AB768-ASA1, s. 219 24Section 219. 50.01 (2m) of the statutes is created to read:
AB768-ASA1,147,3
150.01 (2m) "Nursing care" means nursing procedures, other than personal
2care, that are permitted to be performed by a registered nurse under s. 441.01 (3) or
3by a licensed practical nurse under s. 441.11 (3), directly on or to a resident.
AB768-ASA1, s. 220 4Section 220. 50.01 (3) (intro.) of the statutes is amended to read:
AB768-ASA1,147,115 50.01 (3) (intro.)  "Nursing home" means a place which provides 24-hour
6services including board and room to 3 or more unrelated residents who
where 5 or
7more persons who are not related to the operator or administrator reside, receive care
8or treatment and,
because of their mental or physical condition require nursing care
9or personal care in excess of 7 hours a week
, require access to 24-hour nursing
10services, including limited nursing care, intermediate level nursing care and skilled
11nursing services
. "Nursing home" does not include any of the following:
AB768-ASA1, s. 221 12Section 221. 50.01 (4m) of the statutes is amended to read:
AB768-ASA1,147,1513 50.01 (4m) "Operator" means any person licensed or required to be licensed
14under s. 50.03 (1) or a person who operates an adult family home that is licensed
15under s. 50.033 (1m) (b)
.
AB768-ASA1, s. 222 16Section 222. 50.01 (4o) of the statutes is amended to read:
AB768-ASA1,147,1817 50.01 (4o) "Personal care" means assistance with the activities of daily living,
18such as eating, dressing, bathing and ambulation, but does not include nursing care.
AB768-ASA1, s. 223 19Section 223. 50.01 (5) of the statutes is repealed.
AB768-ASA1, s. 223m 20Section 223m. 50.01 (5r) of the statutes is created to read:
AB768-ASA1,147,2221 50.01 (5r) "Registered nurse" means a nurse who is licensed under s. 441.06
22or permitted under s. 441.08.
AB768-ASA1, s. 224 23Section 224. 50.01 (6) of the statutes is amended to read:
AB768-ASA1,148,3
150.01 (6) "Resident" means a person who is cared for or treated in any and is
2not discharged from a
nursing home or ,community-based residential facility or
3adult family home
, irrespective of how admitted.
AB768-ASA1, s. 225 4Section 225. 50.01 (6v) of the statutes is created to read:
AB768-ASA1,148,65 50.01 (6v) "Skilled nursing services" means those services, to which all of the
6following apply, that are provided to a resident under a physician's orders:
AB768-ASA1,148,97 (a) The services require the skills of and are provided directly by or under the
8supervision of a person whose licensed, registered, certified or permitted scope of
9practice is at least equivalent to that of a licensed practical nurse.
AB768-ASA1,148,1010 (b) Any of the following circumstances exist:
AB768-ASA1,148,1311 1. The inherent complexity of a service prescribed for a resident is such that
12it can be safely and effectively performed only by or under the supervision of
13registered nurses or licensed practical nurses.
AB768-ASA1,148,1614 2. The full recovery or medical improvement of the resident is not possible, but
15the services are needed to prevent, to the extent possible, deterioration of the
16resident's condition or to sustain current capacities of the resident.
AB768-ASA1,148,2017 3. Because of special medical complications, performing or supervising a
18service that is generally unskilled or observing the resident necessitates the use of
19a person whose licensed, registered, certified or permitted scope of practice is at least
20equivalent to that of a licensed practical nurse.
AB768-ASA1, s. 225g 21Section 225g. 50.02 (2) (bm) of the statutes is created to read:
AB768-ASA1,148,2422 50.02 (2) (bm) The department shall, by rule, define "intermediate nursing
23care", "limited nursing care" and "skilled nursing services" for use in regulating
24minimum hours of service provided to residents of nursing homes.
AB768-ASA1, s. 225h 25Section 225h. 50.02 (2) (bn) of the statutes is created to read:
AB768-ASA1,149,2
150.02 (2) (bn) The department may, by rule, increase the minimum hours of
2nursing home care per day that are specified in s. 50.04 (2) (d) 1. to 3.
AB768-ASA1, s. 226 3Section 226. 50.035 (10) of the statutes is created to read:
AB768-ASA1,149,74 50.035 (10) Exceptions to care limitations. (a) Notwithstanding the
5limitations on the type of care that may be required by and provided to residents
6under s. 50.01 (1g) (intro.), the following care may be provided in a community-based
7residential facility under the following circumstances:
AB768-ASA1,149,128 1. Subject to par. (b), a community-based residential facility may provide more
9than 3 hours of nursing care per week or care above intermediate level nursing care
10for not more than 30 days to a resident who does not have a terminal illness but who
11has a temporary condition that requires the care, if all of the following conditions
12apply:
AB768-ASA1,149,1413 a. The resident is otherwise appropriate for the level of care that is limited in
14a community-based residential facility under s. 50.01 (1g) (intro.).
AB768-ASA1,149,1615 b. The services necessary to treat the resident's condition are available in the
16community-based residential facility.
AB768-ASA1,149,2317 2. Subject to par. (b) and if a community-based residential facility has obtained
18a waiver from the department or has requested such a waiver from the department
19and the decision is pending, the community-based residential facility may provide
20more than 3 hours of nursing care per week or care above intermediate level nursing
21care for more than 30 days to a resident who does not have a terminal illness but who
22has a stable or long-term condition that requires the care, if all of the following
23conditions apply:
AB768-ASA1,149,2524 a. The resident is otherwise appropriate for the level of care that is limited in
25a community-based residential facility under s. 50.01 (1g) (intro.).
AB768-ASA1,150,2
1b. The services necessary to treat the resident's condition are available in the
2community-based residential facility.
AB768-ASA1,150,53 c. The community-based residential facility has obtained a waiver from the
4department under this subdivision or has requested such a waiver from the
5department and the decision is pending.
AB768-ASA1,150,86 3. A community-based residential facility may provide more than 3 hours of
7nursing care per week or care above intermediate level nursing care to a resident who
8has a terminal illness and requires the care, under the following conditions:
AB768-ASA1,150,109 a. If the resident's primary care provider is a licensed hospice or a licensed home
10health agency.
AB768-ASA1,150,1411 b. If the resident's primary care provider is not a licensed hospice or a licensed
12home health agency, but the community-based residential facility has obtained a
13waiver of the requirement under subd. 3. a. from the department or has requested
14such a waiver and the department's decision is pending.
AB768-ASA1,150,1915 (b) A community-based residential facility may not have a total of more than
164 residents or 10% of the facility's licensed capacity, whichever is greater, who qualify
17for care under par. (a) 1. or 2. unless the facility has obtained a waiver from the
18department of the limitation of this paragraph or has requested such a waiver and
19the department's decision is pending.
AB768-ASA1,150,2120 (c) The department may grant a waiver of the limitation under par. (a) 2. or 3.
21a. or (b).
AB768-ASA1, s. 226bd 22Section 226bd. 50.04 (2) (d) of the statutes is created to read:
AB768-ASA1,150,2523 50.04 (2) (d) Each nursing home, other than nursing homes that primarily
24serve the developmentally disabled, shall provide at least the following hours of
25service by registered nurses, licensed practical nurses or nurse's assistants:
AB768-ASA1,151,3
11. For each resident in need of intensive skilled nursing care, 3.25 hours per
2day, of which a minimum of 0.65 hour shall be provided by a registered nurse or
3licensed practical nurse.
AB768-ASA1,151,64 2. For each resident in need of skilled nursing care, 2.5 hours per day, of which
5a minimum of 0.5 hour shall be provided by a registered nurse or licensed practical
6nurse.
AB768-ASA1,151,97 3. For each resident in need of intermediate or limited nursing care, 2.0 hours
8per day, of which a minimum of 0.4 hour shall be provided by a registered nurse or
9licensed practical nurse.
AB768-ASA1, s. 226bm 10Section 226bm. 50.04 (2v) of the statutes, as affected by 1997 Wisconsin Act
11114
, is renumbered 50.04 (2v) (intro.) and amended to read:
AB768-ASA1,151,1312 50.04 (2v) Posting of notice required. (intro.) A nursing home shall post in
13a conspicuous location in the nursing home a all of the following:
AB768-ASA1,151,16 14(a) A notice, provided by the board on aging and long-term care, of the name,
15address and telephone number of the long-term care ombudsman program under s.
1616.009 (2) (b).
AB768-ASA1, s. 226br 17Section 226br. 50.04 (2v) (b) of the statutes is created to read:
AB768-ASA1,151,1918 50.04 (2v) (b) The most recent copy of the report for the nursing home that is
19specified under s. 50.095 (3).
AB768-ASA1, s. 226c 20Section 226c. 50.04 (4) (d) of the statutes is created to read:
AB768-ASA1,151,2221 50.04 (4) (d) Suspension of admissions. 1. The department shall suspend new
22admissions to a nursing home if all of the following apply:
AB768-ASA1,151,2423 a. The nursing home received notices of violation for a class "A" violation or 3
24or more class "B" violations in the previous 12 months.
AB768-ASA1,152,3
1b. The nursing home received notices of violation for a class "A" violation or 3
2or more class "B" violations in any 12-month period during the 3 years immediately
3preceding the period specified in subd. 1. a.
AB768-ASA1,152,154 2. A suspension of admissions under subd. 1. shall begin 90 days after a nursing
5home received its last notice of violation for a class "A" or class "B" violation if the
6department determines that the violation remains uncorrected 90 days after the
7nursing home received the last notice of the violation. If the nursing home indicates
8to the department that the violation has been corrected, but the department is
9unable to verify that the violation has been corrected, a suspension of admissions
10under subd. 1. shall begin on the day that the department makes a return visit to the
11nursing home and determines that the violation has not been corrected. A
12suspension of admissions under subd. 1. shall remain in effect until the department
13determines that all class "A" and class "B" violations by the nursing home have been
14corrected. Admission of a new resident during the period for which admissions have
15been suspended constitutes a class "B" violation.
AB768-ASA1,152,1716 3. In determining whether subd. 1. applies, the department may not consider
17a notice of violation found to be unjustified after hearing.
AB768-ASA1,152,2018 4. If the department suspends new admissions to a nursing home under this
19paragraph, the department shall publish a class 1 notice under ch. 985 in a
20newspaper likely to give notice in the area where the nursing home is located.
AB768-ASA1, s. 226d 21Section 226d. 50.04 (5) (a) 1., 2. and 3. (intro.) of the statutes are amended to
22read:
AB768-ASA1,152,2423 50.04 (5) (a) 1. A class "A" violation may be subject to a forfeiture of not more
24than $5,000 $10,000 for each violation.
AB768-ASA1,153,2
12. A class "B" violation may be subject to a forfeiture of not more than $1,000
2$5,000 for each violation.
AB768-ASA1,153,53 3. (intro.) A class "C" violation may be subject to a forfeiture of not more than
4$100 $500. No forfeiture may be assessed for a class "C" violation unless at least one
5of the following applies:
AB768-ASA1, s. 226e 6Section 226e. 50.04 (5) (a) 5. of the statutes is repealed and recreated to read:
AB768-ASA1,153,107 50.04 (5) (a) 5. a. A nursing home that violates a statute or rule resulting in a
8class "A" violation and that has received a notice of violation for a class "A" violation
9within the previous 3-year period shall be subject to a forfeiture 3 times the amount
10authorized for a class "A" violation.
AB768-ASA1,153,1411 b. Except as provided in subd. 5. a., a nursing home that violates a statute or
12rule resulting in a class "A" or class "B" violation and that has received a notice of
13violation of the same statute or rule within the previous 3-year period may be subject
14to a forfeiture 3 times the amount authorized for a class "B" violation.
AB768-ASA1,153,1615 c. A notice of violation found to be unjustified after hearing may not be
16considered in applying this subdivision.
AB768-ASA1,153,2117 d. The forfeiture amount that is tripled under this subdivision shall be the
18amount assessed after all appeals have been exhausted. If an assessment of
19forfeiture is not contested and the forfeiture is paid as provided in par. (fm), the
20forfeiture amount that is tripled is the amount assessed after the reduction specified
21in par. (fm).
AB768-ASA1, s. 226f 22Section 226f. 50.04 (5) (a) 6. of the statutes is amended to read:
AB768-ASA1,154,523 50.04 (5) (a) 6. If a licensee fails to correct a violation within the time specified
24in the notice of violation or approved plan of correction, or within the extended
25correction time granted under sub. (4) (c) 4., or if a violation continues after a report

1of correction, a separate forfeiture may be assessed the department may assess upon
2the licensee in an amount not to exceed a separate forfeiture of not more than $10,000
3for class "A" violations, and may assess a separate forfeiture of not more than $5,000
4for class "B" violations
, for each day of continuing violation , $5,000 for class "A"
5violations and $1,000 for class "B" violations
.
AB768-ASA1, s. 226g 6Section 226g. 50.04 (5) (fm) of the statutes is created to read:
AB768-ASA1,154,117 50.04 (5) (fm) Forfeiture reduction for timely payment. If a nursing home does
8not contest a notice of violation under sub. (4) (e) and does not contest an assessment
9of forfeiture under par. (e) for a class "A" or class "B" violation and pays the forfeiture
10to the department within 10 days after receipt of the notice of assessment, the
11department shall reduce the amount of the assessment by 35%.
AB768-ASA1, s. 226h 12Section 226h. 50.04 (5) (fr) of the statutes is created to read:
AB768-ASA1,154,1913 50.04 (5) (fr) Report to the legislature. Annually, the department shall submit
14a report to the legislature under s. 13.172 (2) that specifies for the previous year the
15number of class "A" violations, the amount of the forfeiture assessment for each of
16those violations and, if known, the amount of the forfeiture actually paid and
17collected with respect to those violations. The report shall also include an
18explanation for any assessment that was less than $2,500 for the violations specified
19in the report.
AB768-ASA1, s. 227 20Section 227. 50.065 (1) (am) of the statutes is created to read:
AB768-ASA1,154,2221 50.065 (1) (am) "Certificate of approval" means a certificate of approval issued
22under s. 50.35.
AB768-ASA1, s. 228 23Section 228. 50.065 (1) (b) of the statutes, as created by 1997 Wisconsin Act
2427
, is amended to read:
AB768-ASA1,155,2
150.065 (1) (b) "Client" means a person who receives direct care or treatment
2services from an entity.
AB768-ASA1, s. 229 3Section 229. 50.065 (1) (c) (intro.) of the statutes, as created by 1997 Wisconsin
4Act 27
, is amended to read:
AB768-ASA1,155,95 50.065 (1) (c) (intro.) "Entity" means a facility, organization or service that is
6regulated, licensed or certified by or registered with the department to provide direct
7care or treatment services to clients
. "Entity" includes a hospital, a personal care
8worker agency and a supportive home care service agency. "Entity" does not include
9any of the following:
AB768-ASA1, s. 230 10Section 230. 50.065 (1) (c) 3. of the statutes, as created by 1997 Wisconsin Act
1127
, is amended to read:
AB768-ASA1,155,1412 50.065 (1) (c) 3. A person certified as a medical assistance provider, as defined
13in s. 49.43 (10), who is not otherwise regulated approved under s. 50.065 (1) (cm),
14licensed or certified by or registered with the department.
AB768-ASA1, s. 231 15Section 231. 50.065 (1) (c) 5. of the statutes, as created by 1997 Wisconsin Act
1627
, is repealed.
AB768-ASA1, s. 232 17Section 232. 50.065 (1) (c) 6. of the statutes is created to read:
AB768-ASA1,155,1818 50.065 (1) (c) 6. A public health dispensary established under s. 252.10.
AB768-ASA1, s. 233 19Section 233. 50.065 (1) (cm) of the statutes is created to read:
AB768-ASA1,155,2120 50.065 (1) (cm) "Hospital" means a facility approved as a hospital under s.
2150.35.
AB768-ASA1, s. 234 22Section 234. 50.065 (2) (a) (intro.) of the statutes, as created by 1997 Wisconsin
23Act 27
, is amended to read:
AB768-ASA1,156,324 50.065 (2) (a) (intro.) Notwithstanding s. 111.335, and except as provided in
25sub. (5), the department may not license, certify, issue a certificate of approval to or

1register
a person to operate an entity or continue the license, certification, certificate
2of approval or registration
of a person to operate an entity if the department knows
3or should have known any of the following:
AB768-ASA1, s. 235 4Section 235. 50.065 (2) (am) (intro.) of the statutes, as created by 1997
5Wisconsin Act 27
, is amended to read:
AB768-ASA1,156,96 50.065 (2) (am) (intro.) The Subject to subd. 5. and par. (bd), the department
7shall obtain all of the following with respect to a person specified under par. (a)
8(intro.) and a person specified under par. (ag) (intro.) who is a nonclient resident or
9prospective nonclient resident of an entity
:
AB768-ASA1, s. 236 10Section 236. 50.065 (2) (am) 5. of the statutes is created to read:
AB768-ASA1,156,2111 50.065 (2) (am) 5. Information maintained by the department under this
12section regarding any denial to the person of a license, certification, certificate of
13approval or registration or of a continuation of a license, certification, certificate of
14approval or registration to operate an entity for a reason specified in par. (a) 1. to 5.
15and regarding any denial to the person of employment at, a contract with or
16permission to reside at an entity for a reason specified in par. (ag) 1. to 5. If the
17information obtained under this subdivision indicates that the person has been
18denied a license, certification, certificate of approval or registration, continuation of
19a license, certification, certificate of approval or registration, a contract, employment
20or permission to reside as described in this subdivision, the department need not
21obtain the information specified in subds. 1. to 4.
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