AB1146,7,75 49.45 (6m) (m) By January 1, 2006, 2007, 2008, and 2009, the department shall
6submit a report to the chief clerk of each house of the legislature, for distribution to
7the legislature under s. 13.172 (2), that shall include all of the following:
AB1146,7,88 1. For the preceding calendar year for each facility:
AB1146,7,109 a. The staff turnover rate for registered nurses, licensed practical nurses, and
10nurse's assistants employed by the facility.
AB1146,7,1611 b. The average hourly wage and fringe benefit costs, including specific
12unemployment compensation and worker's compensation costs, for registered
13nurses, licensed practical nurses, nurse's assistants, dietary staff, housekeeping
14staff, and laundry staff employed by the facility and the average hourly cost for
15nonemployee purchased services, if any, of registered nurses, licensed practical
16nurses, and nurse's assistants.
AB1146,7,2017 c. Total revenues and expenses, total net income after taxes, expenses for each
18of the facility's cost centers under par. (am), the medical assistance reimbursement
19rate and method of calculation, the number of patient beds, and the number of
20patient days.
AB1146,7,2221 d. Total cost of recruiting, screening, educating, and training the nursing staff
22of the facility.
AB1146,8,223 e. Any correlation that may be shown between the number of notices of
24violations for class "A," "B," or "C" violations a facility received under s. 50.04, if any,

1and the frequency with which the facility used nonemployee purchased services of
2registered nurses, licensed practical nurses, or nurse's assistants.
AB1146,8,53 2. Recommendations of the department for incentives for facilities to reduce
4reliance on nonemployee purchased services of registered nurses, licensed practical
5nurses, or nurse's assistants.
AB1146, s. 13 6Section 13. 50.02 (2) (bn) of the statutes is amended to read:
AB1146,8,97 50.02 (2) (bn) The department may, by rule, increase the minimum hours of
8nursing home care per day
staffing standards that are specified in s. 50.04 (2) (d) 1.
9to 3.
(e).
AB1146, s. 14 10Section 14. 50.034 (3) (e) of the statutes is created to read:
AB1146,8,1411 50.034 (3) (e) Post in a conspicuous location in the residential care apartment
12complex a notice, provided by the board on aging and long-term care, of the name,
13address, and telephone number of the Long-Term Care Ombudsman Program under
14s. 16.009 (2) (b).
AB1146, s. 15 15Section 15. 50.034 (9) of the statutes is created to read:
AB1146,8,1716 50.034 (9) Assessment on occupied apartments. (a) In this subsection,
17"complex" means a certified or registered residential care apartment complex.
AB1146,8,2018 (b) For the privilege of doing business in this state, there is imposed on all
19occupied apartments of a complex an annual assessment that shall be credited to the
20appropriation account under s. 20.432 (1) (gt) and that is $12 per apartment.
AB1146,9,221 (c) By July 1 annually, a complex shall submit to the department the amount
22due under par. (b) for each occupied apartment of the complex for the preceding June.
23The department shall verify the number of apartments of a complex and, if necessary,
24make adjustments to the payment, notify the complex of changes in the payment

1owing, and send the complex an invoice for the additional amount due or send the
2complex a refund.
AB1146,9,53 (d) Sections 77.59 (1) to (5), (6) (intro.), (a), and (c), and (7) to (10), 77.60 (1) to
4(7), (9), and (10), 77.61 (9) and (12) to (14), and 77.62, as they apply to the taxes under
5subch. III of ch. 77, apply to the assessment under this subsection.
AB1146,9,86 (e) 1. The department shall enforce and collect the assessment under this
7subsection and shall develop and distribute forms necessary for levying and
8collection.
AB1146,9,109 2. The department shall promulgate rules that establish procedures and
10requirements for levying the assessment under this subsection.
AB1146,9,1311 (f) 1. An affected complex may contest an action by the department under this
12subsection by submitting a written request for a hearing to the department within
1330 days after the date of the department's action.
AB1146,9,1514 2. An order or determination made by the department under a hearing as
15specified in subd. 1. is subject to judicial review as prescribed under ch. 227.
AB1146, s. 16 16Section 16. 50.04 (2) (d) of the statutes is repealed.
AB1146, s. 17 17Section 17. 50.04 (2) (e) of the statutes is created to read:
AB1146,9,1818 50.04 (2) (e) 1. In this paragraph:
AB1146,9,2019 a. "Afternoon work shift" means the 8-hour work shift that begins immediately
20after the morning shift.
AB1146,9,2221 b. "Certified nurse's assistant" means a nurse's assistant who meets the
22requirements specified under 42 USC 1296r (b) (5) (A) to (E).
AB1146,9,2423 c. "Evening work shift" means the 8-hour work shift that begins immediately
24after the afternoon work shift.
AB1146,10,2
1d. "Morning work shift" means the first 8-hour work shift that begins after
2midnight.
AB1146,10,113 2. The department shall promulgate rules that specify minimum staffing
4standards that are based on ratios between the number of registered nurses on duty
5in a nursing home per morning work shift, afternoon work shift, or evening work
6shift and the number of residents of the nursing home, between the number of
7licensed practical nurses on duty in a nursing home per morning work shift,
8afternoon work shift, or evening work shift and the number of residents of the
9nursing home, and between the number of certified nurse's assistants on duty in a
10nursing home per morning work shift, afternoon work shift, or evening work shift
11and the number of residents of the nursing home.
AB1146,10,1512 3. By July 1, 2007, the department shall convert the minimum staffing
13requirements specified in s. 50.04 (2) (d), 2005 stats., to the minimum staffing
14standards specified in subd. 2., shall provide training to staff on enforcement of the
15standards, and shall assist nursing homes in implementing the standards.
AB1146,10,1916 4. By July 1, 2007, a nursing home, other than a nursing home that primarily
17serves the developmentally disabled, shall have on duty the number of registered
18nurses, licensed practical nurses, and certified nurse's assistants necessary to satisfy
19the minimum staffing standards developed by the department under subd. 2.
AB1146,11,220 5. A registered nurse, licensed practical nurse, or certified nurse's assistant
21who while on duty provides primarily support services, including food preparation,
22housekeeping, laundry, or maintenance services, may not be counted for purposes of
23calculating the minimum staffing ratios under subd. 2. A registered nurse who is
24employed as a director of nursing, as an assistant director of nursing, or as the charge
25nurse required under par. (b), may not be counted for purposes of calculating the

1minimum staffing requirements under subd. 2. while he or she is performing the
2duties of a director of nursing, assistant director of nursing, or charge nurse.
AB1146,11,113 6. By January 1, 2009, after first referring to the most recent national research
4on nursing home staffing and consulting with representatives of the nursing home
5industry, labor unions that represent nursing home employees, advocates for elderly
6and disabled persons, recognized experts with experience in long-term care
7reimbursement, economists, the attorney general, the federal centers for medicare
8and medicaid services, and other interested parties, the department shall submit a
9report to the governor, and to the chief clerk of each house of the legislature for
10distribution to the legislature under s. 13.172 (2). The report shall contain all of the
11following recommendations:
AB1146,11,1312 a. Proposed methods by which nursing homes are able more effectively to
13recruit and retain caregivers.
AB1146,11,1714 b. Proposed revised minimum nursing home staffing ratios that minimize
15additional state costs, maximize access to care, facilitate care of the highest quality,
16and take into account the levels of care for physical or mental conditions that nursing
17home residents require.
AB1146,11,2218 c. A proposed revised nursing home medical assistance reimbursement
19methodology that more effectively promotes resident care of high quality, advances
20wages and benefits for nursing home workers, supports nursing home provider
21compliance with applicable state statutes and rules and federal statutes and
22regulations, and encourages administrative efficiency.
AB1146, s. 18 23Section 18. 50.065 (2) (am) 2g. of the statutes is created to read:
AB1146,11,2524 50.065 (2) (am) 2g. Information maintained by the department of corrections
25in the registry of sex offenders under s. 301.45 (2).
AB1146, s. 19
1Section 19. 50.065 (2) (am) 2r. of the statutes is created to read:
AB1146,12,42 50.065 (2) (am) 2r. Information on persons convicted of crimes as specified
3under the circuit court automation information system maintained by the Wisconsin
4court system on its Internet site.
AB1146, s. 20 5Section 20. 50.065 (2) (b) 1g. of the statutes is created to read:
AB1146,12,76 50.065 (2) (b) 1g. Information maintained by the department of corrections in
7the registry of sex offenders under s. 301.45 (2).
AB1146, s. 21 8Section 21. 50.065 (2) (b) 2r. of the statutes is created to read:
AB1146,12,119 50.065 (2) (b) 2r. Information on persons convicted of crimes as specified under
10the circuit court automation information system maintained by the Wisconsin court
11system on its Internet site.
AB1146, s. 22 12Section 22. 50.09 (title) of the statutes is amended to read:
AB1146,12,13 1350.09 (title) Rights of residents in certain facilities and complexes.
AB1146, s. 23 14Section 23. 50.09 (1) of the statutes is renumbered 50.09 (1m), and 50.09 (1m)
15(intro.), (b), (c), (e), (f) 1. and 3., (g), (j) (intro.) and 2. (intro.) and a. and (L), as
16renumbered, are amended to read:
AB1146,12,1917 50.09 (1m) Residents' rights. (intro.) Every resident in a nursing home or
18community-based residential
facility or a complex shall, except as provided in sub.
19(5), have the right to:
AB1146,12,2420 (b) Present grievances on the resident's own behalf or others to the facility's
21staff or administrator of the facility or complex, to public officials or to any other
22person without justifiable fear of reprisal, and to join with other residents or
23individuals within or outside of the facility or complex to work for improvements in
24resident care.
AB1146,13,8
1(c) Manage the resident's own financial affairs, including any personal
2allowances under federal or state programs, unless the resident delegates, in
3writing, such this responsibility to the facility or complex and the facility or complex
4accepts the responsibility, or unless the resident delegates to someone else of the
5resident's choosing and that person accepts the responsibility. The resident shall
6receive, upon written request by the resident or guardian, a written monthly account
7of any financial transactions made by the facility or complex under such a delegation
8of responsibility.
AB1146,13,129 (e) Be treated with courtesy, respect and full recognition of the resident's
10dignity and individuality, by all employees of the facility or complex and licensed,
11certified, or registered providers of health care and pharmacists with whom the
12resident comes in contact.
AB1146,13,1613 (f) 1. Privacy for visits by spouse. If both spouses are residents of the same
14facility or complex, they shall be permitted to share a room or apartment unless
15medically contraindicated as documented by the resident's physician in the
16resident's medical record.
AB1146,13,2017 3. Confidentiality of health and personal records, and the right to approve or
18refuse their release to any individual outside the facility or complex, except in the
19case of the resident's transfer to another facility or complex or as required by law or
203rd-party payment contracts and except as provided in s. 146.82 (2) and (3).
AB1146,13,2221 (g) Not to be required to perform services for the facility or complex that are not
22included for therapeutic purposes in the resident's plan of care.
AB1146,14,523 (j) (intro.) Be transferred or discharged, and be given reasonable advance notice
24of any planned transfer or discharge, and an explanation of the need for and
25alternatives to the transfer or discharge. The facility or complex to which the

1resident is to be transferred must have accepted the resident for transfer, except in
2a medical emergency or if the transfer or discharge is for nonpayment of charges
3following a reasonable opportunity to pay a deficiency. No person may be
4involuntarily discharged for nonpayment under this paragraph if the person meets
5all of the following conditions:
AB1146,14,86 2. (intro.) The funding of his or her care in the nursing home or
7community-based residential
facility under s. 49.45 (6m) is reduced or terminated
8because of one of the following:
AB1146,14,109 a. He or she requires a level or type of care which that is not provided by the
10nursing home or community-based residential facility.
AB1146,14,1211 (L) Receive adequate and appropriate care within the capacity of the facility
12or complex.
AB1146, s. 24 13Section 24. 50.09 (1g) of the statutes is created to read:
AB1146,14,1514 50.09 (1g) In this section, "complex" means a residential care apartment
15complex.
AB1146, s. 25 16Section 25. 50.09 (2), (4) and (5) of the statutes are amended to read:
AB1146,14,2017 50.09 (2) The department, in establishing standards for nursing homes and
18community-based residential
facilities and complexes may establish, by rule, rights
19in addition to those specified in sub. (1) (1m) for residents in such the facilities or
20complexes
.
AB1146,15,4 21(4) Each facility or complex shall make available a copy of the rights and
22responsibilities established under this section and the facility's rules of the facility
23or complex
to each resident and each resident's legal representative, if any, at or prior
24to the time of admission to the facility or complex, to each person who is a resident
25of the facility or complex, and to each member of the facility's staff of the facility or

1complex
. The rights, responsibilities, and rules shall be posted in a prominent place
2in each facility or complex. Each facility or complex shall prepare a written plan and
3provide appropriate staff training to implement each resident's rights established
4under this section.
AB1146,15,8 5(5) Rights established under this section shall not, except as determined by the
6department of corrections, be applicable to residents in such facilities or complexes,
7if the resident is in the legal custody of the department of corrections and is a
8correctional client in such a facility or complex.
AB1146, s. 26 9Section 26. 50.09 (6) (a), (b) and (d) of the statutes are amended to read:
AB1146,15,1310 50.09 (6) (a) Each facility or complex shall establish a system of reviewing
11complaints and allegations of violations of residents' rights established under this
12section. The facility or complex shall designate a specific individual who, for the
13purposes of effectuating this section, shall report to the administrator.
AB1146,15,2114 (b) Allegations of violations of such rights by persons licensed, certified, or
15registered under chs. 441, 446 to 450, 455, and 456 shall be promptly reported by the
16facility or complex to the appropriate licensing, examining, or affiliated
17credentialing board and to the person against whom the allegation has been made.
18Any employee of the facility or complex and any person licensed, certified, or
19registered under chs. 441, 446 to 450, 455, and 456 may also report such allegations
20to the board. Such The board may make further investigation and take such
21disciplinary action, within the board's statutory authority, as the case requires.
AB1146,16,222 (d) The facility or complex shall attach a statement, which summarizes
23complaints or allegations of violations of rights established under this section, to the
24report required under s. 50.03 (4) (c) 1. or 2. The statement shall contain the date
25of the complaint or allegation, the name of the persons involved, the disposition of

1the matter, and the date of disposition. The department shall consider the statement
2in reviewing the report.
AB1146, s. 9102 3Section 9102. Nonstatutory provisions; aging and long-term care
board.
AB1146,16,84 (1) Residential care apartment complex activities. The authorized FTE
5positions for the board on aging and long-term care are increased by 1.0 PR position
6on July 1, 2006, to be funded from the appropriation account under section 20.432
7(1) (gt) of the statutes, as created by this act, for the purpose of performing long-term
8care ombudsman activities in residential care apartment complexes.
AB1146, s. 9121 9Section 9121. Nonstatutory provisions; health and family services.
AB1146,16,1410 (1) Nursing home staffing standards; rules. The department of health and
11family services shall submit in proposed form the rules required under section 50.02
12(2) (e) of the statutes, as created by this act, to the legislative council staff under
13section 227.15 (1) of the statutes no later than the first day of the 13th month
14beginning after the effective date of this subsection.
AB1146,16,1915 (2) Nursing home staffing standards; report. By January 1, 2007, the
16department of health and family services shall report to the legislature in the
17manner provided under section 13.172 (3) of the statutes and to the governor
18concerning the status of the department's compliance with the requirements of
19section 50.04 (2) (e) 3. of the statutes, as created by this act.
AB1146,16,2020 (3) Assessments on residential care apartment complexes; rules.
AB1146,17,221 (a) The department of health and family services shall submit in proposed form
22the rules required under section 50.034 (9) (e) 2. of the statutes, as created by this
23act, to the legislative council staff under section 227.15 (1) of the statutes no later

1than the first day of the 4th month beginning after the effective date of this
2paragraph.
AB1146,17,123 (b) Using the procedure under section 227.24 of the statutes, the department
4of health and family services may promulgate rules required under section 50.034
5(9) (e) 2. of the statutes, as created by this act, for the period before the effective date
6of the rules submitted under paragraph (a ), but not to exceed the period authorized
7under section 227.24 (1) (c) and (2) of the statutes. Notwithstanding section 227.24
8(1) (a), (2) (b), and (3) of the statutes, the department is not required to provide
9evidence that promulgating a rule under this paragraph as an emergency rule is
10necessary for the preservation of the public peace, health, safety, or welfare and is
11not required to provide a finding of emergency for a rule promulgated under this
12paragraph.
AB1146,17,2313 (4) Proposal for nursing home quality improvement grant program. By the
14first day of the 7th month beginning after the effective date of this subsection, the
15department of health and family services shall submit to the legislature in the
16manner provided under section 13.172 (2) of the statutes a proposal for legislation
17to create a program to provide grants to nursing homes for quality-of-care
18improvement projects. In creating the proposal, the department of health and family
19services shall consult with advocates for residents of nursing homes, employees of
20or contractors for services with nursing homes or representatives of the employees
21or contractors, nursing home administrators, and experts in long-term care issues.
22Funding for the proposal required under this subsection must be generated within
23the nursing home industry and may not include general purpose revenues.
AB1146, s. 9321 24Section 9321. Initial applicability; health and family services.
AB1146,18,3
1(1) Assessments on residential care apartment complexes. The treatment of
2section 50.034 (9) of the statutes first applies to an assessment due from a residential
3care apartment complex for June 2006.
AB1146, s. 9421 4Section 9421. Effective dates; health and family services. This act takes
5effect on the day after publication, except as follows:
AB1146,18,76 (1) Nursing home staffing standards. The treatment of sections 50.02 (2) (bn)
7and 50.04 (2) (d) of the statutes takes effect on July 1, 2007.
AB1146,18,108 (2) Residential care apartment complexes. The treatment of sections 16.009
9(1) (em) 7., 20.432 (1) (gt), 50.034 (3) (e) and (9), 50.09 (title), 50.09 (1), (1g), (2), (4),
10(5), and (6) (a), (b), and (d) of the statutes takes effect on June 1, 2006.
AB1146,18,1111 (End)
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