50.36(1)
(1) The department shall promulgate, adopt, amend and enforce such rules and standards for hospitals for the construction, maintenance and operation of the hospitals deemed necessary to provide safe and adequate care and treatment of the patients in the hospitals and to protect the health and safety of the patients and employees; and nothing contained herein shall pertain to a person licensed to practice medicine and surgery or dentistry. The building codes and construction standards of the department of commerce shall apply to all hospitals and the department may adopt additional construction codes and standards for hospitals, provided they are not lower than the requirements of the department of commerce. Except for the construction codes and standards of the department of commerce and except as provided in
s. 50.39 (3), the department shall be the sole agency to adopt and enforce rules and standards pertaining to hospitals.
50.36(2)(a)(a) The department shall conduct plan reviews of all capital construction and remodeling projects of hospitals to ensure that the plans comply with building code requirements under
ch. 101 and with physical plant requirements under this chapter or under rules promulgated under this chapter.
50.36(2)(b)
(b) The department shall promulgate rules that establish a fee schedule for its services in conducting the plan reviews under
par. (a). The schedule established under these rules shall set fees for hospital plan reviews in amounts that are less than the sum of the amounts required on September 30, 1995, for fees under this subsection and for fees for examination of hospital plans under s.
101.19 (1) (a), 1993 stats.
50.36(2)(c)
(c) The department shall promulgate rules that require that a hospital, before discharging a patient who is aged 65 or older or who has developmental disability or physical disability and whose disability or condition requires long-term care that is expected to last at least 90 days, refer the patient to the resource center under
s. 46.283. The rules shall specify that this requirement applies only if the secretary has certified under
s. 46.281 (3) that a resource center is available for the hospital and for specified groups of eligible individuals that include persons seeking admission to or patients of the hospital.
50.36(3)(a)(a) Any person licensed to practice medicine and surgery under
subch. II of ch. 448 or podiatry under
subch. IV of ch. 448 shall be afforded an equal opportunity to obtain hospital staff privileges and may not be denied hospital staff privileges solely for the reason that the person is an osteopathic physician and surgeon or a podiatrist. Each individual hospital shall retain the right to determine whether the applicant's training, experience and demonstrated competence is sufficient to justify the granting of hospital staff privileges or is sufficient to justify the granting of limited hospital staff privileges.
50.36(3)(b)
(b) If, as a result of peer investigation or written notice thereof, a hospital staff member who is licensed by the medical examining board or podiatrists affiliated credentialing board, for any reasons that include the quality of or ability to practice, loses his or her hospital staff privileges, has his or her hospital staff privileges reduced or resigns from the hospital staff, the hospital shall so notify the medical examining board or podiatrists affiliated credentialing board, whichever is applicable, within 30 days after the loss, reduction or resignation takes effect. Temporary suspension due to incomplete records need not be reported.
50.36(3)(c)
(c) If, as a result of peer investigation or written notice thereof, a hospital staff member who is licensed by the medical examining board or podiatrists affiliated credentialing board, for reasons that do not include the quality of or ability to practice, loses his or her hospital staff privileges for 30 days or more, has his or her hospital staff privileges reduced for 30 days or more or resigns from the hospital staff for 30 days or more, the hospital shall so notify the medical examining board or podiatrists affiliated credentialing board, whichever is applicable, within 30 days after the loss, reduction or resignation takes effect. Temporary suspension due to incomplete records need not be reported.
50.36(3d)(a)(a) A hospital shall develop and maintain a system under which the hospital may grant emergency staff privileges to a health care provider, as defined in
s. 146.81 (1), to whom all of the following apply:
50.36(3d)(a)1.
1. The health care provider seeks to provide care at the hospital during a period of a state of emergency related to public health declared by the governor under
s. 166.03 (1) (b) 1.
50.36(3d)(a)2.
2. The health care provider does not have staff privileges at the hospital at the time that the state of emergency related to public health is declared by the governor under
s. 166.03 (1) (b) 1.
50.36(3d)(a)3.
3. The health care provider has staff privileges at another hospital.
50.36(3d)(b)
(b) A hospital that grants emergency staff privileges under
par. (a) has immunity from civil liability for acts or omissions by a health care provider who is granted emergency staff privileges under
par. (a).
50.36(3g)(b)
(b) A hospital that admits patients for treatment of mental illness may grant to a psychologist who is listed or eligible to be listed in the national register of health services providers in psychology or who is certified by the American board of professional psychology an opportunity to obtain hospital staff privileges to admit, treat and discharge patients. Each hospital may determine whether the applicant's training, experience and demonstrated competence are sufficient to justify the granting of hospital staff privileges or of limited hospital staff privileges.
50.36(3g)(c)
(c) If a hospital grants a psychologist hospital staff privileges or limited hospital staff privileges under
par. (b), the psychologist or the hospital shall, prior to or at the time of hospital admission of a patient, identify an appropriate physician with admitting privileges at the hospital who shall be responsible for the medical evaluation and medical management of the patient for the duration of his or her hospitalization.
50.36(3m)
(3m) The department shall require a hospital that is accredited as a hospital by a private accrediting organization to submit to the department a copy of the summary accreditation recommendation and may require the hospital to submit to the department copies of all correspondence sent or received on or after August 30, 1989, including survey results, between the hospital and the accrediting organization. Accreditation letters, reports and related correspondence submitted to the department, except those submitted by a county mental health complex under
s. 51.08, under this subsection are not subject to inspection, copying or receipt under
s. 19.35 (1) and may not be released by the department.
50.36(4)
(4) The department shall make or cause to be made such inspections and investigation, as are reasonably deemed necessary to obtain compliance with the rules and standards. It shall afford an opportunity for representatives of the hospitals to consult with members of the staff of the department concerning compliance and noncompliance with rules and standards.
50.36 Cross-reference
Cross Reference: See also ch.
HFS 124, Wis. adm. code.
50.36 Annotation
A hospital owes a duty to its patients to exercise reasonable care in the selection of medical staff and in granting special privileges. Johnson v. Misericordia Community Hospital,
99 Wis. 2d 708,
301 N.W.2d 156 (1981).
50.37
50.37
Notification to accrediting organization. The department shall notify a private accrediting organization that has accredited a hospital and the board of governors of the patients compensation fund under
s. 619.04 (3) if the department has done any of the following:
50.37(1)
(1) Suspended or revoked the hospital's approval under
s. 50.35.
50.37(2)
(2) Issued an order to the hospital.
50.37(4)
(4) Recommended to the federal health care financing administration that the hospital be decertified from the federal medicare program under
42 USC 1395 to
1395ccc or the federal medicaid program under
42 USC 1396 to
1396r-3 for failure to meet a condition of participation under the program.
50.37 History
History: 1989 a. 37.
50.38(1)(1) Whoever violates rules promulgated under
s. 50.36 (2) (c) may be required to forfeit not more than $500 for each violation.
50.38(2)
(2) The department may directly assess forfeitures provided for under
sub. (1). If the department determines that a forfeiture should be assessed for a particular violation, the department shall send a notice of assessment to the hospital. 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 hospital of the right to a hearing under
sub. (3).
50.38(3)
(3) A hospital may contest an assessment of a forfeiture by sending, within 10 days after receipt of notice under
sub. (2), a written request for a hearing under
s. 227.44 to the division of hearings and appeals created under
s. 15.103 (1). The administrator of the division may designate a hearing examiner to preside over the case and recommend a decision to the administrator under
s. 227.46. The decision of the administrator of the division shall be the final administrative decision. The division shall commence the hearing within 30 days after receipt of the request for a 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. In any petition for judicial review of a decision by the division, the party, other than the petitioner, who was in the proceeding before the division shall be the named respondent.
50.38(4)
(4) All forfeitures shall be paid to the department within 10 days after receipt of notice of assessment or, if the forfeiture is contested under
sub. (3), within 10 days after receipt of the final decision after exhaustion of administrative review, unless the final decision is appealed and the order is stayed by court order. The department shall remit all forfeitures paid to the state treasurer for deposit in the school fund.
50.38(5)
(5) The attorney general may bring an action in the name of the state to collect any forfeiture imposed under this section if the forfeiture has not been paid following the exhaustion of all administrative and judicial reviews. The only issue to be contested in any such action shall be whether the forfeiture has been paid.
50.38 History
History: 1999 a. 9.
50.39
50.39
Exemptions and enforcement. 50.39(1)
(1)
Sections 50.32 to
50.39 and the rules promulgated pertaining thereto shall apply to all facilities coming under the definition of a "hospital" which are not specifically exempt by
ss. 50.32 to
50.39.
50.39(2)
(2) The use of the title "hospital" to represent or identify any facility which does not meet the definition of a "hospital" as provided herein or is not subject to approval under
ss. 50.32 to
50.39 is prohibited, except that institutions governed by
s. 51.09 are exempt.
50.39(3)
(3) Facilities governed by
ss. 45.365,
48.62,
49.70,
49.72,
50.02,
51.09 and
252.10, secured correctional facilities as defined in
s. 938.02 (15m), correctional institutions governed by the department of corrections under
s. 301.02 and the offices and clinics of persons licensed to treat the sick under
chs. 446,
447 and
448 are exempt from
ss. 50.32 to
50.39.
Sections 50.32 to
50.39 do not abridge the rights of the medical examining board, physical therapists affiliated credentialing board, podiatrists affiliated credentialing board, dentistry examining board, pharmacy examining board, chiropractic examining board and board of nursing in carrying out their statutory duties and responsibilities.
50.39(4)
(4) All orders issued by the department pursuant to
ss. 50.32 to
50.39 shall be enforced by the attorney general. The circuit court of Dane County shall have jurisdiction to enforce such orders by injunctional and other appropriate relief.
50.39(5)(a)(a) The department may, in the event of an emergency condition that imminently threatens the health or safety of patients of a hospital, suspend new admissions to all or a part of the hospital until such time as the department decides that the hospital has removed or corrected the causes or deficiencies creating the emergency.
50.39(5)(b)
(b) Immediately upon the suspension of new admissions under
par. (a), the department shall notify the hospital in writing. Notice of the suspension shall include a clear and concise statement of the causes or deficiencies creating the emergency condition on which the suspension is based and notice of the opportunity for a hearing on the suspension or on recision of the suspension under
s. 227.44. If the hospital desires to contest the suspension, it shall provide written notice to the department of a request for a hearing within 10 days after receipt of the notice of suspension. If the hospital desires to contest failure by the department to rescind the suspension, it shall provide written notice to the department of a request for a hearing.
50.39(6)
(6) In addition to any other remedies provided by law, any person suffering a pecuniary loss because of a violation of
s. 50.36 (3) (a) may bring a civil action in any court of competent jurisdiction to recover the amount of the pecuniary loss, together with costs and disbursements, including reasonable attorney fees.
50.39 Cross-reference
Cross Reference: See also ch.
HFS 124, Wis. adm. code.
50.49
50.49
Licensing and regulation of home health agencies. 50.49(1)(1)
Definitions. As used in this section, unless a different meaning appears from the context:
50.49(1)(a)
(a) "Home health agency" means an organization that:
50.49(1)(a)1.
1. Primarily provides skilled nursing and other therapeutic services;
50.49(1)(a)2.
2. Has policies established by a professional group including at least one physician and at least one registered nurse to govern services, and provides for supervision of these services by a physician or a registered nurse; and
50.49(1)(b)
(b) "Home health services" means the following items and services that are furnished to an individual, who is under the care of a physician, by a home health agency or by others under arrangements made by the home health agency, that are under a plan for furnishing those items and services to the individual that is established and periodically reviewed by a physician and that are, except as provided in
subd. 6., provided on a visiting basis in a place of residence used as the individual's home:
50.49(1)(b)1.
1. Part-time or intermittent nursing care provided by or under the supervision of a registered professional nurse;
50.49(1)(b)2.
2. Physical or occupational therapy or speech-language pathology;
50.49(1)(b)3.
3. Medical social services under the direction of a physician;
50.49(1)(b)4.
4. Medical supplies, other than drugs and biologicals, and the use of medical appliances, while under such a plan;
50.49(1)(b)5.
5. In the case of a home health agency which is affiliated or under common control with a hospital, medical services provided by an intern or resident-in-training of such hospital, under an approved teaching program of such hospital; and
50.49(1)(b)6.
6. Any of the foregoing items and services which are provided on an outpatient basis, under arrangements made by the home health agency, at a hospital or extended care facility, or at a rehabilitation center which meets such standards as may be prescribed by rule, and the furnishing of which involves the use of equipment of such a nature that the items and services cannot readily be made available to the individual in such place of residence, or which are furnished at such facility while the individual is there to receive any such item or service, but not including transportation of the individual in connection with any such item or service.
50.49(1)(c)
(c) "Patient" means individuals cared for or treated by home health agencies.
50.49(2)(a)(a) The department may develop, establish and enforce standards for the care, treatment, health, safety, welfare and comfort of patients by home health agencies and for the maintenance and operation of home health agencies which, in the light of advancing knowledge, will promote safe and adequate care and treatment of such patients by home health agencies.
50.49(2)(b)
(b) The department shall, by rule, set a license fee to be paid by home health agencies.
50.49(3)
(3) Administration. The administration of this section shall be under the department which shall make or cause to be made such inspections and investigations as it deems necessary.
50.49(4)
(4) Licensing, inspection and regulation. Except as provided in
sub. (6m), the department may register, license, inspect and regulate home health agencies as provided in this section. The department shall ensure, in its inspections of home health agencies, that a sampling of records from private pay patients are reviewed. The department shall select the patients who shall receive home visits as a part of the inspection. Results of the inspections shall be made available to the public at each of the regional offices of the department.
50.49(5)
(5) Application for registration and license. 50.49(5)(a)(a) Registration shall be in writing in such form and contain such information as the department requires.
50.49(5)(b)
(b) The application for a license shall be in writing upon forms provided by the department and shall contain such information as it requires.
50.49(6)
(6) Issuance of license; inspection and investigation; annual report; nontransferability; content. 50.49(6)(a)(a) Except as provided in
s. 50.498, the department shall issue a home health agency license if the applicant is fit and qualified, and if the home health agency meets the requirements established by this section. The department, or its designated representatives, shall make such inspections and investigations as are necessary to determine the conditions existing in each case and file written reports. Each licensee shall annually file a report with the department.
50.49(6)(b)
(b) A home health agency license is valid until suspended or revoked, except as provided in
s. 50.498.
50.49(6)(c)
(c) Each license shall be issued only for the home health agency named in the application and is not transferable or assignable. Any license granted shall state such additional information and special limitations as the department, by rule, prescribes.
50.49(6)(d)
(d) Every 12 months, on a schedule determined by the department, a licensed home health agency shall submit an annual report in the form and containing the information that the department requires, including payment of the fee required under
sub. (2) (b). If a complete annual report is not timely filed, the department shall issue a warning to the licensee. The department may revoke the license for failure to timely and completely report within 60 days after the report date established under the schedule determined by the department.
50.49(6m)
(6m) Exceptions. None of the following is required to be licensed as a home health agency under
sub. (4), regardless of whether any of the following provides services that are similar to services provided by a home health agency:
50.49(7)
(7) Denial, suspension or revocation of license; notice. The department after notice to the applicant or licensee is authorized to deny, suspend or revoke a license in any case in which it finds that there has been a substantial failure to comply with the requirements of this section and the rules established hereunder.
50.49(8)
(8) Failure to register or operating without license; penalty. It is unlawful for any person, acting jointly or severally with any other person, to conduct, maintain, operate, or permit to be maintained or operated, or to participate in the conducting, maintenance or operating of a home health agency, unless, it is licensed as a home health agency by the department. Any person who violates this section shall be fined not more than $100 for the first offense and not more than $200 for each subsequent offense, and each day of violation after the first conviction shall constitute a separate offense.
50.49(9)
(9) Right of injunction. All orders issued by the department under this section shall be enforced by the attorney general. The circuit court of Dane County shall have jurisdiction to enforce such orders by injunctional and other appropriate relief.
50.49(10)
(10) Provisional licenses. Except as provided in
s. 50.498, a provisional license if approved by the department may be issued to any home health agency, the facilities of which are in use or needed for patients, but which is temporarily unable to conform to all the rules established under this section. A provisional license may not be issued for more than one year.
50.49 Cross-reference
Cross Reference: See also ch.
HFS 133, Wis. adm. code.
50.495
50.495
Fees permitted for a workshop or seminar. If the department develops and provides a workshop or seminar relating to the provision of services by hospitals and home health agencies under this subchapter, the department may establish a fee for each workshop or seminar and impose the fee on registrants for the workshop or seminar. A fee so established and imposed shall be in an amount sufficient to reimburse the department for the costs directly associated with developing and providing the workshop or seminar.
50.495 History
History: 1997 a. 27.
