DHS 105.07(2)(2) A hospital providing outpatient alcohol and other drug abuse (AODA) services shall meet the requirements specified in s. DHS 105.23; DHS 105.07(4)(4) A hospital participating in a PRO review program shall meet the requirements of 42 CFR 456.101 and any additional requirements established under state contract with the PRO; and DHS 105.07 NoteNote: For certification of a hospital that is an institution for mental disease, see s. DHS 105.21. For covered hospital services, see s. DHS 107.08. DHS 105.07 HistoryHistory: Cr. Register, February, 1986, No. 362, eff. 3-1-86; r. and recr. (intro.), am. (1) to (4), cr. (5), Register, September, 1991, No. 429, eff. 10-1-91; correction in (intro.) made under s. 13.92 (4) (b) 7., Stats., Register December 2008 No. 636. DHS 105.075DHS 105.075 Rehabilitation hospitals. For MA certification, a rehabilitation hospital shall be approved as a general hospital under s. 50.35, Stats., and ch. DHS 124, and shall meet the conditions of participation for medicare and shall have a utilization review plan that meets the requirements of 42 CFR 456.101. No facility determined by the department or the federal health care financing administration to be an institution for mental disease (IMD) may be certified as a rehabilitation hospital under this section. DHS 105.075 NoteNote: For covered hospital services, see s. DHS 107.08. DHS 105.08DHS 105.08 Skilled nursing facilities. For MA certification, skilled nursing facilities shall be licensed pursuant to s. 50.03, Stats., and ch. DHS 132. DHS 105.08 NoteNote: For covered nursing home services, see s. DHS 107.09. DHS 105.08 HistoryHistory: Cr. Register, February, 1986, No. 362, eff. 3-1-86; correction made under s. 13.92 (4) (b) 7., Stats., Register December 2008 No. 636. DHS 105.09(1)(1) Definition. In this section, “sufficient number of medicare-certified beds” means a supply of beds that accommodates the demand for medicare beds from both the home county and contiguous counties so that no dual eligible recipient is denied access to medicare SNF benefits because of a lack of available beds. In this subsection, “dual eligible recipient” means a person who qualifies for both medical assistance and medicare. DHS 105.09(2)(2) Medicare bed obligation. Each county shall have a sufficient number of skilled nursing beds certified by the medicare program pursuant to ss. 49.45 (6m) (g) and 50.02 (2), Stats. The number of medicare-certified beds required in each county shall be at least 3 beds per 1000 persons 65 years of age and older in the county. DHS 105.09(3)(a)(a) If a county does not have sufficient medicare-certified beds as determined under sub. (1), each SNF within that county which does not have one or more medicare-certified beds shall be subject to a fine to be determined by the department of not less than $10 nor more than $100 for each day that the county continues to have an inadequate number of medicare-certified beds. DHS 105.09(3)(b)(b) The department may not enforce penalty in par. (a) if the department has not given the SNF prior notification of criteria specific to its county which shall be used to determine whether or not the county has a sufficient number of medicare-certified beds. DHS 105.09(3)(c)(c) If the number of medicare-certified beds in a county is reduced so that the county no longer has a sufficient number of medicare-certified beds under sub. (1), the department shall notify each SNF in the county of the number of additional medicare-certified beds needed in the county. The department may not enforce the penalty in par. (a) until 90 days after this notification has been provided. DHS 105.09(4)(a)(a) In this subsection, a “swing-bed hospital” means a hospital approved by the federal health care financing administration to furnish skilled nursing facility services in the medicare program. DHS 105.09(4)(b)(b) A home or portion of a home certified as an ICF-IID is exempt from this section. DHS 105.09(4)(c)(c) The department may grant an exemption based on but not limited to: DHS 105.09(4)(c)1.1. Availability of a swing-bed hospital operating within a 30 mile radius of the nursing home; or DHS 105.09(4)(c)2.2. Availability of an adequate number of medicare-certified beds in a facility within a 30 mile radius of the nursing home. DHS 105.09(4)(d)(d) A skilled nursing facility located within a county determined to have an inadequate number of medicare-certified beds and which has less than 100 beds may apply to the department for partial exemption from the requirements of this section. An SNF which applies for partial exemption shall recommend to the department the number of medicare-certified beds that the SNF should have to meet the requirements of this section based on the facility’s analysis of the demand for medicare-certified beds in the community. The department shall review all recommendations and issue a determination to each SNF requesting a partial exemption. DHS 105.09 HistoryHistory: Cr. Register, February, 1986, No. 362, eff. 3-1-86; renum. (1), (2), (3) (a) and (b) to be (2), (3), (4) (a) and (b) and am. (2) and (4) (b), cr. (1), (4) (c) and (d), Register, February, 1988, No. 386, eff. 7-1-88; 2019 Wis. Act 1: am. (4) (b) Register May 2019 No. 761, eff. 6-1-19. DHS 105.10DHS 105.10 SNFs and ICFs with deficiencies. If the department finds a facility deficient in meeting the standards specified in s. DHS 105.08, 105.09, 105.11 or 105.12, the department may nonetheless certify the facility for MA under the conditions specified in s. DHS 132.21 and 42 CFR 442, Subpart C.