. The licensee shall notify the department in writing of any changes in the director of nursing of the nursing home service within 2 business days of the change.
DHS 127.03(6)(b)
(b)
Changes requiring new application. An application for a new license shall be submitted to the department within 30 calendar days after any of the following:
DHS 127.03(6)(b)1.
1. The licensee transfers title of the rural medical center, regardless of whether the transfer includes title to the real estate.
DHS 127.03(6)(b)2.
2. In a partnership, the removal, addition or substitution of an individual as a partner or the dissolving of an existing partnership and the creation of a new partnership.
DHS 127.03(6)(b)3.
3. The operator has relinquished management of the rural medical center.
DHS 127.03(7)(a)1.1. `Denial.' The department shall deny an application for an initial rural medical center license or for modification of a license to provide an additional health care service to any applicant not receiving a favorable license application determination under
sub. (4) or failing to pay the license fee under
sub. (3). The department shall provide written notice to the applicant within 45 calendar days after receipt of the complete application. If the department denies an application for a license or for authorization to provide a specific type of health care service for the sole reason that the applicant has an outstanding adverse action and the cause of the adverse action is subsequently corrected, the department shall issue the license within 30 calendar days after receiving notice from the applicant that the cause of the adverse action has been corrected, provided that the application is otherwise complete and the applicant pays the license fee under
sub. (3).
DHS 127.03(7)(a)2.a.a. Non-emergency. The department, after providing written notice to the licensee, may suspend or revoke a rural medical center license or authorization to provide a specific type of health care service if the department determines that the rural medical center has substantially failed to comply with the requirements of ss.
50.50 to
50.56, Stats., or this chapter. Except as provided in
subd. 2. b., the department shall provide written notice to the licensee of the suspension or revocation at least 30 days before the suspension or revocation is to take effect.
DHS 127.03(7)(a)2.b.
b. Emergency. The department may, in the event of an emergency condition that imminently threatens the health, safety or welfare of rural medical center patients or residents, order summary suspension of new admissions to all or part of the rural medical center or order summary suspension of the rural medical center's authorization to provide a specific type of health care service until such time as the department decides that the rural medical center has removed or corrected the causes or violations creating the emergency.
DHS 127.03(7)(b)
(b)
Contents of notice. In a notice of denial, suspension or revocation under
par. (a), the department shall state the reasons for its action and specify the statute or rule and facts that constitute any violation or noncompliance. The notice shall identify the process under
par. (g) for an appeal of the denial, suspension or revocation.
DHS 127.03(7)(c)
(c)
Return receipt. If the department receives a return receipt for the notice sent under
par. (a), the return receipt is conclusive evidence that the addressee received the notice. If the department does not receive a return receipt for the notice sent under
par. (a), the addressee shall be presumed to have received the notice on the fifth calendar day after the date the notice was mailed.
DHS 127.03(7)(d)1.1. Subject to s.
227.51, Stats., a denial, suspension or revocation is effective on the date set by the department in the notice of denial, suspension or revocation, on the date of expiration of an existing license, except that:
DHS 127.03(7)(d)1.a.
a. In the event of a contested case hearing pursuant to s.
227.42, Stats., the effective date is the date of final action.
DHS 127.03(7)(d)1.b.
b. In the event of judicial review pursuant to s.
227.52, Stats., or a stay granted under s.
227.54, Stats., the effective date is the date of final action.
DHS 127.03(7)(d)2.
2. The department may delay the effective date of license revocation in order to permit orderly removal and relocation of patients or residents served by the rural medical center.
DHS 127.03(7)(f)
(f)
Effect on other licenses, approvals, certifications or health care services. The department's denial, suspension or revocation of an application, license or authorization to provide a specific type of health care service shall have no bearing on any other license, approval or certification of health care services maintained in good standing as specified under
sub. (4) (d) 6., unless the applicant ceases to qualify as a rural medical center.
DHS 127.03(7)(g)
(g)
Appeal of denial, suspension or revocation. An applicant or licensee may request a hearing under
ch. 227, Stats., to appeal the department's decision to deny, suspend or revoke the application or license. The request for hearing shall be in writing and filed in the department of administration's division of hearings and appeals within 10 working days after receipt of the notice of denial under
par. (a) 1. or of suspension or revocation under
par. (a) 2. A request for a hearing is considered filed on the date of its receipt by the division of hearings and appeals. Review of the department's decision by that office is not available if the request for a hearing is received more than 10 working days after the date that the applicant or licensee receives the notice of denial, suspension or revocation of the license.
DHS 127.03 Note
Note:
A hearing request should be sent or may be delivered to the Department of Administration's Division of Hearings and Appeals, 5005 University Avenue, Suite 201, Madison, Wisconsin, 53705-5400.
DHS 127.03 History
History: Cr.
Register, February, 1999, No. 518, eff. 3-1-99; corrections in (2) (a), (3) (a), (4) (d) 5. and 6. made under s.
13.92 (4) (b) 7., Stats.,
Register January 2009 No. 637; correction in (3) (a) 4. made under s.
13.92 (4) (b) 7., Stats.,
Register December 2010 No. 660; correction in (3) (a) 4. made under s.
13.92 (4) (b) 7., Stats.,
Register January 2011 No. 661.
DHS 127.04
DHS 127.04 Compliance with laws. All rural medical centers shall operate and provide health care services in compliance with all applicable federal, state and local government statutes, regulations, rules and ordinances and accepted standards and principles that apply to professionals providing health care services for the center.
DHS 127.04 History
History: Cr.
Register, February, 1999, No. 518, eff. 3-1-99.
DHS 127.05
DHS 127.05 Inspections and investigations. DHS 127.05(1)
(1) The department may conduct an unannounced inspection of a rural medical center facility as often as required by the federal government or as the department deems necessary. The department may investigate complaints it receives concerning the operation of a rural medical center.
DHS 127.05(2)(a)(a) A rural medical center surveyed or investigated under this section shall provide the department with access to patient or resident health care records, regardless of the source of patient or resident health care payment, as well as clinical, financial and administrative records, throughout the duration of any survey, inspection or investigation that the department conducts.
DHS 127.05(2)(b)
(b) A rural medical center shall release patient or resident health care records without the informed consent of the patient or resident in response to a request by any federal or state governmental agency to perform a legally authorized function, including but not limited to management audits, financial audits, program monitoring and evaluation or facility licensure or certification.
DHS 127.05(3)
(3) A survey or investigation by the department may include visits with patients or residents with the prior consent of the patients or residents. Upon the department's request, a rural medical center shall provide the department a list of names, addresses and other identifying information of current and past patients or residents. The department may select the names of the patients or residents to be visited and may visit those patients or residents with their prior consent.
DHS 127.05(4)
(4) If a rural medical center interferes with or refuses to allow any survey, inspection or investigation under this section or
s. DHS 127.06, the department may suspend or revoke the rural medical center's license.
DHS 127.05 History
History: Cr.
Register, February, 1999, No. 518, eff. 3-1-99.
DHS 127.06
DHS 127.06 Consolidated survey requirement. DHS 127.06(1)(1) Any survey by the department of a rural medical center shall be comprehensive and consolidated with all health care services listed on the license. In conducting a survey, the department shall select a sample of patients or residents served by the center to facilitate an outcome-based, program-wide consolidated survey.
DHS 127.06(2)
(2) The department shall afford opportunities for representatives of the rural medical center to consult with department staff concerning compliance, noncompliance and findings throughout the duration of a survey.
DHS 127.06 History
History: Cr.
Register, February, 1999, No. 518, eff. 3-1-99.
DHS 127.07(1)
(1)
Notice of violation. Upon determining that a rural medical center is in violation of a requirement of this chapter, including any requirement under
ss. DHS 127.16 to
127.24, the department shall promptly send a notice of violation to the chief executive officer, director, administrator or other designated agent of the rural medical center. The notice shall specify the rule violated and state the facts that constitute the violation. If the department receives a return receipt for the notice, the return receipt is conclusive evidence that the addressee received the notice. If the department does not receive a return receipt for the notice, the addressee shall be presumed to have received the notice on the fifth calendar day after the date the notice was mailed.
DHS 127.07(2)
(2) Plan of correction. Within 10 calendar days of receipt of a notice of violation under
sub. (1), the rural medical center shall submit a plan of correction to the department, detailing how the center plans to correct the violation or how the center has already corrected the violation. If the rural medical center fails to submit an acceptable plan of correction, the department may impose a plan with which the center shall comply. The department shall verify that the rural medical center has completed or complied with the plan of correction.
DHS 127.07(3)
(3) Prohibitions. No person may do any of the following:
DHS 127.07(3)(a)
(a) Intentionally prevent, interfere with or impede in any way the work of any duly authorized representative of the department in making investigations under this chapter or in enforcing this chapter.
DHS 127.07(3)(b)
(b) Intentionally retaliate or discriminate against any patient, resident or employee of a rural medical center for contacting or providing information to any state agency, as defined by s.
16.004 (12) (a), Stats., or for initiating, participating in or testifying in an action to enforce any provision of this chapter.
DHS 127.07(3)(c)
(c) Intentionally destroy, change or modify the original report of an inspection that the department conducts under this chapter.
DHS 127.07(3)(d)
(d) Fail to correct, or attempt to interfere with the correction of, a violation within the maximum time for correction specified in a notice of violation or plan of correction, unless the department grants an extension and the rural medical center corrects the violation before expiration of the extension.
DHS 127.07(3)(e)
(e) Prevent or attempt to prevent any duly authorized representative of the department from examining any relevant accounts, books or records of the center in the conduct of official duties under this chapter.
DHS 127.07(3)(f)
(f) Prevent or attempt to prevent any duly authorized representative of the department from preserving evidence of any violation of any provision of this chapter.
DHS 127.07(4)
(4) Penalties. As provided by s.
50.55 (2), Stats., whoever violates
sub. (3) (a),
(b), or
(c) may be imprisoned for up to 6 months or fined not more than $1,000, or both, for each violation.
DHS 127.07(5)
(5) Forfeitures. The department may assess forfeitures in the manner prescribed by s.
50.55, Stats., against any person who violates any provision of this chapter except
sub. (3) (a),
(b), or
(c).
DHS 127.07(6)
(6) Appeal. Except as provided by s.
50.55 (1), Stats., a rural medical center that chooses to contest any department assessment under
sub. (5) may request a hearing by sending, within 10 calendar days after receipt of a notice of assessment, a written request for hearing under
ch. 227, Stats., to the department of administration's division of hearings and appeals.
DHS 127.07 Note
Note:
A hearing request should be sent or may be delivered to the Department of Administration's Division of Hearings and Appeals, 5005 University Avenue, Suite 201, Madison, Wisconsin, 53705-5400.
DHS 127.07 History
History: Cr.,
Register, February, 1999, No. 518, eff. 3-1-99; correction in (1) made under s.
13.92 (4) (b) 7., Stats.,
Register January 2009 No. 637.
DHS 127.08(1)(a)
(a) “Variance" means the granting by the department of an alternative requirement in place of a nonstatutory requirement of this chapter.
DHS 127.08(1)(b)
(b) “Waiver" means the granting by the department of an exception from a nonstatutory requirement of this chapter.
DHS 127.08(2)
(2) Requirements for waivers and variances. The department may grant a waiver or variance if the department finds that:
DHS 127.08(2)(a)
(a) The waiver or variance will not adversely affect the health, safety or welfare of any rural medical center patient or resident.
DHS 127.08(2)(b)
(b) The requirement from which the rural medical center seeks relief would result in unreasonable hardship or is infeasible as applied to the rural medical center or a patient or resident of the rural medical center.
DHS 127.08(2)(c)
(c) If the request is for a variance, the proposed condition, method, procedure, practice, technique, equipment, personnel qualification, pilot project or other alternative is in the interests of the management of patient or resident care.
DHS 127.08(3)(a)1.1. A request for a waiver or variance shall be made in writing to the department and shall include all of the following:
DHS 127.08(3)(a)1.c.
c. The reason or reasons for the request. The center shall provide an explanation of why the requirement from which the center seeks relief results in unreasonable hardship or is infeasible as applied to the rural medical center or a patient or resident of the rural medical center.
DHS 127.08(3)(a)1.d.
d. If the request is for a variance, the rural medical center's proposal of the alternative condition, method, procedure, practice, technique, equipment, personnel qualification, pilot project or other alternative is in the interests of the management of patient or resident care and is as protective as the requirement from which the waiver or variance is being sought.
DHS 127.08(3)(a)3.
3. The department may require additional information from the rural medical center before acting on the request.
DHS 127.08 Note
Note:
A request for a waiver or variance should be addressed to the Division of Quality Assurance, P.O. Box 2969, Madison, Wisconsin 53701-2969.
DHS 127.08(3)(b)1.1. The department shall grant or deny in writing each request for a waiver or variance. A notice of denial shall state the department's findings and reasons for denial and shall indicate that the rural medical center may request a hearing under
par. (c). Except when additional information is requested under
par. (a) 3., if a notice of denial is not issued within 60 calendar days after the receipt of a complete request, the waiver or variance shall be automatically approved.
DHS 127.08(3)(b)3.
3. The department may impose conditions on a waiver or variance if the department finds that the conditions are necessary to protect the health, safety or welfare of rural medical center patients or residents.
DHS 127.08(3)(b)4.
4. The terms of a waiver or variance may be modified only upon written agreement between the department and the rural medical center.
