DHS 83.27(1)(a)(a) No CBRF may have more residents, including respite care residents, than the maximum bed capacity on its license. DHS 83.27(1)(b)(b) The CBRF may not have more than 4 residents, or 10% of the licensed capacity, whichever is greater, who need more than 3 hours of nursing care per week or care above intermediate level nursing care for not more than 30 days unless the facility has obtained a waiver from the department or the department has received a request for a waiver from the CBRF and the department’s decision is pending. DHS 83.27(2)(2) Admission and retention limitations. A CBRF may not admit or retain any of the following persons: DHS 83.27(2)(a)(a) A person who has an ambulatory or cognitive status that is not compatible with the license classification under s. DHS 83.04 (2). DHS 83.27(2)(b)(b) A person who is destructive of property or self, or who is physically or mentally abusive to others, unless the CBRF has sufficient resources to care for such an individual and is able to protect the resident and others. DHS 83.27(2)(c)(c) A person who has physical, mental, psychiatric or social needs that are not compatible with the client group as described in the CBRF’s program statement. DHS 83.27(2)(d)(d) A person who needs more than 3 hours of nursing care per week except for a temporary condition needing more than 3 hours of nursing care per week for no more than 30 days. If the CBRF requests a waiver or variance, the department may grant a waiver or variance to this requirement, as described under s. DHS 83.03, if the following conditions are met: DHS 83.27(2)(d)1.1. The resident’s clinical condition is stable and predictable, does not change rapidly, and medical orders are unlikely to involve frequent changes or complex modifications and the resident’s clinical condition is one that may be treatable, or the resident has a long-term condition needing more than 3 hours of nursing care per week for more than 30 days. DHS 83.27(2)(d)2.2. The resident is otherwise appropriate for the level of care provided in the CBRF. DHS 83.27(2)(d)3.3. The services needed to treat the resident’s condition are available in the CBRF. DHS 83.27(2)(e)(e) A person whose condition requires 24-hour supervision by a registered nurse or licensed practical nurse. DHS 83.27(2)(f)(f) A person whose condition requires care above intermediate level nursing care. DHS 83.27(2)(h)(h) A person who is incapacitated, as defined under s. 50.06 (1), Stats., unless the person has a health care agent under a valid and properly activated power of attorney for health care under ch. 155, Stats., or a court appointed guardian under ch. 54, Stats., except for the admission of an incapacitated individual who does not have such a legal representative, and who is admitted directly from the hospital according to the provision of s. 50.06, Stats. DHS 83.27(2)(i)(i) A person who resides in a CBRF licensed for 16 or more residents, and has been found incompetent under ch. 54, Stats., and does not have a court-ordered protective placement under s. 55.12, Stats. DHS 83.27(3)(3) Admission of minors. The CBRF may not admit a person under 18 years of age without written approval of the department and only if any of the following apply: DHS 83.27(3)(a)(a) The CBRF is also licensed under ch. DCF 57 as a group foster care home or under ch. DCF 52 as a residential care center for children and youth. DHS 83.27(3)(c)(c) The minor is the child of an adult resident. When the minor child of an adult resident resides in a CBRF, all of the following shall apply: DHS 83.27(3)(c)2.2. The CBRF shall have written policies related to the presence of minors in the CBRF, including policies on parental responsibility, school attendance and any care, treatment or services provided to the minors by the CBRF. DHS 83.27 HistoryHistory: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; corrections in (3) (a) made under 13.92 (4) (b) 7., Stats., Register January 2009 No. 637. DHS 83.28(2)(2) Services and charges. Before or at the time of admission, the CBRF shall provide written information regarding services available and charges for those services as required in s. DHS 83.29 (1). DHS 83.28(3)(3) Admission agreement. Before or at the time of admission, the CBRF shall provide the admission agreement as required under s. DHS 83.29 (2). DHS 83.28(4)(a)1.1. Within 90 days before or 7 days after admission, a physician, physician assistant, clinical nurse practitioner or a licensed registered nurse shall screen each person admitted to the CBRF for clinically apparent communicable disease, including tuberculosis, and document the results of the screening. DHS 83.28(4)(a)2.2. Screening for tuberculosis and all immunizations shall be conducted using centers for disease control and prevention standards. DHS 83.28(4)(a)3.3. The CBRF shall maintain the screening documentation in each resident’s record. DHS 83.28(4)(b)1.1. Within 90 days before or 7 days after admission for persons in respite care who will reside in the CBRF for more than 7 days, a physician, physician assistant, clinical nurse practitioner or a licensed registered nurse shall screen each respite care person for clinically apparent communicable disease, including tuberculosis, and document the results of the screening. DHS 83.28(4)(b)2.2. If the person did not provide evidence of health screening required under subd. 1., prior to the second admission in a calendar year of a person in respite care, a physician, physician assistant, clinical nurse practitioner or a licensed registered nurse shall screen each respite care person for clinically apparent communicable disease, including tuberculosis, and document the results of the screening. DHS 83.28(4)(b)3.3. Screening for tuberculosis and all immunizations shall be conducted using centers for disease control and prevention standards. DHS 83.28(4)(b)4.4. The CBRF shall maintain the screening documentation for each respite care person. DHS 83.28(5)(5) Temporary service plan. Upon admission, the CBRF shall develop a temporary service plan as required under s. DHS 83.35 (2). DHS 83.28(6)(6) Resident rights, grievance procedure and house rules. Before or at the time of admission, the CBRF shall provide and explain resident rights, the house rules of the CBRF as required under s. DHS 83.32 (2), and the grievance procedure, including written information regarding the names, addresses and telephone numbers of all resident advocacy groups serving the client groups in the facility, including the long term care ombudsman program and the protection and advocacy services of Disability Rights Wisconsin, Inc. DHS 83.28(7)(7) Advanced directives. At the time of admission, the CBRF shall determine if the resident has executed an advanced directive. An advanced directive describes, in writing, the choices about treatments the resident may or may not want and about how health care decisions should be made for the resident if the resident becomes incapacitated and cannot express their wishes. A copy of the document shall be maintained in the resident record as required under s. DHS 83.42 (1) (s). A CBRF may not require an advanced directive as a condition of admission or as a condition of receiving any health care service. An advanced directive may be a living will, power of attorney for health care, or a do-not-resuscitate order under ch. 154 or 155, Stats., or other authority as recognized by the courts of this state. DHS 83.29(1)(a)(a) Definition. In this section, “entrance fee” means a payment required for admission to the CBRF that is in addition to the fees for services and security deposit. DHS 83.29(1)(b)(b) Written information regarding services and charges. Before or at the time of admission, the CBRF shall provide written information regarding services available and the charges for those services to each resident, including persons admitted for respite care, or the resident’s legal representative. This information shall include any charges for services not covered by the daily or monthly rate, any entrance fees, assessment fees and security deposit. DHS 83.29(1)(c)(c) Written notice of any change in services or in charges. The CBRF shall give the resident or the resident’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. DHS 83.29(2)(2) admission agreement requirements. The admission agreement shall be given in writing and explained orally in the language of the prospective resident or legal representative. Admission is contingent on a person or that person’s legal representative signing and dating an admission agreement. The admission agreement shall include all of the following: DHS 83.29(2)(a)(a) An accurate description of the basic services provided, the rate charged for those services and the method of payment. DHS 83.29(2)(b)(b) Information about all additional services offered, but not included in the basic services. The CBRF shall provide a written statement of the fees charged for each of these services. DHS 83.29(2)(c)(c) The method for notifying residents of a change in charges for services. DHS 83.29(2)(d)(d) Terms for resident notification to the CBRF of voluntary discharge. This paragraph does not apply to a resident in the custody of a government correctional agency. DHS 83.29(2)(e)(e) Terms for refunding charges for services paid in advance, entrance fees, or security deposits in the case of transfer, death or voluntary or involuntary discharge. DHS 83.29(2)(f)(f) A statement that the amount of the security deposit may not exceed one month’s fees for services, if a security deposit is collected. DHS 83.29(2)(g)(g) Terms for holding and charging for a resident’s room during a resident’s temporary absence. This paragraph does not apply to a resident in the custody of a government correctional agency. DHS 83.29(2)(h)(h) Reasons and notice requirements for involuntary discharge or transfer, including transfers within the CBRF. This paragraph does not apply to a resident in the custody of a government correctional agency. DHS 83.29(3)(a)(a) The CBRF shall return all refunds due a resident under the terms of the admission agreement within 30 days after the date of discharge. DHS 83.29(3)(b)(b) During the first 6 months following the date of initial admission, the CBRF shall refund the entire entrance fee when the resident is discharged or when the resident meets the terms for notification to the CBRF of voluntary discharge as contained in the CBRF’s admission agreement. DHS 83.29(4)(4) Conflict with this chapter. No statement of the admission agreement may be in conflict with any part of this chapter, unless the department has granted a waiver or variance of a provision of this chapter. DHS 83.29 HistoryHistory: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09. DHS 83.30DHS 83.30 Family care information and referral. If the secretary of the department has certified that a resource center, as defined under s. DHS 10.13 (42), is available for the facility under s. DHS 10.71, the CBRF shall provide information to prospective residents and refer residents and prospective residents to an aging and disability resource center as required under s. 50.035 (4m) and (4n), Stats., and s. DHS 10.73. DHS 83.30 HistoryHistory: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; corrections made under 13.92 (4) (b) 7., Stats., Register January 2009 No. 637; CR 23-046: am. Register April 2024 No. 820, eff. 5-1-24. DHS 83.31(1)(1) Applicability. This section applies to all resident discharges except for persons in respite care. DHS 83.31(2)(2) Emergency or temporary transfers. If a condition or action of a resident requires the emergency transfer of the resident to a hospital, nursing home or other facility for treatment not available from the CBRF, the CBRF may not involuntarily discharge the resident unless the requirements under sub. (4) are met. DHS 83.31(3)(3) Discharge or transfer initiated by resident. DHS 83.31(3)(a)(a) Any competent resident may initiate transfer or discharge at any time in accordance with the terms of the admission agreement if the resident is not in the custody of a government correctional agency, committed under s. 51.20, Stats., or under a court-ordered protective placement under s. 55.12, Stats. DHS 83.31(3)(b)(b) If a resident found incompetent under ch. 54, Stats., protests the resident’s admission or continued stay, the licensee or designee shall immediately notify the legal representative and the county protective services agency to obtain a determination about whether to discharge the resident under s. 55.055 (3), Stats. DHS 83.31(4)(a)1.1. Before a CBRF involuntarily discharges a resident, the licensee shall give the resident or legal representative a 30 day written advance notice. The notice shall explain to the resident or legal representative the need for and possible alternatives to the discharge. Termination of placement initiated by a government correctional agency does not constitute a discharge under this section. DHS 83.31(4)(a)2.2. The CBRF shall provide assistance in relocating the resident and shall ensure that a living arrangement suitable to meet the needs of the resident is available before discharging the resident. DHS 83.31(4)(b)(b) Reasons for involuntary discharge. The CBRF may not involuntarily discharge a resident except for any of the following reasons: DHS 83.31(4)(b)2.2. Care is required that is beyond the CBRF’s license classification. DHS 83.31(4)(b)3.3. Care is required that is inconsistent with the CBRF’s program statement and beyond that which the CBRF is required to provide under the terms of the admission agreement and this chapter. DHS 83.31(4)(b)5.5. There is imminent risk of serious harm to the health or safety of the resident, other residents or employees, as documented in the resident’s record. DHS 83.31(4)(c)(c) Notice requirements. Every notice of involuntary discharge shall be in writing to the resident or resident’s legal representative and shall include all of the following: DHS 83.31(4)(c)1.1. A statement setting forth the reason and justification for discharge listed under par. (b). DHS 83.31(4)(c)2.2. A statement that the resident or the resident’s legal representative may ask the department to review the involuntary discharge by sending a written request within 10 days of receipt of the discharge statement to the department’s regional office with a copy to the CBRF. The notice shall state that the request must provide an explanation why the discharge should not take place. DHS 83.31(4)(c)3.3. The name, address and telephone number of the department’s regional office director. DHS 83.31(4)(c)4.4. The name, address and telephone number of the regional office of the board on aging and long term care’s ombudsman program. For residents with developmental disability or mental illness, the notice shall include the name, address and telephone number of the protection and advocacy agency designated under s. 51.62 (2) (a), Stats. DHS 83.31(4)(d)1.1. A resident may request department review of an involuntary discharge within 10 days of receipt of such notice. If a timely request is sent to the department, the CBRF may not proceed with an involuntary discharge until the department has completed its review and notified the resident or the resident’s legal representative and the CBRF of the department’s decision. DHS 83.31(4)(d)2.2. Within 7 days after receiving the copy of the letter requesting the review, the CBRF may provide to the department’s regional office, additional information justifying the discharge. DHS 83.31(4)(d)3.3. The department shall complete its review within 10 days after the CBRF submits additional information under subd. 2., if any, and will notify in writing the resident or the resident’s legal representative and the CBRF of the department’s decision. DHS 83.31 NoteNote: See Appendix A for the addresses and phone numbers of the Department’s Division of Quality Assurance, Bureau of Assisted Living regional offices.
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