50.034(2)(e)
(e) Establishing intermediate sanctions and penalties for and standards and procedures for imposing intermediate sanctions or penalties on certified assisted living facilities and for appeals of intermediate sanctions or penalties.
50.034(2)(f)
(f) Establishing standards and procedures for appeals of revocations of certification or refusal to issue or renew certification.
50.034(3)
(3) Requirements for operation. A certified or registered assisted living facility shall do all of the following:
50.034(3)(a)
(a) Establish, with each resident of the assisted living facility, a mutually agreed-upon written service agreement that identifies the services to be provided to the resident, based on a comprehensive assessment of the resident's needs and preferences that is conducted by one of the following:
50.034(3)(a)3.
3. For residents who have private or 3rd-party funding, by the assisted living facility.
50.034(3)(b)
(b) Establish a schedule of fees for services to residents of the assisted living facility.
50.034(3)(c)
(c) Provide or ensure the provision of services that are sufficient and qualified to meet the needs identified in a resident's service agreement under
par. (a), to meet unscheduled care needs and to provide emergency assistance 24 hours a day.
50.034(3)(d)
(d) Establish, with each resident of the assisted living facility, a signed, negotiated risk agreement that identifies situations that could put the resident at risk and for which the resident understands and accepts responsibility.
50.034(4)
(4) Limitation. A nursing home or a community-based residential facility may not convert a separate area of its total area to an assisted living facility unless the department first approves the conversion. A nursing home, other than the nursing home operated at the Wisconsin Veterans Home at King, that intends to convert a separate area of its total area to an assisted living facility shall also agree to reduce its licensed nursing home beds by the corresponding number of assisted living facility residential units proposed for the conversion.
50.034(5)
(5) Use of name prohibited. An entity that does not meet the definition under
s. 50.01 (1d) may not designate itself as an "assisted living facility" or use the word "assisted living facility" to represent or tend to represent the entity as an assisted living facility or services provided by the entity as services provided by an assisted living facility.
50.034(6)
(6) Funding. Funding for supportive, personal or nursing services that a person who resides in an assisted living facility receives, other than private or 3rd-party funding, may be provided only under
s. 46.27 (11) (c) 7. or
46.277 (5) (e), unless the provider of the services is a certified medical assistance provider under
s. 49.45.
50.034(7)
(7) Revocation of certification. Certification for an assisted living facility may be revoked because of the substantial and intentional violation of this section or of rules promulgated by the department under
sub. (2) or because of failure to meet the minimum requirements for certification. The operator of the certified assisted living facility shall be given written notice of any revocation of certification and the grounds for the revocation. Any assisted living facility certification applicant or operator of a certified assisted living facility may, if aggrieved by the failure to issue or renew the certification or by revocation of certification, appeal under the procedures specified by the department by rule under
sub. (2).
50.034 History
History: 1995 a. 27.
50.035
50.035
Special provisions relating to regulation of community-based residential facilities. 50.035(1)
(1)
Personnel training. Each employe of a community-based residential facility shall, within 90 days after the beginning date of employment, receive basic first aid training and other safety training. The department shall indicate acceptable sources from which facility employes may receive this training. The department shall also develop instructional materials for use by facilities concerning acceptable methods of operation and procedures for protecting and serving the needs of facility residents. The department may require that all facility employes complete a program involving these materials and may sell the materials to facilities at cost. In addition, each facility employe shall, within 90 days after the beginning date of employment, receive training in fire prevention and control and evacuation techniques. Each facility shall coordinate its training in fire prevention and control and evacuation techniques with the local fire department.
50.035(2)(a)1.1. Except as provided in
subd. 2., each community-based residential facility shall provide, at a minimum, a low-voltage interconnected smoke detection system to protect the entire facility that, if any detector is activated, either triggers alarms throughout the building or triggers an alarm located centrally.
50.035(2)(a)2.
2. A community-based residential facility that has 8 or less beds may use a radio-transmitting smoke detection system that triggers an audible alarm in a central area of the facility in lieu of the interconnected smoke detection system specified in
subd. 1.
50.035(2)(a)3.
3. The department or the department of commerce may waive the requirement under
subd. 1. or
2. for a community-based residential facility that has a smoke detection or sprinkler system in place that is at least as effective for fire protection as the type of system required under the relevant subdivision.
50.035(2)(b)
(b) No facility may install a smoke detection system that fails to receive the approval of the department or of the department of commerce. At least one smoke detector shall be located at each of the following locations:
50.035(2)(b)2.
2. At the door leading to every enclosed stairway on each floor level.
50.035(2)(b)3.
3. In every corridor, spaced not more than 30 feet apart and not further than 15 feet from any wall.
50.035(2)(b)4.
4. In each common use room, including living rooms, dining rooms, family rooms, lounges and recreation rooms but not including kitchens.
50.035(2)(c)
(c) A community-based residential facility does not have to meet the requirements under
pars. (a) and
(b) prior to May 1, 1985. Beginning on May 1, 1985, the department may waive the requirements under
pars. (a) and
(b) for a community-based residential facility for a period not to exceed 6 months if the department finds that compliance with those requirements would result in an extreme hardship for the facility.
50.035(3)
(3) Manager's presence in facility. 50.035(3)(a)(a) The person responsible for managing a Class C community-based residential facility, or that person's agent, shall be present in the facility at any time that residents are in the facility. The person responsible for managing a Class A or a Class B community-based residential facility, or that person's agent, shall be present in the facility from 7 p.m. to 7 a.m. when residents are in the facility and the person responsible for managing a Class B community-based residential facility, or that person's agent, shall be readily available to the residents of the facility from 7 a.m. to 7 p.m. In this subsection, "Class A, B and C community-based residential facilities" have the meanings provided in
s. HSS 3.41 (1), Wis. adm. code.
50.035(3)(b)
(b) The department may waive a requirement under
par. (a) for a community-based residential facility:
50.035(3)(b)1.
1. For a specified period of time, not to exceed one year, if the department finds that compliance with the requirement would result in an unreasonable hardship for the facility and that all of the residents are physically and mentally capable of taking independent action in an emergency; or
50.035(3)(b)2.
2. For a specified period of time if the department finds that the primary purpose of the facility's program is to promote the independent functioning of its residents with minimum supervision.
50.035(4)
(4) Fire notice. The licensee of a community-based residential facility, or his or her designee, shall notify the department and any county department under
s. 46.215 or
46.22 that has residents placed in the facility of any fire that occurs in the facility for which the fire department is contacted. The notice shall be provided within 72 hours after such a fire occurs.
50.035(5)(a)1.b.
b. A device or garment that interferes with an individual's freedom of movement and that the individual is unable to remove easily.
50.035(5)(a)1.c.
c. Restraint by a facility staff member of a resident by use of physical force.
50.035(5)(a)2.
2. "Psychotropic medication" means an antipsychotic, antidepressant, lithium carbonate or a tranquilizer.
50.035(5)(b)
(b) No later than 24 hours after the death of a resident of a community-based residential facility, the community-based residential facility shall report the death to the department if one of the following applies:
50.035(5)(b)1.
1. There is reasonable cause to believe that the death was related to the use of physical restraint or a psychotropic medication.
50.035(5)(b)3.
3. There is reasonable cause to believe that the death was a suicide.
50.035(6)
(6) Posting of notice required. Beginning on January 1, 1992, the licensee of a community-based residential facility, or his or her designee, shall post in a conspicuous location in the community-based residential facility a notice, provided by the board on aging and long-term care, of the name, address and telephone number of the long-term care ombudsman program under
s. 16.009 (2) (b).
50.035(7)
(7) Statement of financial condition required. 50.035(7)(a)(a) No community-based residential facility may initially admit as a resident an individual who applies for admission to the facility and who intends to pay for residence in the facility from private funds, unless the individual provides certain financial information to the community-based residential facility. From this information, the community-based residential facility shall prepare and provide to the individual a statement of financial condition to which all of the following apply:
50.035(7)(a)2.
2. The statement estimates a date, if any, by which the individual's assets and other private funding sources would be depleted if the individual resides continuously in the community-based residential facility.
50.035(7)(a)3.
3. The statement indicates that public funding may not be available when the individual's assets and other private funding sources, if any, are depleted and specifies options that may be available to the individual at that time.
50.035(7)(b)
(b) The individual shall waive his or her right to confidentiality for the information provided under
par. (a), to the administrator of the community-based residential facility, to the preparer of the statement of financial condition and, if
par. (c) applies, to the county department under
s. 46.215 or
46.22.
50.035(7)(c)
(c) If the date estimated under
par. (a) 2. is less than 24 months after the date of the individual's statement of financial condition, the community-based residential facility shall provide the statement to the county department under
s. 46.215 or
46.22.
50.037
50.037
Community-based residential facility licensing fees. 50.037(1)(1)
Definition. In this section, "total monthly charges" means the total amount paid per month, including the basic monthly rate plus any additional fees, for care, treatment and services provided to a resident of a community-based residential facility by a community-based residential facility.
50.037(2)(a)(a) The biennial fee for a community-based residential facility is $170, plus an annual fee of $22 per resident, based on the number of residents that the facility is licensed to serve.
50.037(2)(b)
(b) Such fees shall be paid to the department by the community-based residential facility before the department may issue a license under
s. 50.03 (4) (a) 1. b. A community-based residential facility that wishes to renew a license issued under
s. 50.03 (4) (a) 1. b. shall pay the fee under
par. (a) by the renewal date of the license. A new community-based residential facility shall pay the fee under this subsection no later than 30 days before the opening of the facility.
50.037(2)(c)
(c) A community-based residential facility that wishes to renew a license issued under
s. 50.03 (4) (a) 1. b. and that fails to submit the biennial fee prior to the renewal date of the license, or a new community-based residential facility subject to this section that fails to submit the biennial fee by 30 days prior to the opening of the new community-based residential facility, shall pay an additional fee of $10 per day for every day after the deadline that the facility does not pay the fee.
50.037(3)
(3) Exemption. Community-based residential facilities where the total monthly charges for each resident do not exceed the monthly state supplemental payment rate under
s. 49.77 (3s) that is in effect at the time the fee under
sub. (2) is assessed are exempt from this section.
50.037 Annotation
Duty of a private hospital to render emergency treatment. 1974 WLR 279.
50.04
50.04
Special provisions applying to licensing and regulation of nursing homes. 50.04(1)
(1)
Applicability. This section applies to nursing homes as defined in
s. 50.01 (3).
50.04(1m)
(1m) Definitions. In this section, "class "C" repeat violation" means a class "C" violation by a nursing home under the same statute or rule under which, within the previous 2 years, the department has served the nursing home a notice of violation or a correction order or has made a notation in the report under
sub. (3) (b).
50.04(2)(a)(a) No nursing home within the state may operate except under the supervision of an administrator licensed under
ch. 456 by the nursing home administrators examining board. If the holder of a nursing home license is unable to secure a new administrator because of the departure of an administrator, such license holder may, upon written notice to the department and upon the showing of a good faith effort to secure a licensed administrator, place the nursing home in the charge of an unlicensed individual subject to conditions and time limitations established by the department, with advice from the nursing home administrator examining board. An unlicensed individual who administers a nursing home as authorized under this subsection is not subject to the penalty provided under
s. 456.09.
50.04(2)(b)
(b) Each nursing home shall employ a charge nurse. The charge nurse shall either be a licensed practical nurse acting under the supervision of a professional nurse or a physician, or shall be a professional nurse. The department shall, by rule, define the duties of a charge nurse.
50.04(2)(c)1.1. Except as provided in
subd. 2., beginning July 1, 1988, the department shall enforce nursing home minimum staffing requirements based on daily staffing levels.
50.04(2)(c)2.
2. The department may enforce nursing home minimum staffing requirements based on weekly staffing levels for a nursing home if the secretary determines that the nursing home is unable to comply with nursing home minimum staffing requirements based on daily staffing levels because:
50.04(2)(c)2.a.
a. The nursing home minimum staffing requirements based on daily staffing levels violate the terms of a collective bargaining agreement that is in effect on December 8, 1987; or
50.04(2)(c)2.b.
b. A shortage of nurses or nurse's assistants available for employment by the nursing home exists; or
50.04(2m)
(2m) Plan of care and assessment required. No nursing home may admit any patient until a physician has completed a plan of care for the patient and the patient is assessed or the patient is exempt from or waives assessment under
s. 46.27 (6) (a). Failure to comply with this subsection is a class "C" violation under
sub. (4) (b) 3.
50.04(2r)
(2r) Admissions requiring approval. Except in an emergency, a nursing home that is not certified as a provider of medical assistance or that is an intermediate care facility for the mentally retarded, as defined in
s. 46.278 (1m) (am), or an institution for mental diseases, as defined under
42 CFR 435.1009, may not admit as a resident an individual who has a developmental disability, as defined in
s. 51.01 (5), or who is both under age 65 and has mental illness, as defined in
s. 51.01 (13), unless the county department under
s. 46.23,
51.42 or
51.437 of the individual's county of residence has recommended the admission.
50.04(2t)(a)1.b.
b. A device or garment that interferes with an individual's freedom of movement and that the individual is unable to remove easily.
50.04(2t)(a)1.c.
c. Restraint by a facility staff member of a resident by use of physical force.
50.04(2t)(a)2.
2. "Psychotropic medication" means an antipsychotic, antidepressant, lithium carbonate or a tranquilizer.
50.04(2t)(b)
(b) No later than 24 hours after the death of a resident of a nursing home, the nursing home shall report the death to the department if one of the following applies:
50.04(2t)(b)1.
1. There is reasonable cause to believe that the death was related to the use of physical restraint or a psychotropic medication.
50.04(2t)(b)3.
3. There is reasonable cause to believe that the death was a suicide.
50.04(2v)
(2v) Posting of notice required. Beginning on January 1, 1992, a nursing home shall post in a conspicuous location in the nursing home a notice, provided by the board on aging and long-term care, of the name, address and telephone number of the long-term care ombudsman program under
s. 16.009 (2) (b).
50.04(3)(a)(a)
Inspection. The department shall make or cause to be made at least one inspection biennially of each nursing home. The department may determine if conditions and practices comply with applicable standards by examining only a portion of the residents, records or physical plant when it conducts an inspection.
