A statement from the attending physician that the person is free from tuberculosis and other clinically apparent communicable diseases; and
The registered nurse, with verbal agreement of the attending physician, shall develop a written plan of care for the person being admitted prior to or at the time of admission. The plan of care shall be based on the comprehensive resident assessment under subd. 1.
, the physician's orders and any special assessments under subd. 1.
The facility shall send a copy of the comprehensive resident assessment, the physician's orders and the plan of care under subd. 2.
to the person's attending physician. The attending physician shall sign the assessment and the plan of care within 48 hours after the person is admitted.
For a person admitted to a facility for recuperative care, the following admission and resident care planning procedures may be carried out in place of the requirements under ss. DHS 134.52
and 134.60 (1)
The person may be admitted only on order of a physician accompanied by information about the person's medical condition and diagnosis, the physician's initial plan of care, and either the physician's written certification that the person is free of tuberculosis and other clinically apparent communicable diseases or an order of a physician for procedures to treat any disease the person may have.
A registered nurse shall prepare an initial plan of care for nursing services to be implemented on the day of admission, which shall be based on the physician's initial plan of care under subd. 1.
and shall be superseded by the plan of care under subd. 5.
A physician shall conduct a physical examination of the new resident within 48 hours following admission, unless a physical examination was performed by a physician within 15 days before admission.
A registered nurse shall complete a comprehensive resident assessment of the person prior to or within 72 hours after admission. The comprehensive assessment shall include evaluation of the person's nursing, dietary, rehabilitative, pharmaceutical, dental, social and activity needs. The consulting or staff pharmacist shall participate in the comprehensive assessment as provided under sub. (4) (a)
. As part of the comprehensive assessment, when the registered nurse has identified a need for a special service, staff from the discipline that provides the service shall, on referral from the registered nurse, complete a and assessment of the person's prior health and care in that discipline.
The registered nurse, with verbal agreement of the attending physician, shall develop a written plan of care for the new resident within one week after admission. The plan of care shall be based on the comprehensive resident assessment under subd. 4.
, the physician's orders, and any special assessment under subd. 4.
The facility shall send a copy of the comprehensive resident assessment, the physician's orders and the plan of care under subd. 5.
to the new resident's attending physician. The attending physician shall sign the assessment and the plan of care.
No person may be admitted to a facility for respite care or recuperative care without signing or the person's guardian or designated representative signing an acknowledgement of having received a statement before or on the day of admission which contains at least the following information:
An indication of the expected length of stay, with a note that the responsibility for care of the resident reverts to the resident or other responsible party following expiration of the designated length of stay;
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;
Terms for refunding advance payments in case of transfer, death or voluntary or involuntary termination of the service agreement;
The facility's policy regarding possession and use of personal belongings;
In the case of a person admitted for recuperative care, the terms for holding and charging for a bed during the resident's temporary absence; and
In summary form, the residents' rights recognized and protected by s. DHS 134.31
and all facility policies and regulations governing resident conduct and responsibilities.
The consulting or staff pharmacist shall review the drug regimen of each person admitted to the facility for respite care or recuperative care as part of the comprehensive resident assessment under sub. (2) (a) 1.
or (b) 4.
The consulting or staff pharmacist, who is required under s. DHS 134.67 (3) (b)
to visit the facility at least quarterly to review drug regimens and medication practices, shall review the drug regimen of each resident admitted for recuperative care and the drug regimen of each resident admitted for respite care who may still be a resident of the facility at the time of the pharmacist's visit.
Respite care residents and recuperative care residents may bring medications into the facility as permitted by written policy of the facility.
(5) Physician visits.
The requirements under s. DHS 134.66 (2) (b)
for physician visits do not apply in the case of a respite care resident, except when the nursing assessment indicates there has been a change in the resident's condition following admission, in which case the physician shall visit the resident if this appears indicated by the assessment of the resident.
For residents receiving recuperative care, a planning conference shall be conducted at least 10 days before the designated date of termination of the short-term care, except in an emergency, to determine the appropriateness of discharge or need for the resident to stay at the facility. At the planning conference a care plan shall be developed for a resident who is being discharged to home care or to another health care facility. If discharge is not appropriate, the period for recuperative care shall be extended, if it was originally less than 90 days, for up to the 90 day limit, or arrangements shall be made to admit the person to the facility for care that is not short-term, as appropriate.
The medical record for each respite care resident and each recuperative care resident shall include, in place of the items required under s. DHS 134.47 (4)
Admission nursing notes identifying pertinent problems to be addressed and areas of care to be maintained;
For recuperative care residents, nursing notes addressing pertinent problems identified in the resident care plan and, for respite care residents, nursing notes prepared by a registered nurse or licensed practical nurse to document the resident's condition and the care provided;
Any progress notes by physicians or other persons providing health care to the resident that document resident care and progress;
For respite care residents, a record of change in condition during the stay at the facility; and
For recuperative care residents, the physician's discharge summary with identification of resident progress and, for respite care residents, the registered nurse's discharge summary with notes of resident progress during the stay.
(b) Location and accessibility.
The medical record for each short-term care resident shall be kept with the medical records of other residents and shall be readily accessible to authorized representatives of the department.
DHS 134.70 History
Cr. Register, June, 1988, No. 390
, eff. 7-1-88.
DHS 134.71 Furniture, equipment and supplies. DHS 134.71(1)(a)1.1.
The facility shall provide each resident with a separate bed of proper size and height for the convenience of the resident. The bed shall be in good repair and have a headboard of sturdy construction. Rollaway beds, day beds, cots, double-beds or folding beds may not be used.
Each bed shall be provided with a clean, comfortable mattress of appropriate size for the bed.
When required by the resident's condition or age, or both, side rails shall be installed for both sides of the bed.
Each resident shall be provided at least one clean, comfortable pillow. Additional pillows shall be provided if requested by the resident or required by the resident's condition.
A moisture-proof mattress cover shall be provided for each mattress to keep the mattress clean and dry. A moisture-proof pillow cover shall be provided for each pillow to keep the pillow clean and dry.
A supply of sheets and pillow cases sufficient to keep beds clean and odor-free shall be stocked. At least 2 sheets and 2 pillow cases shall be furnished to each resident each week.
A sufficient number of blankets appropriate to the weather and seasonal changes shall be provided. Blankets shall be changed and laundered as necessary to maintain cleanliness.
A dresser or adequate compartment or drawer space shall be provided for each resident to store personal clothing and effects and to store, as space permits, other personal possessions in a reasonably secure manner.
Other appropriate furniture, such as a table or desk and a chair, shall be provided for each resident.
(2) Towels and washcloths.
Clean towels and washcloths shall be provided to each resident as needed. Towels and washcloths may not be used by more than one resident between launderings.
(3) Window coverings.
Every window shall be supplied with flame-retardant shades, draw drapes or other covering material or devices which, when properly used and maintained, shall afford privacy and light control for the resident.
All furnishings and equipment shall be maintained in a usable, safe and sanitary condition.
Facilities that have residents who require oxygen shall meet all of the following requirements:
When placed at the resident's bedside, oxygen tanks shall be securely fastened to a tip-proof carrier or base.
Oxygen regulators may not be stored with solution left in the attached humidifier bottles.
When in use at the resident's bedside, cannulas, hoses, and humidifier bottles shall be maintained and used in accordance with current standards of practice and manufacturers' recommendations.
Disposable inhalation equipment shall be maintained and used in accordance with current standards of practice and manufacturers' recommendations.
With nondisposable inhalation equipment such as intermittent positive pressure breathing equipment, the entire resident breathing circuit, including nebulizers and humidifiers, shall be maintained and used in accordance with current standards of practice and manufacturers' recommendations.
DHS 134.71 History
Cr. Register, June, 1988, No. 390
, eff. 7-1-88; 2015 Wis. Act 107
: am. (5) (intro.), (a) to (f) Register November 2015 No. 719
, eff. 12-1-15.
Facilities shall develop and implement policies that provide for a safe and sanitary environment for residents and personnel at all times.
Facilities shall be kept clean and free from offensive odors, accumulations of dirt, rubbish, dust and safety hazards.
Floors and carpeting shall be kept clean. If polishes are used on floors, a nonslip finish shall be provided. Carpeting or any other material covering the floors that is worn, damaged, contaminated or badly soiled shall be replaced.
Ceilings and walls shall be kept clean and in good repair. The interior and exterior of the buildings shall be painted or stained as needed to protect the surfaces. Loose, cracked or peeling wallpaper or paint shall be replaced or repaired.
A facility shall use lead-free paint inside the facility and shall remove or cover any surfaces containing lead-based paint that are accessible to residents.
All furniture and other furnishings shall be kept clean and in good repair at all times.
(3) Combustibles in storage areas.
Attics, cellars and other storage areas shall be kept safe and free from dangerous accumulations of combustible materials. Combustibles, including cleaning rags and compounds, shall be kept in closed metal containers.
The grounds of the facility shall be kept free from refuse, litter and waste water. Areas around buildings, sidewalks, gardens and patios shall be kept clear of dense undergrowth.
All poisonous compounds shall be clearly labelled as poisonous and, when not in use, shall be stored in locked areas. These areas shall be separate from food storage, kitchenware storage and medication storage areas.
All garbage and rubbish shall be stored in leakproof, nonabsorbent containers with close-fitting covers and in areas separate from areas used for the preparation and storage of food. Containers shall be cleaned regularly. Paperboard containers may not be used.
Garbage and rubbish shall be disposed of promptly in a safe and sanitary manner.
(7) Linen and towels.
Linens and towels shall be handled, stored, processed and transported in such a manner as to prevent the spread of infection. Soiled linen may not be sorted, rinsed or stored in bathrooms, resident rooms, kitchens, food storage areas or common hallways. If it is necessary to transport soiled linen through food preparation areas to laundry facilities, linens shall be in covered containers.