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.
50.04(3)(b)
(b)
Biennial report. The department shall make at least one report on each nursing home in the state biennially. All conditions and practices not in compliance with applicable standards within the last 2 years shall be specifically stated. If a violation is corrected, is contested or is subject to an approved plan of correction, the same shall be specified in the biennial report. The department shall send a copy of the report to the nursing home and shall provide a copy to any person on request. The department may charge a reasonable fee to cover copying costs.
50.04(3)(c)
(c)
Posting of notice. The nursing home administrator shall retain a copy of the most recent biennial report prepared by the department under
par. (b) and shall post in a place readily visible to residents and visitors, such as the lobby or reception area of the facility, a notice stating that a copy of the report is available for public inspection on request to the administrator and that a copy will be provided by the department upon request for a minimal fee.
50.04(3)(d)
(d)
Survey of institutions for mental diseases. Before July 1, 1988, the department shall conduct a survey to determine whether any nursing home that is licensed under this section is an institution for mental diseases, as defined under
42 CFR 435.1009. On or after July 1, 1988, the department shall make these determinations during inspections conducted under
par. (a).
50.04(4)
(4) Notice of violation; correction. 50.04(4)(a)1.1. If upon inspection or investigation the department determines that a nursing home is in violation of this subchapter or the rules promulgated under it and the violation is a class "A" or "B" violation, it shall promptly serve a notice of violation upon the licensee. Each notice of violation shall be prepared in writing and shall specify the nature of the violation, and the statutory provision or rule alleged to have been violated. The notice shall inform the licensee of the right to a hearing under
par. (e). The written notice of a class "A" violation may be written and served by an agent of the department at the time of the inspection.
50.04(4)(a)1g.a.a. If upon inspection or investigation the department determines that a nursing home is in violation of this subchapter or the rules promulgated under it and the violation is a class "C" violation, the department may serve a correction order upon the licensee unless the nursing home corrects the violation before the completion of the inspection or investigation. If the correction is made before the completion of the inspection or investigation, the department may make a notation in the report under
sub. (3) (b) that shall specify the nature of the violation and the statute or rule alleged to have been violated.
50.04(4)(a)1g.b.
b. If upon inspection or investigation the department determines that a nursing home is in violation of this subchapter or the rules promulgated under it and the violation is a class "C" repeat violation, the department may serve a correction order or notice of violation upon the nursing home. If the nursing home corrects the violation before completion of the inspection or investigation, the department may, as an alternative to serving a correction order or notice of violation, make a notation in the report under
sub. (3) (b) that shall specify the nature of the violation and the statute or rule alleged to have been violated.
50.04(4)(a)1m.
1m. A correction order shall be prepared in writing and shall specify the nature of the violation, the statutory provision or rule alleged to have been violated and the date by which the violation shall be corrected. The department may grant an extension of the date for correction specified in the correction order. The nursing home shall correct the class "C" violation by the date specified in the correction order or the extended date, if granted.
50.04(4)(a)1r.
1r. The department may serve a notice of violation on a nursing home determined to be in violation of this subchapter or the rules promulgated under it for a class "C" violation if either of the following conditions apply:
50.04(4)(a)1r.a.
a. The nursing home fails to make a correction by the date specified in a correction order served under
subd. 1g. b. or by an extension of the date, if granted.
50.04(4)(a)1r.b.
b. The violation is a class "C" repeat violation, regardless of whether a correction order has first been served.
50.04(4)(a)2.
2. The department is not required to serve a notice of violation if each of the following conditions exists:
50.04(4)(a)2.a.
a. The nursing home brings the violation to the department's attention.
50.04(4)(a)2.b.
b. The nursing home has made every reasonable effort to prevent and correct the violation, but the violation occurred and remains uncorrected due to circumstances beyond the nursing home's control.
50.04(4)(a)3.
3. The department is not required to serve a notice of a class "C" violation if it finds that the nursing home is in substantial compliance with the specific rule violated.
50.04(4)(b)1.1. A class "A" violation is a violation of this subchapter or of the rules promulgated thereunder which creates a condition or occurrence relating to the operation and maintenance of a nursing home presenting a substantial probability that death or serious mental or physical harm to a resident will result therefrom.
50.04(4)(b)2.
2. A class "B" violation is a violation of this subchapter or of the rules promulgated thereunder which creates a condition or occurrence relating to the operation and maintenance of a nursing home directly threatening to the health, safety or welfare of a resident.
50.04(4)(b)3.
3. A class "C" violation is a violation of this subchapter or of the rules promulgated thereunder which creates a condition or occurrence relating to the operation and maintenance of a nursing home which does not directly threaten the health, safety or welfare of a resident.
50.04(4)(b)4.
4. Each day of violation constitutes a separate violation. Except as provided in
sub. (5) (a) 4., the department shall have the burden of showing that a violation existed on each day for which a forfeiture is assessed. No forfeiture may be assessed for a condition for which the nursing home has received a variance or waiver of a standard.
50.04(4)(c)1.1. The situation, condition or practice constituting a class "A" violation shall be abated or eliminated immediately unless a fixed period of time, as determined by the department and specified in the notice of violation, is required for correction. If the class "A" violation is not abated or eliminated within the specified time period, the department shall maintain an action in circuit court for injunction or other process against the licensee, owner, operator, administrator or representative of the facility to restrain and enjoin violation of applicable rules, regulations and statutes.
50.04(4)(c)2.
2. At the time of issuance of a notice of a class "B" or "C" violation, the department shall request a plan of correction which is subject to the department's approval. The nursing home shall have 10 days after receipt of notice of violation in which to prepare and submit a plan of correction but the department may extend this period up to 30 days where correction involves substantial capital improvement. The plan shall include a fixed time period within which violations are to be corrected. If the nursing home plan of correction is substantially in compliance, it may be modified upon agreement between the department and the nursing home to achieve full compliance. If it rejects a plan of correction, the department shall send notice of the rejection and the reason for the rejection to the nursing home and impose a plan of correction. The imposed plan of correction may be modified upon agreement between the department and the nursing home.
