Alert! This chapter may be affected by an emergency rule:
1. The program description included as part of an application under par. (a) 2. 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) (c).
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 par. (i).
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), 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) or suspended or revoked under par. (g) 3. or 4. 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) 5., suspension under par. (g) 3., or revocation under par. (g) 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 par. (a) 2. at least 30 days prior to the change of ownership.
2. If a participant is given less than 30 days’ notice of the change of ownership, neither the transferor nor the transferee may enforce any advanced notice requirements for discharge as specified in any participant’s enrollment agreement.
3. The transferor shall notify the department within 30 days before a change of ownership of an ADCC and shall include the name and contact information of the transferee.
4. The transferor remains responsible for the operation of the ADCC until the department issues a certification to the transferee.
5. The transferor shall disclose to the transferee any waiver or variance granted by the department under sub. (1) (c), or outstanding deficiencies.
6. Any violation reported in a department inspection report shall be corrected prior to the change of ownership. Any correction must be verified by the department prior to the issuance of the certification to the transferee.
7. The department shall issue a certification only for the premises and persons named in the certification application. A certification may not be transferred or reassigned without following the change of ownership provisions in this paragraph.
(j) ADCC closure.
1. An ADCC that intends to close shall notify the department, each participant or legal representative, and case manager, if any, in writing at least 30 days before closing and comply with the discharge requirements under sub. (5) (c).
2. The ADCC shall surrender the certification to the department when the ADCC closes.
3. The ADCC shall surrender its certification if it has not served any participants for 24 months.
(k) Death reporting requirements.
1. If a participant dies while at or under the supervision of the ADCC, the ADCC shall report the following to the department no later than 3 days after any of the following occurs:
a. Death due to physical restraint, psychotropic medication, or suicide, if there is reasonable cause to believe that the death was related to physical restraint, psychotropic medication, or suicide.
b. Death due to accident or injury not attributable to physical restraint, psychotropic medication, or suicide.
2. An ADCC is not required to report a death to the department if the death is the result of natural causes, and none of the circumstances surrounding the death involve a condition under subd. 1.
(L) Other reporting requirements. An ADCC shall send a written report to the department within 3 working days after any of the following occurs:
1. Any time a participant’s whereabouts are unknown, except those instances when a participant who is competent chooses not to disclose his or her whereabouts or location to the ADCC. The ADCC shall also notify the local law enforcement authority immediately upon discovering that a participant is missing.
2. Any time law enforcement is called to the ADCC as a result of an incident that jeopardizes the health, safety or welfare of a participant or caregiver. The ADCC’s report to the department shall provide a description of the circumstances requiring the law enforcement intervention.
3. Any incident or accident resulting in serious injury requiring hospital admission or emergency room treatment of a participant.
4. A catastrophe causing structural damage to the ADCC that results in any change in services provided to the participants.
5. A fire occurs on the premises of the ADCC.
6. Anytime the ADCC must evacuate and temporarily relocate participants and caregivers from the ADCC for reasons other than a fire drill.
(m) Investigation and reporting requirements.
1. ‘Misconduct reporting.’ When an ADCC receives a report of an allegation of abuse or neglect of a participant, or misappropriation of property, the ADCC shall take immediate action to ensure the safety of each participant and security of their property. The ADCC shall do all of the following:
a. Thoroughly investigate any allegation of abuse or neglect of a participant, or misappropriation of property and document all allegations, investigations, and the results of investigations.
b. Report incidents to the department when the ADCC’s investigation concludes the alleged abuse, or neglect of a participant or misappropriation of property meets the definition of abuse or neglect of a participant, or of misappropriation of property under ch. DHS 13. The ADCC shall maintain documentation of any investigations.
Note:  Information and resources for reporting misconduct through the Misconduct Incident Reporting system are available at https://www.dhs.wisconsin.gov/caregiver/complaints.htm.
c. Use the form or web-based application provided by the department to submit all reportable incidents to the department within 7 days from the date the ADCC knew or should have known about the abuse, neglect, or misappropriation of property.
d. Document its conclusions and rationales in writing if it concludes, after investigation, that the incident did not meet the definition of abuse, neglect, or misappropriation.
2. ‘Elder abuse and adults-at-risk reporting.’ The ADCC shall follow the elder abuse reporting requirements under s. 46.90, Stats., and the adult at risk requirements under s. 55.043, Stats., whichever is applicable.
3. ‘Injuries of unknown source.’ When an ADCC receives a report of a participant’s injury with an unknown cause, it shall thoroughly investigate, document, and report an injury of unknown source in a manner consistent with the requirements of subd. 1. or 2. when both of the following conditions are met:
a. The source of the injury was not observed by any person or the source of the injury could not be explained by the participant.
b. The injury appears suspicious because of the extent of the injury or the location of the injury on the participant.
c. The ADCC shall maintain documentation for each investigation of an injury referenced under subd. 3.
4. ‘Other duties.’ Filing reports under subd. 1. or 2. does not relieve the operator of any obligation to report an incident to any other authority, including law enforcement or the coroner, or both.
(n) Notification of changes affecting a participant.
1. The ADCC shall immediately notify the participant’s legal representative and the participant’s residential provider and document the notification when there is an incident or injury to the participant or a significant change in the participant’s physical or mental condition.
2. The ADCC shall immediately notify the participant’s legal representative and document the notification when there is an allegation of abuse or neglect of the participant.
3. The ADCC shall notify the participant’s legal representative within 72 hours when there is an allegation of misappropriation of the participant’s property and document the notification.
4. The ADCC shall give the participant or the participant’s legal representative a 30-day written notice of any change in services available or in charges for services that will be in effect for more than 30 days.
(o) Documentation requirement. All written reports required under sub. (2) (k) to (n), shall include, at a minimum, all of the following:
1. The time, date, place, and details of the reportable occurrence.
2. Any individuals involved in the reportable occurrence.
3. The action taken by the provider to ensure the health, safety, welfare and well-being of each participant following the reportable occurrence.
(p) Record retention.
1. The ADCC shall retain all records required under this section for 2 years, unless otherwise specified in this section.
2. Participant records shall be retained for 7 years following the date of a participant’s final discharge.
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Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date the chapter was last published.