22. “Psychotropic medication” means a prescription drug, defined in s. 450.01 (20), Stats., that is used to treat or manage a psychiatric symptom or challenging behavior. 23. “Qualified Caregiver” means an employee who is at least 18 years of age and has successfully completed all of the applicable orientation and training under sub. (4), pars. (a) and (b) of this section.
24. a. “Seclusion” means physical or social separation of a participant from others by actions of caregivers.
b. “Seclusion” does not include separation to prevent the spread of communicable disease or voluntary cool-down periods in an unlocked room.
25. “Serious injury” means an injury from any incident or accident which results in any of the following:
a. A temporary or permanent increase in the level of assistance needed in one or more ADL categories, such as bathing, eating, oral hygiene, dressing, toileting, incontinence care, or mobility and transferring.
b. A fracture.
c. A pronounced decline in communication or cognitive abilities.
26. “Significant change” in a participant’s physical or mental condition means any of the following:
a. A decline in a participant’s medical condition that results in further impairment.
b. A decline in 2 or more ADLs.
c. A pronounced decline in communication or cognitive abilities.
d. A decline in behavior or mood which requires either a temporary or permanent increase in the level of assistance needed in one or more ADL categories, such as bathing, eating, oral hygiene, dressing, toileting, incontinence care, or mobility and transferring.
27. “Standard precautions” are a set of infection control practices used to prevent transmission of diseases that can be acquired by contact with blood, body fluids, non-intact skin (including rashes), and mucous membranes. These measures are used when providing care to all individuals, whether or not they appear infectious or symptomatic.
28. a. “Supervision” means oversight of a participant’s functioning.
b. Supervision includes keeping track of a participant’s whereabouts and providing guidance and intervention when needed by a participant.
29. “Transferor” means the current operator in a change of ownership process who will voluntarily relinquish the current certification.
30. “Transferee” means the recipient of a property or business in a change of ownership process who will submit application for a new certification.
31. “Utensils” means dishes, silverware and pots and pans used for storing, preparing, serving, or consuming food.
32. “Variance” means an alternate means of meeting a requirement in this section, as approved by the department under par. (c).
33. “Volunteer” means any person who provides services for participants without compensation.
34. “Waiver” means an exemption from a requirement in this section, as approved by the department under par. (c).
(c) Variances and waivers.
1. The department may grant approval of a waiver or variance if the department determines that the proposed waiver or variance will not jeopardize the health, safety, welfare or rights of any participant.
2. A written request for a waiver or variance shall be sent to the department and include justification that the waiver or variance will not adversely affect the health, safety or welfare of any participant for the requested action.
3. A written request for a variance shall include a description of an alternative means planned to meet the intent of the requirement.
4. The department may terminate approval of a waiver or variance if any of the following occurs:
a. The department determines the waiver or variance has adversely affected the health, safety, well-being or welfare of a participant.
b. The ADCC fails to comply with any of the conditions of the waiver or variance as granted.
c. A change in circumstances from the time the waiver or variance approval was initially granted.
d. The ADCC failed to disclose a fact that is material to the approval.
(2) Certification.
(a) General requirements.
1. No person may receive reimbursement under s. 46.27 (11), Stats., for the provision of services to a participant in an ADCC unless the ADCC is certified by the department. A person who assumes ownership interest in a certified ADCC, regardless of whether the transfer includes title to the real estate, or changes the location of the ADCC shall complete an application as required under this subsection. 2. An application for certification shall be on a form or web-based application provided by the department and shall include all of the following:
a. A program description as specified under par. (b) of this subsection.
b. A floor plan specifying dimensions of the ADCC, including exits and planned room usage.
c. A fire inspection report.
d. All required fees.
e. A balance sheet.
f. Evidence that the applicant has 60 days of projected operating funds in reserve.
g. Proof of transportation liability insurance if the ADCC provides transportation.
h. Well water test results if the ADCC uses well water.
i. A program evaluation plan.
j. Any additional information requested by the department.
3. An ADCC may not be located on a parcel of land zoned for industrial or manufacturing use.
(b) Program description.
1. The program description included as part of an application under par. (a), subd. 2. of this subsection shall include all of the following:
a. The name of the operator, the program director, and the caregiver position in charge when the operator or program director is away from the ADCC.
b. The participant capacity of the ADCC.
c. A definition of the program goals and a description of the services provided or made available to participants at the ADCC.
d. The days and hours of operation of the ADCC.
e. A description of any limits the program establishes for providing service to a participant with specific care needs.
f. A fee schedule which includes the daily charges and additional fees for specific services, goods, or supplies that are not included in the daily charge, and the method for notifying a participant or a legal representative of fee changes.
g. A procedure for informing the participant’s legal representative, family, or caregiver of any major change in the participant’s general functioning or medical condition.
h. A procedure for documenting any incident occurring at the site which would affect the health, safety or welfare of a participant.
i. The participant group to be served and, if serving more than one participant group, an explanation acceptable to the department of how each participant group is compatible with one another.
j. A grievance procedure for investigating and resolving complaints made by a participant, legal representative, family member, caregiver, or other interested persons about the services provided by the ADCC which includes informing such persons of appropriate local, county and/or state agency contacts and informing such persons that pursuant to s. DHS 13.05 (4) (a) and s. 146.40 (4r) (a), Stats., any individual may report to the department that he or she believes that any person employed by or under contract with the ADCC has neglected or abused a participant or misappropriated the participant’s property. k. The criteria for voluntary and involuntary discharge of a participant from the program as defined in sub. (5), par. (c) of this section.
2. Before finalizing an agreement to provide care, the ADCC shall provide its program description to each person seeking services or to the person’s legal representative, or both.
3. The program description shall be provided to each caregiver and any other person upon request.
(c) Fit and qualified determination. An applicant may not be certified unless the department determines the applicant is fit and qualified to operate an ADCC. To determine whether a person is fit and qualified, the department shall consider all of the following:
1. Whether the applicant, any operator, or any non-client residents, as defined in s.50.065 (1) (cn), Stats., meet the requirements of ch. DHS 12 and s. 50.065, Stats. 2. The applicant’s history of compliance with Wisconsin or any other state or federal licensing or certification requirements, including any license revocation or denial.
3. The applicant’s arrest and criminal records, including any of the following:
a. Crimes or acts involving abuse, neglect or mistreatment of a person or misappropriation of property of a person.
b. Crimes or acts subject to elder abuse reporting under s. 46.90, Stats. c. Crimes or acts related to the manufacture, distribution, use, or dispensing of a controlled substance.
d. Fraud or substantial or repeated violations of applicable laws and rules in the operation of any health care center or in the care of dependent persons.
e. A conviction or pending criminal charge which substantially relates to the care of adults or minors, to the funds or property of adults or minors, or to the operation of a residential or health care center.
4. The financial history and the financial viability of the applicant or the applicant’s organization, including any outstanding debts, fees, or fines due to the department or other government agencies.
(d) Department action.
1. Within 70 days of receipt of a complete application, the department shall review the application and either approve or deny certification of the ADCC.
2. A certification issued by the department shall be only for the premises and operator named in the application. A certification may not be transferred or assigned to another operator without following the change of ownership provisions in sub. (2), par. (i) of this section.
3. A certification is valid until suspended or revoked by the department.
4. The department shall deny a certification to any applicant who does not substantially comply with any provision of this chapter or ch. 49, Stats., who is not deemed fit and qualified as specified in par. (c) of this subsection, or who has failed to pay any fee or any outstanding amounts due to the department. 5. The department shall provide the reasons for denial and the process for appeal of the denial in writing to the applicant.
(e) Monitoring after certification. The department shall conduct periodic inspections of the ADCC during the period of certification and may, without notice to the operator, visit an ADCC at any time to determine if the ADCC is compliant with this section. The operator shall be able to verify compliance with this section and shall provide the department access to the ADCC, its staff, each participant, and records.
(f) Biennial reporting and fees. Every 24 months, on a date determined by the department, the operator shall submit a biennial report on the form provided by the department, and shall submit payment of the certification continuation fees.
(g) Sanctions for noncompliance.
1. ‘Notice of violation.’ The department shall issue a written notice of violation when it finds that an ADCC is in violation of this section or with any federal, state, or local laws and codes that govern the operation of the ADCC. The notice shall explain the grounds for the notice of violation, the sanction to be imposed, if any, and, if certification is suspended or revoked, and the process for an appeal.
2. ‘Plan of correction.’ An ADCC may submit a written plan of correction to the department within 10 days after the date of receipt of the notice of violation.
3. ‘Suspension.’ The department may summarily suspend the ADCC’s certification following procedures in ch. 227, Stats., when the department finds that participant health, safety or welfare requires emergency action. 4. ‘Revocation.’ The department may revoke the ADCC’s certification whenever the department finds that the ADCC has failed to maintain substantial compliance with one or more of the requirements set forth in this section.
(h) Appeals.
1. Any person whose application for certification is denied under par. (d) of this subsection or suspended or revoked under par. (g), subd. 3. or 4. of this subsection may request a hearing on that decision in accordance with s. 227.42, Stats. 2. A request for hearing shall be made in writing to the department of administration’s division of hearings and appeals. The request for a hearing must be received by the division of hearings and appeals within 10 days of the department’s written notice of certification denial under par. (d), subd. 5., suspension under par. (g), subd. 3., or revocation under par. (g), subd. 4.
(i) Change of ownership.
1. When an ADDC seeks a change of ownership, the transferee shall submit a complete application for certification as required under sub. (2), par. (a), subd. 2. of this section at least 30 days prior to the change of ownership.
