Disclosure of any financial failures directly or indirectly involving any person or business entity identified in the application concerning the operation of a residential or health care facility that resulted in any debt consolidation or restructuring, insolvency proceeding or mortgage foreclosure, or in the closing of a residential or health care facility or the moving of its residents. In this subdivision “insolvency" means bankruptcies, receiverships, assignments for the benefit of creditors, and similar court-supervised proceedings.
The applicant shall provide any additional information requested by the department during its review of the license application.
The applicant shall provide information to demonstrate that any person having the authority to directly manage the operation of the facility has the education, training or experience to operate and manage a health care facility to provide for the health, safety, and welfare of its residents in substantial compliance with state and federal requirements.
The applicant shall submit evidence to establish that he or she has sufficient resources to permit operation of the facility for a period of 6 months.
No license may be issued unless and until the applicant has supplied all information requested by the department.
DHS 132.14(4)(a)(a) Investigation.
After receiving a complete application, the department shall investigate the applicant to determine if the applicant is fit and qualified to be a licensee and to determine if the applicant is able to comply with this chapter.
(b) Fit and qualified.
In making its determination of the applicant's fitness, the department shall review the information contained in the application and shall review any other documents that appear to be relevant in making that determination, including survey and complaint investigation findings for each facility with which the applicant is affiliated or was affiliated during the past 5 years. The department shall consider at least the following:
Any class A or class B violation, as defined under s. 50.04
, Stats., issued by the department relating to the applicant's operation of a residential or health care facility in Wisconsin;
Any adverse action against the applicant or any person or business entity named in the application by the licensing agency of this state or any other state relating to the applicant's or any person or business entity named in the application's operation of a residential or health care facility. In this subdivision,“adverse action" means an action initiated by a state licensing agency which resulted in a conditional license, the placement of a monitor or the appointment of a receiver, or the denial, suspension or revocation of the license of a residential or health care facility operated by the applicant or any person or business entity named in the application;
Any adverse action against the applicant or any person or business entity named in the application based upon noncompliance with federal statutes or regulations in the applicant's or any person or business entity named in the application's operation of a residential or health care facility in this or any other state. In this subdivision, “adverse action" means an action by a state or federal agency which resulted in the imposition of Category 3 remedies pursuant to 42 CFR sec. 488.408 (e), placement of a state monitor or the appointment of a receiver, transfer of residents, or the denial, non-renewal, cancellation or termination of certification of a residential or health care facility operated by the applicant;
The frequency of noncompliance with state licensure and federal certification laws in the applicant's operation of a residential or health care facility in this or any other state;
Any denial, suspension, enjoining or revocation of a license the applicant had as a health care provider as defined in s. 146.81 (1)
, Stats., or any conviction of the applicant for providing health care without a license;
Any conviction of the applicant for a crime involving neglect or abuse of patients or of the elderly or involving assaultive behavior or wanton disregard for the health or safety of others;
Any conviction of the applicant for a crime related to the delivery of health care services or items;
Any conviction of the applicant for a crime involving controlled substances;
Any knowing or intentional failure or refusal by the applicant to disclose required ownership information; and
Any prior financial failures of the applicant and any person and related business entity identified in the application concerning the operation of a residential or health care facility that resulted in any debt consolidation or restructuring, insolvency proceeding or mortgage foreclosure or in the closing of residential or health care facility or the moving of its residents. “Insolvency" has the meaning provided in s. DHS 132.14 (3) (a) 5.
Action by the department.
Within 60 days after receiving a complete application for a license, the department shall either approve the application and issue a license or deny the application. The department shall deny a license to any applicant who has a history, determined under sub. (4) (b) 1.
, of substantial noncompliance with federal or this state's or any state's nursing home requirements, or who fails under sub. (4) (b) 5.
, to qualify for a license. If the application for a license is denied, the department shall give the applicant reasons, in writing, for the denial and shall identify the process for appealing the denial.
DHS 132.14(6)(a)(a) Probationary license.
If the applicant has not been previously licensed under this chapter or if the facility is not in operation at the time application is made, the department shall issue a probationary license. A probationary license shall be valid for 12 months from the date of issuance unless sooner suspended or revoked under s. 50.03 (5)
, Stats. If the applicant is found to be fit and qualified under sub. (4)
and in substantial compliance with this chapter, the department shall issue a regular license upon expiration of the probationary license. The regular license is valid indefinitely unless suspended or revoked.
(b) Regular license.
If the applicant has been previously licensed, the department shall issue a regular license if the applicant is found to be in substantial compliance with this chapter. A regular license is valid indefinitely unless suspended or revoked.
The license is issued only for the premises and the persons named in the license application, and may not be transferred or assigned by the licensee.
The license shall state any applicable restrictions, including maximum bed capacity and the level of care that may be provided, and any other limitations that the department considers appropriate and necessary taking all facts and circumstances into account.
A licensee shall fully comply with all requirements and restrictions of the license.
Every 12 months, on a schedule determined by the department, a nursing home licensee shall submit a report to the department in the form and containing the information that the department requires, including payment of the fee required under s. 50.135 (2) (a)
, Stats. If a complete report is not timely filed, the department shall issue a warning to the licensee. If a nursing home licensee who has not filed a timely report fails to submit a complete report to the department within 60 days after the date established under the schedule determined by the department, the department may revoke the license.
Reporting involuntary administration of psychotropic medication.
The licensee shall provide, in a format approved by the department, information required by the department to assess the facility's compliance with s. 55.14
, Stats., relating to involuntary administration of psychotropic medication to a resident.
DHS 132.14 History
Cr. Register, July, 1982, No. 319
, eff. 8-1-82; cr. (5), Register, November, 1985, No. 359
, eff. 12-1-85; r. and recr., Register, January, 1987, No. 373
, eff. 2-1-87; emerg. cr. (1m), eff. 7-1-88; am. (3) (c), renum. (4) to (6) to be (5) to (7) and am. (5) and (6) (a), cr. (4), Register, February, 1989, No. 398
, eff. 3-1-89; cr. (1m), Register, October, 1989, No. 406
, eff. 11-1-89; am. (6), cr. (8), Register, August, 2000, No. 536
, eff. 9-1-00; CR 06-053
: cr. (3) (a) 5. and (bm), am. (4) (b) 2., 3. and 10., Register August 2007 No. 620
, eff. 9-1-07; CR 07-042
: cr. (9) Register October 2007 No. 622
, eff. 11-1-07.
DHS 132.15 Certification for medical assistance.
For requirements for certification under the medical assistance program, see ch. DHS 105
DHS 132.15 History
Cr. Register, July, 1982, No. 319
, eff. 8-1-82; correction made under s. 13.92 (4) (b) 7.
, Stats., Register January 2009 No. 637
DHS 132.16 Quality assurance and improvement projects. DHS 132.16(1)(1)
Pursuant to ss. 49.499 (2m)
and 50.04 (8)
, Stats., the department may, from the appropriation under s. 20.435 (6) (g)
, Stats., distribute funds for innovative projects designed to protect the property and the health, safety, and welfare of residents in a facility and to improve the efficiency and cost effectiveness of the operation of a facility so as to improve the quality of life, care, and treatment of its residents.
The department shall establish and maintain a quality assurance and improvement committee to review proposals and award funds to facilities for innovative projects approved by the committee under sub. (3)
Committee members shall be appointed by the secretary for a term of up to 12 months and include, at the secretary's discretion, one or more representatives from the department, the board on aging and long term care, disability, aging and long term care advocates, facilities, and other persons with an interest or expertise in quality improvement or delivery of long term care services. Facility members shall comprise at least half of the committee membership.
A representative's term may be extended at the secretary's discretion.
The quality assurance and improvement committee shall do all of the following:
Develop and propose for the secretary's approval criteria for review and approval of projects proposed under this section.
Considering the criteria approved by the secretary under par. (b)
, review proposals submitted by facilities under this section and approve submitted proposals, defer a determination pending additional information, or deny approval of proposals submitted.
Identify areas of need within a facility or corporation, the state or regions as projects to be addressed.
Develop opportunities and strategies for general improvement concerning licensed facilities.
Encourage proposals that develop innovative cost-effective methods for improving the operation and maintenance of facilities and that protect residents' rights, health, safety and welfare and improve residents' quality of life.
Disseminate within the department and to facilities and other interested individuals and organizations the information learned from approved projects.
A decision under sub. (3) (c)
to defer or deny approval of or award funds for a proposal may not be appealed.
“Waiver" means the grant of an exemption from a requirement of this chapter.
“Variance" means the granting of an alternate requirement in place of a requirement of this chapter.
Requirements for waivers or variances.
A waiver or variance may be granted if the department finds that the waiver or variance will not adversely affect the health, safety, or welfare of any resident and that:
Strict enforcement of a requirement would result in unreasonable hardship on the facility or on a resident; or
An alternative to a rule, including new concepts, methods, procedures, techniques, equipment, personnel qualifications, or the conducting of pilot projects, is in the interests of better care or management.
All applications for waiver or variance from the requirements of this chapter shall be made in writing to the department, specifying the following:
If the request is for a variance, the specific alternative action which the facility proposes;
The department may require additional information from the facility prior to acting on the request.
The department shall grant or deny each request for waiver or variance in writing. Notice of denials shall contain the reasons for denial. If a notice of denial is not issued within 60 days after the receipt of a complete request, the waiver or variance shall be automatically approved.
The terms of a requested variance may be modified upon agreement between the department and a facility.
The department may impose such conditions on the granting of a waiver or variance which it deems necessary.
Denials of waivers or variances may be contested by requesting a hearing as provided by ch. 227
The licensee shall sustain the burden of proving that the denial of a waiver or variance was unreasonable.
The department may revoke a waiver or variance if:
It is determined that the waiver or variance is adversely affecting the health, safety or welfare of the residents; or
The licensee notifies the department in writing that it wishes to relinquish the waiver or variance and be subject to the rule previously waived or varied; or
DHS 132.21 History
Cr. Register, July, 1982, No. 319
, eff. 8-1-82; am. (3) (a) 1. d., Register, January, 1987, No. 373
, eff. 2-1-87.
Every resident shall have the right to all of the following:
(d) Admission information.
Be fully informed in writing, prior to or at the time of admission, of all services and the charges for these services, and be informed in writing, during the resident's stay, of any changes in services available or in charges for services, as follows:
No person may be admitted to a facility without that person or that person's guardian or any other responsible person designated in writing by the resident signing an acknowledgement of having received a statement of information before or on the day of admission which contains at least the following information or, in the case of a person to be admitted for short-term care, the information required under s. DHS 132.70 (3)
An accurate description of the basic services provided by the facility, the rate charged for those services, and the method of payment for them;
Information about all additional services regularly offered but not included in the basic services. The facility shall provide information on where a statement of the fees charged for each of these services can be obtained. These additional services include pharmacy, x-ray, beautician and all other additional services regularly offered to residents or arranged for residents by the facility;