Chapter DHS 83

DHS 83.14(2)(d) (d) The licensee shall provide to each resident, or the resident’s legal representative, referral agency and third party payer, a 30-day written notice of any change in size, class or client group.

DHS 83.14(2)(e) (e) The licensee shall notify the department within 7 days after there is a change in the administrator.

DHS 83.14(2)(f) (f) The licensee shall ensure a copy of this chapter is in the CBRF.

DHS 83.14(2)(g) (g) 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 83.14(2)(h) (h) The licensee shall post the CBRF license, any statement of deficiency, notice of revocation and any other notice of enforcement action in a public area that is visually and physically available. A statement of deficiency shall remain posted for 90 days following receipt. Notices of revocation and other notices of enforcement action shall remain posted until a final determination is made.

DHS 83.14(2)(i) (i) The licensee shall make available the results of all department license renewal surveys, monitoring visits and any complaint investigations for the preceding 2 years when requested by any current or prospective resident, resident’s legal representative, case manager or family member.

DHS 83.14(2)(j) (j) The licensee may not permit the existence or continuation of any condition which is or may create a substantial risk to the health, safety or welfare of any resident.

DHS 83.14(2)(k) (k) The licensee shall ensure that the presence of other occupants does not adversely affect the health, safety or welfare of residents.

DHS 83.14 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; correction in (1) (b) made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637.

DHS 83.15 DHS 83.15 Administrator.

DHS 83.15(1) (1) Qualifications. The administrator of a CBRF shall be at least 21 years of age and exhibit the capacity to respond to the needs of the residents and manage the complexity of the CBRF. The administrator shall have any one of the following qualifications:

DHS 83.15(1)(a) (a) An associate degree or higher from an accredited college in a health care related field.

DHS 83.15(1)(b) (b) A bachelor’s degree in a field other than in health care from an accredited college and one year experience working in a health care related field having direct contact with one or more of the client groups identified under s. DHS 83.02 (16).

DHS 83.15(1)(c) (c) A bachelor’s degree in a field other than in health care from an accredited college and have successfully completed an assisted living administrator’s training course approved by the department or the department’s designee.

DHS 83.15(1)(d) (d) At least 2 years experience working in a health care related field having direct contact with one or more of the client groups identified under s. DHS 83.02 (16) and have successfully completed an assisted living administrator’s training course approved by the department or the department’s designee.

DHS 83.15(1)(e) (e) A valid nursing home administrator’s license issued by the department of safety and professional services.

DHS 83.15(2) (2) Persons who are the qualified administrator of record with the department of a CBRF on April 1, 2009, shall be exempt from the qualification requirements specified under sub. (1).

DHS 83.15(3) (3) Responsibilities.

DHS 83.15(3)(a) (a) The administrator shall supervise the daily operation of the CBRF, including but not limited to, resident care and services, personnel, finances, and physical plant. The administrator shall provide the supervision necessary to ensure that the residents receive proper care and treatment, that their health and safety are protected and promoted and that their rights are respected.

DHS 83.15(3)(b) (b) The administrator shall be responsible for the training and competency of all employees.

DHS 83.15(3)(c) (c) A qualified resident care staff shall be designated as in charge whenever the administrator is absent from the CBRF.

DHS 83.15 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; CR 10-091: am. (1) (c) and (d) Register December 2010 No. 660, eff. 1-1-11; correction in (1) (e) made under s. 13.92 (4) (b) 6., Stats., Register December 2011 No. 672.

DHS 83.16 DHS 83.16 Employee.

DHS 83.16(1) (1) Each employee shall have the skills, education, experience and ability to fulfill the employee’s job requirements.

DHS 83.16(2) (2) Resident care staff shall be at least 18 years old.

DHS 83.16 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

DHS 83.17 DHS 83.17 Hiring and employment.

DHS 83.17(1) (1) Caregiver background check. At the time of hire, employment or contract and every 4 years after, the licensee shall conduct and document a caregiver background check following the procedures in s. 50.065, Stats., and ch. DHS 12. A licensee shall not employ, contract with or permit a person to reside at the CBRF if the person has been convicted of the crimes or offenses, or has a governmental finding of misconduct, found in s. 50.065, Stats., and ch. DHS 12, Appendix A, unless the person has been approved under the department’s rehabilitation process as defined in ch. DHS 12.

DHS 83.17(2) (2) Employee health communicable disease control.

DHS 83.17(2)(a) (a) The CBRF shall obtain documentation from a physician, physician assistant, clinical nurse practitioner or a licensed registered nurse indicating all employees have been screened for clinically apparent communicable disease including tuberculosis. Screening for tuberculosis shall be conducted using centers for disease control and prevention standards. The screening and documentation shall be completed within 90 days before the start of employment. The CBRF shall keep screening documentation confidential, except the department shall have access to the screening documentation for verification purposes.

DHS 83.17(2)(b) (b) Employees shall be re-screened for clinically apparent communicable disease as described in par. (a) based on the likelihood of exposure to communicable disease, including tuberculosis.

DHS 83.17(2)(c) (c) A person who has a communicable disease shall not be permitted to work or be present in the CBRF if the disease would present a risk to the health or safety of residents.

DHS 83.17 Note Note: For information from the center for disease control and prevention regarding screening for tuberculosis go to http://www.cdc.gov/

DHS 83.17 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; corrections in (1) made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637.

DHS 83.18 DHS 83.18 Employee records.

DHS 83.18(1) (1) A separate record for each employee shall be maintained, kept current, and at a minimum, include:

DHS 83.18(1)(a) (a) A written job description including duties, responsibilities and qualifications required for the employee.

DHS 83.18(1)(b) (b) Beginning date of employment.

DHS 83.18(1)(c) (c) Educational qualifications for administrators.

DHS 83.18(1)(d) (d) A completed caregiver background check following procedures under s. 50.065, Stats., and ch. DHS 12.

DHS 83.18(1)(e) (e) Documentation of training, or exemption verification.

DHS 83.18(2) (2) Employee records shall be available upon request at the CBRF for review by the department.

DHS 83.18 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; correction in (1) (d) made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637.

subch. IV of ch. DHS 83 Subchapter IV — Orientation and Training

DHS 83.19 DHS 83.19 Orientation. Before an employee performs any job duties, the CBRF shall provide each employee with orientation training which shall include all of the following:

DHS 83.19(1) (1) Job responsibilities.

DHS 83.19(2) (2) Prevention and reporting of resident abuse, neglect and misappropriation of resident property.

DHS 83.19(3) (3) Information regarding assessed needs and individual services for each resident for whom the employee is responsible.

DHS 83.19(4) (4) Emergency and disaster plan and evacuation procedures under s. DHS 83.47 (2).

DHS 83.19(5) (5) CBRF policies and procedures.

DHS 83.19(6) (6) Recognizing and responding to resident changes of condition.

DHS 83.19 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

DHS 83.20 DHS 83.20 Department-approved training.

DHS 83.20(1) (1) Approved training.

DHS 83.20(1)(a) (a) Training for standard precautions, fire safety, first aid and choking, and medication administration and management shall be approved by the department or designee and shall be provided by trainers approved by the department or designee. Approvals for training plans and trainers for standard precautions, fire safety, first aid and choking, and medication administration and management issued before April 1, 2009, shall expire April 1, 2010.

DHS 83.20(1)(b) (b) The CBRF shall maintain documentation of the training in par. (a), including the trainer approval number, the name of the employee, training topic and the date training was completed.

DHS 83.20(2) (2) Approved courses.

DHS 83.20(2)(a) (a) Standard precautions. All employees who may be occupationally exposed to blood, body fluids or other moist body substances, including mucous membranes, non-intact skin, secretions, and excretions except sweat, whether or not they contain visible blood shall successfully complete training in standard precautions before the employee assumes any responsibilities that may expose the employee to such material.

DHS 83.20(2)(b) (b) Fire safety. Within 90 days after starting employment, all employees shall successfully complete training in fire safety.

DHS 83.20(2)(c) (c) First aid and choking. Within 90 days after starting employment, all employees shall successfully complete training in first aid and procedures to alleviate choking.

DHS 83.20(2)(d) (d) Medication administration and management. Any employee who manages, administers or assists residents with prescribed or over-the-counter medications shall complete training in medication administration and management prior to assuming these job duties.

DHS 83.20 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

DHS 83.21 DHS 83.21 All employee training. The CBRF shall provide, obtain or otherwise ensure adequate training for all employees in all of the following:

DHS 83.21(1) (1) Resident rights. Training shall include general rights of residents including rights as specified under s. DHS 83.32 (3). Training shall be provided as applicable under ss. 50.09 and 51.61 and chs. 54, 55, and 304, Stats., and ch. DHS 94, depending on the legal status of the resident or service the resident is receiving. Specific training topics shall include house rules, coercion, retaliation, confidentiality, restraints, self-determination, and the CBRF’s complaint and grievance procedures. Residents’ rights training shall be completed within 90 days after starting employment.

DHS 83.21(2) (2) Client group.

DHS 83.21(2)(a) (a) Training shall be specific to the client group served and shall include the physical, social and mental health needs of the client group. Specific training topics shall include, as applicable: characteristics of the client group served, activities, safety risks, environmental considerations, disease processes, communication skills, nutritional needs, and vocational abilities. Client group specific training shall be completed within 90 days after starting employment.

DHS 83.21(2)(b) (b) In a CBRF serving more than one client group, employees shall receive training for each client group.

DHS 83.21(3) (3) Recognizing, preventing, managing and responding to challenging behaviors. Specific training topics shall include, as applicable: elopement, aggressive behaviors, destruction of property, suicide prevention, self-injurious behavior, resident supervision, and changes in condition. Challenging behaviors training shall be completed within 90 days after starting employment.

DHS 83.21 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; correction in (1) made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637.

DHS 83.22 DHS 83.22 Task specific training. The CBRF shall provide, obtain or otherwise ensure adequate training for employees performing job duties in all of the following:

DHS 83.22(1) (1) Assessment of residents. All employees responsible for resident assessment shall successfully complete training in the assessment of residents prior to assuming these job duties. Specific training topics shall include: assessment methodology, assessment of changes in condition, sources of assessment information, and documentation of the assessment.

DHS 83.22(2) (2) Individual service plan development. All employees responsible for service plan development shall successfully complete training in individual service plan development prior to assuming these job duties. Specific training topics shall include: identification of the resident’s needs and desired outcomes, development of goals and interventions, service plan evaluation and review of progress.

DHS 83.22(3) (3) Provision of personal care. All employees responsible for providing assistance with activities of daily living shall successfully complete training prior to assuming these job duties. Specific training topics shall include, as appropriate: bathing, eating, dressing, oral hygiene, nail and foot care, toileting and incontinence care, positioning and body alignment, and mobility and transferring.

DHS 83.22(4) (4) Dietary training. All employees performing dietary duties shall complete dietary training within 90 days after assuming these job duties. Specific training topics shall include: determining nutritional needs, menu planning, food preparation and food sanitation.

DHS 83.22 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

DHS 83.23 DHS 83.23 Employee supervision. Until an employee has completed all required training, the employee shall be directly supervised by the administrator or by qualified resident care staff.

DHS 83.23 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

DHS 83.24 DHS 83.24 Exemptions.

DHS 83.24(1) (1) Exemptions for completed training. Employees who have completed department-approved training in standard precautions, fire safety, first aid and choking, and medication administration and management prior to or on April 1, 2009, or who receive such training within one year after April 1, 2009, shall be exempt from the training specified under s. DHS 83.20 (2).

DHS 83.24(2) (2) General exemptions. A practitioner, licensed pharmacist, registered nurse or licensed practical nurse is exempt from training specified in ss. DHS 83.20 (2) (a), (c) and (d), 83.21 and 83.22.

DHS 83.24(3) (3) Exemptions from standard precautions training. Except as stated in subs. (1) and (2), the following individuals are exempt from training in standard precautions:

DHS 83.24(3)(a) (a) Emergency medical services practitioners.

DHS 83.24(3)(b) (b) Employees who can provide documentation that they have had training from a regulated health care entity in the practice of standard precautions within the previous year.

DHS 83.24(3)(c) (c) A nurse aide certified after 1999 and in good standing on the Wisconsin Nurse Aide Registry.

DHS 83.24(4) (4) Exemptions from fire safety training. Except as stated under sub. (1), firefighters are exempt from training in fire safety.

DHS 83.24(5) (5) Exemptions from first aid and choking training. Except as stated in subs. (1) and (2), the following individuals are exempt from training in first aid and choking:

DHS 83.24(5)(a) (a) Emergency medical technicians.

DHS 83.24(5)(b) (b) Student nurses who have successfully completed related training.

DHS 83.24(6) (6) Exemptions from medication administration and management training. Except as stated under subs. (1) and (2), the following individuals are exempt from medication administration and management training: