DEFINITIONS AND GENERAL PROVISIONS
150.01
150.01
Definitions. In this chapter:
150.01(1)
(1) "Acquisition" includes a change in ownership.
150.01(2)
(2) "Affected party" means the applicant, local planning agencies, governmental agencies, other persons providing similar services in the applicant's service area, the public to be served by the proposed project, 3rd party payers and any other person who the department determines to be affected by an application for approval of a project.
150.01(3)
(3) "Approval" means a written statement from the department authorizing a person to commence implementing a project under review.
150.01(4m)
(4m) "Approved bed capacity" means the bed count collected and verified by the department and by a hospital.
150.01(5)
(5) "Bed capacity" means the number of beds stated on the license of a nursing home issued under
s. 50.03.
150.01(6)
(6) "Capital expenditure" means an expenditure by or on behalf of a nursing home or hospital that, under generally accepted accounting principles, is not properly chargeable as an expense of operations or maintenance.
150.01(8)
(8) "Community-based residential facility" has the meaning specified in
s. 50.01 (1g).
150.01(9)
(9) "Cost overrun" means an obligation exceeding the maximum capital expenditure authorized by an approval.
150.01(10)
(10) "Department" means the department of health and family services.
150.01(16)
(16) "Obligation" means any enforceable contract that is entered into for the construction, leasing, acquisition or permanent financing of a capital asset.
150.01(19)
(19) "Statewide bed limit" means the maximum number of nursing home beds or beds in facilities primarily serving the developmentally disabled allowed to be licensed under
ch. 50.
150.01(20)
(20) "Substantial and continuing progress" means spending more than 20% of a project's approved cost, including fees for legal services, planning studies, financing, consultants, inspections, permits, architectural services and interest during construction.
150.01 Annotation
A new health game. Thomas and Wagner. WBB Feb. 1984.
150.03
150.03
Rule making; forms. The department shall adopt rules and set standards to administer
subchs. I and
II. The department shall create the forms to be used and timetables to be followed under
subchs. I and
II in applying for an approval and in applying for the renewal or modification of an approval. The department shall issue a statement of the applicable rules and procedures to be followed in reviewing an application under
subchs. I and
II with each application form.
150.03 History
History: 1983 a. 27;
1991 a. 250.
150.05
150.05
Actions in circuit court. Notwithstanding the existence or pursuit of any other remedy the department may, after consulting with the attorney general, maintain an action in the name of the state in circuit court to restrain or enjoin any violation of this chapter or rules adopted under this chapter.
150.05 History
History: 1983 a. 27.
150.09
150.09
Staff. The department may employ staff as needed to administer this chapter.
150.09 History
History: 1983 a. 27.
150.11(1)(1) The department may refuse to issue or renew, under
s. 50.03, any license for a nursing home, and may withhold, suspend or revoke, under
s. 50.35, any approval for a hospital, that fails to comply with this chapter.
150.11(2)
(2) No person may recover through charges or rates any depreciation, interest or principal payments or any operating expenses associated with a project subject to
subch. II that does not have the department's approval.
150.11(3)(a)(a) If a project whose cost falls below the minimum threshold specified in
s. 150.21 (3) or
(4) incurs costs exceeding the threshold, the person who operates the project shall submit an application for the department's approval under
s. 150.21.
150.11(3)(b)
(b) If a project that has received the department's approval incurs a cost overrun, the person who operates the project shall submit another application for the department's approval under
s. 150.21.
150.11(3)(c)
(c) Any person required to submit an application under this subsection for the department's approval under
s. 150.21 shall comply with the time limits for submission of applications under
s. 150.33 (3) and
(3m). The department shall afford an applicant under this subsection a reasonable time to obtain its approval but if it rejects the application it may refuse to issue or renew a license or approval, as specified in
sub. (1), and costs associated with the project may not be recovered through charges or rates, as specified in
sub. (2). If the department approves the project it shall impose a forfeiture on the person who operates the project of not less than 10% and not more than 50% of the costs exceeding the threshold under
par. (a) or of the cost overrun under
par. (b). Project approval takes effect only after payment of the forfeiture has been made.
150.11(4)
(4) The department's approval of any project is revoked if the capital expenditures specified in the approval have not been obligated, if financing in an amount sufficient to complete the project has not been obtained or if substantial and continuing progress has not been undertaken within the period specified in the approval. In addition, the department's approval of any project is revoked if the person who operates a project misses any other deadlines specified in the approval and fails to make a good faith effort to meet these deadlines.
150.11(5)
(5) The department may reject the application for approval of a project operated by any person who has repeatedly been subject to the penalties specified in this section or may impose restrictions as part of its approval to ensure compliance with
subchs. I and
II.
150.13
150.13
Fees. Any person applying for approval under
subch. I or
II shall pay an application fee equal to 0.37% of the estimated project cost, but not less than $1,850 and not more than $37,000. No application is complete without payment of the correct fee.
150.13 History
History: 1983 a. 27;
1991 a. 250.
RESOURCE ALLOCATION PROGRAM;
LONG-TERM CARE
150.21
150.21
Applicability. Except as provided in
s. 150.46, this subchapter applies to any person who intends to engage in any of the following activities:
150.21(1)
(1) The construction or total replacement of a nursing home.
150.21(2)
(2) An increase in the bed capacity of a nursing home.
150.21(3)
(3) A capital expenditure that exceeds $1,000,000 by or on behalf of a nursing home.
150.21(4)
(4) An expenditure that exceeds $600,000 for clinical equipment by or on behalf of a nursing home.
150.21(5)
(5) The partial or total conversion of a nursing home to a facility primarily serving the developmentally disabled or of a facility primarily serving the developmentally disabled to a nursing home.
150.27
150.27
Per diem capital rates. An application for approval of an activity specified under
s. 150.21 (1),
(3),
(4) or
(5) shall state the applicant's per diem capital rates, which are the maximum allowable reimbursement that may be granted by the department for the first 12 months following completion of the approved project. If the medical assistance facility payment formula under
s. 49.45 (6m) generates per diem capital rates that are less than those stated in the application under review, the department shall use the lower rates.
150.29
150.29
Approval requirement. 150.29(1)
(1) No person may enter into an obligation for a project described in
s. 150.21 or engage in activities described in that section without the department's prior approval.
150.29(2)
(2) In its approval of any project the department shall specify the total number of approved additional beds and the maximum capital expenditure and per diem rates permitted.
150.29(3)
(3) In determining whether expenditures require prior approval under this section, the department shall aggregate separate expenditures and consider them together if any of the following applies:
150.29(3)(a)
(a) The aggregated expenditures were agreed upon at the same time, authorized by one act or devised or designed as parts of one plan.
150.29(3)(b)
(b) The needs for or purposes of the aggregated expenditures reasonably could have been foreseen when the first expenditure was made, and the aggregated expenditures most economically and efficiently would be made at the same time.
150.29 History
History: 1983 a. 27;
1993 a. 290.
150.31
150.31
Statewide bed limit. 150.31(1)(1) In order to enable the state to budget accurately for medical assistance and to allocate fiscal resources most appropriately, the maximum number of licensed nursing home beds statewide is 51,795 and the maximum number of beds statewide in facilities primarily serving the developmentally disabled is 3,704. The department may adjust these limits on licensed beds as provided in
subs. (2) to
(6). The department shall also biennially recommend changes to this limit based on the following criteria:
150.31(1)(c)
(c) The total number of additional nursing home beds approved under
s. 150.29.
150.31(1)(d)
(d) The availability of alternatives less costly than increasing the number of nursing home beds to provide long-term care.
150.31(1)(e)
(e) The amount of medical assistance funds available or to be made available in the following biennial executive budget for additional nursing home beds.
150.31(1)(f)
(f) The cost of providing additional nursing home beds.
150.31(2)
(2) The department may increase the statewide bed limit specified in
sub. (1) to account for the conversion of community-based residential facilities to nursing homes in order to maintain medical assistance certification, as provided in
s. 49.45 (16).
150.31(2m)(a)(a) The department may, on July 1, 1990, increase the statewide bed limit in
sub. (1) by not more than 25 beds to permit the permanent and complete conversion of a hospital to a nursing home if the hospital seeking conversion:
150.31(2m)(a)1.
1. Had, on January 1, 1990, an approved bed capacity of no more than 50 beds; and
150.31(2m)(a)2.
2. Ceases to exist as an acute care hospital by July 1, 1990.
150.31(2m)(b)
(b) The department shall decrease the number of beds authorized for increase under
par. (a) by the amount of any addition in the actual number of available beds within the limit specified in
sub. (1), up to 25 beds, that exists on July 1, 1990.
150.31(3)
(3) The department may decrease the statewide bed limit specified in
sub. (1) to account for nursing home beds that are not set up or not staffed due to life safety code or physical plant requirements under
s. 50.04, but that have not been permanently removed from the nursing home's bed capacity. In addition, the department may decrease the statewide bed limit specified in
sub. (1) to account for beds closed under a medical assistance waiver, as specified in
42 USC 1396n (c) or under other medical assistance waivers specified in
42 USC 1396 to
1396n.
150.31(4)
(4) The department may decrease the statewide bed limit in facilities primarily serving the developmentally disabled in order to account for any decreased use of beds at the state centers for the developmentally disabled due to the community integration program under
s. 46.275.
150.31(5)
(5) The department may decrease the statewide bed limits specified in
sub. (1) to account for any reduction of available beds not included under
sub. (3) or
(4), in accordance with criteria promulgated by rule.
150.31(5m)
(5m) The department shall decrease the statewide bed limit specified in
sub. (1) to account for any reduction in the approved bed capacity of the nursing home operated at the Wisconsin Veterans Home at King, as specified in
s. 45.375 (2).
150.31(5r)
(5r) The department shall decrease the statewide bed limit specified in
sub. (1) by the number of any beds that a nursing home shall agree to reduce in order to convert a separate area of its total area to an assisted living facility under
s. 50.034 (4) [
(b)].
150.31 Note
NOTE: There is no s. 50.034 (4) (b).
150.31(6)
(6) The department may adjust the statewide bed limits specified in
sub. (1) to account for the partial or total conversion of nursing homes to facilities primarily serving the developmentally disabled or of facilities primarily serving the developmentally disabled to nursing homes. The department may promulgate rules limiting the number of nursing home beds converted under this subsection, allocating the beds so converted, and establishing standards for the limitation and allocation.
150.31(7)
(7) The department may not approve or license any additional nursing home beds if the addition of those beds would exceed the limits established under
subs. (1) to
(6).
150.31(8)
(8) The department may allocate or distribute nursing home beds in a manner, developed by rule, that is consistent with the criteria specified in
sub. (1) (a) to
(f) and
s. 150.39.
150.32
150.32
Distinct-part facilities primarily serving the developmentally disabled. 150.32(1)
(1) Upon application to the department, the department may approve the operation for a period of time not to exceed 4 years of a distinct part of a nursing home as a facility primarily serving the developmentally disabled. Renewals of approvals initially granted under this subsection may be granted for periods of time not to exceed 4 years and only if all of the following conditions are met by the renewal applicant:
150.32(1)(a)
(a) Continued operation of the facility primarily serving the developmentally disabled meets the review criteria and standards under
ss. 150.31 (6) and
150.39.
150.32(1)(b)
(b) There is continued need, as determined by the department, for the facility primarily serving the developmentally disabled in the health planning area in which the facility is located.
150.32(1)(c)
(c) Community-based services, including services developed under
s. 46.278, are inappropriate for the individuals served in the facility primarily serving the developmentally disabled.
150.32(2)
(2) The department may require that a nursing home seeking approval or a facility primarily serving the developmentally disabled seeking renewal under
sub. (1) agree to reduce the size of the facility primarily serving the developmentally disabled, under a plan submitted by the facility and approved by the department, during the approval or renewal period, in order to reflect reduced service need or increased availability of community-based services providing long-term care.
150.32(3)
(3) Notwithstanding
s. 150.31 (6), the department may waive any minimum size limits established under
s. 150.31 (6) for a facility with an approved plan under
sub. (2).
