50.50(11)
(11) "Rural medical center" means an arrangement of facilities, equipment, services and personnel that is all of the following:
50.50(11)(a)
(a) Organized under a single governing and corporate structure.
50.50(11)(b)
(b) Capable of providing or assuring health care services, including appropriate referral, treatment and follow-up services, at one or more locations in a county, city, town or village that has a population of less than 15,000 and that is in an area that is not an urbanized area, as defined by the federal bureau of the census.
50.50(11)(c)
(c) A provider of at least 2 health care services under the arrangement or through a related corporate entity.
50.50(12)
(12) "Rural primary care hospital" means a facility that is currently designated by the federal health care financing administration as meeting the applicable requirements of
42 USC 1395i-4 (i) (2) and of
42 CFR 485, Subpart F.
50.50 History
History: 1995 a. 98 50.51
50.51
Departmental powers. The department shall do all of the following:
50.51(1)
(1) Provide uniform, statewide licensing, inspection and regulation of rural medical centers as specified in this subchapter.
50.51(2)
(2) Promulgate rules that establish all of the following:
50.51(2)(a)
(a) For the operation of licensed rural medical centers, standards that are designed to protect and promote the health, safety, rights and welfare of patients who receive health care services in rural medical centers.
50.51(2)(b)
(b) Minimum requirements for issuance of a provisional license, a regular initial license or a license renewal to rural medical centers.
50.51(2)(c)
(c) Fees for rural medical center provisional licensure and regular initial licensure and licensure renewal. The amounts of the fees shall be based on the health care services provided by the rural medical center.
50.51(2)(d)
(d) A procedure and criteria for waiver of or variance from standards under
par. (a) or minimum requirements under
par. (b).
50.51 History
History: 1995 a. 98 50.52
50.52
Licensing procedure and requirements. 50.52(1)
(1) No person may be required to obtain licensure as a rural medical center, except that no person may conduct, maintain, operate or permit to be conducted, maintained or operated health care services as a rural medical center unless the rural medical center is licensed by the department.
50.52(2)
(2) The department shall issue a provisional license, a regular initial license or a license renewal as a rural medical center to an applicant if all of the following are first done:
50.52(2)(a)
(a) The applicant pays the appropriate license fee, as established under
s. 50.51 (2) (c). Fees collected under this paragraph shall be credited to the appropriation under
s. 20.435 (1) (gm) for licensing and inspection activities.
50.52(2)(b)
(b) Except as provided in
par. (c), the department inspects the health care services provided by the applying rural medical center and finds that the applicant is fit and qualified and meets the requirements and standards of this subchapter and the rules promulgated under this subchapter.
50.52(2)(c)
(c) In lieu of conducting the inspection under
par. (b), the department accepts evidence that an applicant meets one of the following requirements:
50.52(2)(c)1.
1. Has applicable current, valid state licensure or approval as a hospital, a nursing home, a hospice or a home health agency.
50.52(2)(c)2.
2. Has an applicable, current agreement to participate as an eligible provider in medicare.
50.52(2)(c)4.
4. Satisfies qualifications that are specified by the department by rule.
50.52(3)
(3) Each license shall bear the name of the owner of the rural medical center, the name and address of the rural medical center and the health care services that the department licenses the rural medical center to provide.
50.52(4)
(4) Unless sooner revoked or suspended, a regular initial license or a license renewal issued to a rural medical center is valid for 24 months from the date of issuance and a provisional license issued to a rural medical center is valid for 6 months from the date of issuance.
50.52(5)
(5) Each license shall be issued only for the rural medical center and owner that are named in the license application and may not be transferred or assigned.
50.52 History
History: 1995 a. 98 50.53
50.53
Inspections and investigations. 50.53(1)
(1) The department may conduct unannounced inspections or investigations of a rural medical center as the department considers necessary.
50.53(2)
(2) A rural medical center that is inspected or investigated under this section shall provide the department with access to patient health care records, regardless of the source of patient health care payment, to fulfill the purpose of any inspections or investigations that the department conducts.
50.53 History
History: 1995 a. 98 50.54
50.54
Prohibitions. 50.54(1)(1) An entity that is not licensed as a rural medical center under this subchapter may not designate itself as a "rural medical center" or use the phrase "rural medical center" to represent or tend to represent the entity as a rural medical center or services provided by the entity as health care services provided by a rural medical center.
50.54(2)
(2) No person may do any of the following:
50.54(2)(a)
(a) Intentionally prevent, interfere with or impede an investigation by the department of an alleged violation or enforcement by the department of a requirement of this subchapter or the rules promulgated under this subchapter.
50.54(2)(b)
(b) Intentionally retaliate or discriminate against a patient or rural medical center employe for doing any of the following:
50.54(2)(b)2.
2. Initiating, participating in or testifying in an action to enforce any provision of this subchapter or rules promulgated under this subchapter.
50.54(2)(c)
(c) Intentionally destroy or modify the original report of an inspection that the department conducts under this subchapter or the rules promulgated under this subchapter.
50.54 History
History: 1995 a. 98 50.55
50.55
Penalties and remedies. 50.55(1)(a)(a) Any person who violates this subchapter or any rule promulgated under this subchapter, except
s. 50.54 (2), may be required to forfeit not less than $100 nor more than $500 for each offense. Each day of continued violation constitutes a separate offense.
50.55(1)(b)
(b) In determining whether a forfeiture is to be imposed and in fixing the amount of the forfeiture to be imposed, if any, for a violation, the department shall consider all of the following factors:
50.55(1)(b)3.
3. Any previous violations committed by the licensee.
50.55(1)(b)4.
4. The financial benefit to the rural medical center of committing or continuing to commit the violation.
50.55(1)(c)
(c) The department may directly assess forfeitures provided for under
par. (a). If the department determines that a forfeiture should be assessed for a particular violation or for failure to correct it, the department shall send a notice of assessment to the rural medical center. The notice shall specify the amount of the forfeiture assessed, the violation, and the statute or rule alleged to have been violated, and shall inform the licensee of the right to a hearing under
par. (d).
50.55(1)(d)
(d) A rural medical center may contest an assessment of forfeiture by sending, within 10 days after receipt of notice under
par. (c), a written request for hearing under
s. 227.44 to the division of hearings and appeals under
s. 15.103 (1). The division shall commence the hearing within 30 days after receipt of the request for hearing and shall issue a final decision within 15 days after the close of the hearing. Proceedings before the division are governed by
ch. 227.
50.55(1)(e)
(e) All forfeitures shall be paid to the department within 10 days after receipt of notice of assessment or, if the forfeiture is contested under
par. (d), within 10 days after receipt of the final decision, unless the final decision is appealed and the decision is in favor of the appellant. The department shall remit all forfeitures paid to the state treasurer for deposit in the school fund.
50.55(2)
(2) Other penalty. Whoever violates
s. 50.54 (2) may be fined not more than $1,000 or imprisoned for not more than 6 months or both.
50.55(3)
(3) Injunction. The department may, upon the advice of the attorney general, who shall represent the department in all proceedings under this subsection, institute an action in the name of the state in the circuit court for Dane County for injunctive relief or other process against any licensee, owner, operator, administrator or representative of any owner of a rural medical center for the violation of any of the provisions of this subchapter or rules promulgated under this subchapter if the department determines that the violation seriously affects the care, treatment, health, safety, rights, welfare or comfort of patients.
50.55 History
History: 1995 a. 98 50.56
50.56
Applicability. 50.56(1)(1) Any of the following facilities or entities is not required to obtain licensure or a certificate of approval under the following statutes or to pay initial or renewal license fees under the following statutes if all of the services of the facility or entity are provided as a part of a rural medical center that holds a current, valid license under this subchapter:
50.56(2)
(2) Subsection (1) may not be construed to apply to limit the authority of the department to develop, establish or enforce any statutes and rules for the care, treatment, health, safety, rights, welfare and comfort of patients or residents of facilities or entities that are specified in
sub. (1) (a) to
(d) and for the construction, general hygiene, maintenance or operation of those facilities or entities.
50.56(3)
(3) Notwithstanding
sub. (2), insofar as a conflict exists between this subchapter, or the rules promulgated under this subchapter, and
subch. I,
II or
IV, or the rules promulgated under
subch. I,
II or
IV, the provisions of this subchapter and the rules promulgated under this subchapter control.
50.56 History
History: 1995 a. 98
HOSPICES
50.90
50.90
Definitions. In this subchapter:
50.90(1)
(1) "Hospice" means any of the following:
50.90(1)(a)
(a) An organization that primarily provides palliative care and supportive care to an individual with terminal illness where he or she lives or stays and, if necessary to meet the needs of an individual with terminal illness, arranges for or provides short-term inpatient care and treatment or provides respite care.
50.90(1)(b)
(b) A program, within an organization, that primarily provides palliative care and supportive care to an individual with terminal illness where he or she lives or stays, that uses designated staff time and facility services, that is distinct from other programs of care provided, and, if necessary to meet the needs of an individual with terminal illness, that arranges for or provides short-term inpatient care and treatment or respite care.
50.90(1)(c)
(c) A place, including a freestanding structure or a separate part of a structure in which other services are provided, that primarily provides palliative and supportive care and a place of residence to individuals with terminal illness and provides or arranges for short-term inpatient care as needed.
50.90(1m)
(1m) "Managing employe" means a general manager, business manager, administrator, director or other individual who exercises operational or managerial control over, or who directly or indirectly conducts, the operation of the hospice.
50.90(2)
(2) "Organization" means a public agency, as defined in
s. 46.93 (1m) (e), a nonprofit corporation, a for-profit stock corporation, a cooperative, a partnership, a limited liability company or a sole proprietorship.
50.90(3)
(3) "Palliative care" means management and support provided for the reduction or abatement of pain, for other physical symptoms and for psychosocial or spiritual needs of individuals with terminal illness and includes physician services, skilled nursing care, medical social services, services of volunteers and bereavement services. "Palliative care" does not mean treatment provided in order to cure a medical condition or disease or to artificially prolong life.
50.90(3g)
(3g) "Respite care" means care provided to a terminally ill individual in order to provide temporary relief to the primary caregiver.
50.90(3m)
(3m) "Short-term care" means care provided to a terminally ill individual in an inpatient setting for brief periods of time for the purpose of pain control or acute or chronic symptom management.
50.90(4)
(4) "Supportive care" means services provided during the final stages of an individual's terminal illness and dying and after the individual's death to meet the psychosocial, social and spiritual needs of family members of the terminally ill individual and other individuals caring for the terminally ill individual. "Supportive care" includes personal adjustment counseling, financial counseling, respite services, bereavement counseling and follow-up services provided by volunteers or other persons.
50.90(5)
(5) "Terminal illness" means a medical prognosis that an individual's life expectancy is less than 12 months.
50.90 History
History: 1989 a. 199;
1993 a. 112.
50.91
50.91
Departmental powers and duties. The department shall provide uniform, statewide licensing, inspection and regulation of hospices as specified in this subchapter.
50.91 History
History: 1989 a. 199.
50.92
50.92
Licensing requirements. 50.92(1)
(1) No person may conduct, maintain, operate or otherwise participate in conducting, maintaining or operating a hospice unless the hospice is licensed by the department.
50.92(2)
(2) The department shall issue an initial license or a renewal of a license if the department finds that the applicant is fit and qualified and that the hospice meets the requirements of this subchapter and the rules promulgated under this subchapter.
50.92(3)
(3) The department or the department's designated representative shall inspect or investigate a hospice prior to issuance of a license for the hospice except as provided in
sub. (4) and may inspect or investigate a hospice as the department deems necessary, including conducting home visits or a review of health care records of any individuals with terminal illness served by the hospice, to determine if any person is in violation of this subchapter.
50.92(4)(a)(a) In lieu of inspecting or investigating a hospice under
sub. (3) prior to issuance of an initial license, the department may accept evidence that a hospice applying for licensure under
s. 50.93 has been inspected under and is currently certified as meeting the conditions for medicare participation under
42 USC 1395 to
1395ccc. In lieu of inspecting or investigating a hospice under
sub. (3) prior to issuance of a license renewal, the department shall accept evidence that a hospice applying for licensure under
s. 50.93 has been inspected under and is currently certified as meeting the conditions for medicare participation under
42 USC 1395 to
1395ccc. The department shall inspect or investigate under
sub. (3) prior to issuance of an initial license or a renewal of a license a hospice that fails to meet the conditions for medicare participation under
42 USC 1395 to
1395ccc.
50.92(4)(b)
(b) In lieu of inspecting or investigating a hospice under
sub. (3) prior to issuance of an initial license or a renewal of a license, the department may accept evidence that a hospice applying for licensure under
s. 50.93 has been inspected under and is currently in compliance with the hospice requirements of the joint commission for the accreditation of health organizations. A hospice shall provide the department with a copy of the report by the joint commission for the accreditation of health organizations of each periodic review the association conducts of the hospice.
50.92(5)
(5) The past record of violations of applicable laws or regulations of the United States or of state statutes or rules of this or any other state, in the operation of any health-related organization, by an operator, managing employe or direct or indirect owner of a hospice or of an interest of a hospice is relevant to the issue of the fitness of an applicant for receipt of an initial license or the renewal of a license. The department or the department's designated representative shall inspect and investigate as necessary to determine the conditions existing in each case under this subsection and shall prepare and maintain a written report concerning the investigation and inspection.
