Waiver of federal requirements.
The department shall petition the secretary of the U.S. department of health and human services for a waiver of the requirement that it conduct annual medical assistance surveys of nursing homes, for a waiver of the requirement that it conduct annual independent medical reviews and independent professional reviews, to allow the department under 42 USC 1396a
(a) (26) and (31) to conduct biennial surveys and reviews and for any waivers necessary to implement the special requirements promulgated under s. 50.02 (3) (d)
History: 1981 c. 121
; 1985 a. 29
Fees permitted for a workshop or seminar.
If the department develops and provides a workshop or seminar relating to the provision of service by facilities, adult family homes or residential care apartment complexes 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.
History: 1985 a. 120
; 1997 a. 27
Licensing and approval fees for inpatient health care facilities. 50.135(1)(1)
In this section, “inpatient health care facility" means any hospital, nursing home, county home, county mental hospital or other place licensed or approved by the department under ss. 49.70
, but does not include community-based residential facilities.
The annual fee for any inpatient health care facility except a nursing home is $18 per bed, based on the number of beds for which the facility is licensed. The annual fee for any nursing home is $6 per bed, based on the number of beds for which the nursing home is licensed. This fee shall be paid to the department on or before October 1 for the ensuing year. Each new inpatient health care facility shall pay this fee no later than 30 days before it opens.
Any inpatient health care facility that fails to pay its fee on or before the date specified in par. (a)
shall pay an additional fee of $10 per day for every day after the deadline.
The fees collected under par. (a)
shall be credited to the appropriation account under s. 20.435 (6) (jm)
for licensing, review and certifying activities.
Sub. (1) requires that all of the specifically enumerated facilities must be places licensed or approved by DHFS. A VA hospital is not within the definition of inpatient health care facility as it is subject to federal regulation and is not licensed or regulated by the state. State v. Powers, 2004 WI App 156
, 276 Wis. 2d 107
, 687 N.W.2d 50
Assessments on licensed beds. 50.14(1)(a)
Notwithstanding s. 50.01 (1m)
, “facility" means a nursing home or an intermediate care facility for persons with an intellectual disability that is not located outside the state.
“Intermediate care facility for persons with an intellectual disability" has the meaning given for “intermediate care facility for the mentally retarded" under 42 USC 1396d
For the privilege of doing business in this state, there is imposed on all licensed beds of a facility an assessment in the following amount per calendar month per licensed bed of the facility:
For nursing homes, an amount not to exceed $150 in state fiscal year 2009-10, and, beginning in state fiscal year 2010-11, an amount not to exceed $170.
For intermediate care facilities for persons with an intellectual disability, $910.
The assessment moneys collected under this section shall be deposited in the Medical Assistance trust fund.
In determining the number of licensed beds, all of the following apply:
If the amount of the beds is other than a whole number, the fractional part of the amount shall be disregarded unless it equals 50 percent or more of a whole number, in which case the amount shall be increased to the next whole number.
By the end of each month, each facility shall submit to the department the amount due under sub. (2)
for each licensed bed of the facility for the month preceding the month during which the payment is being submitted. The department shall verify the number of beds licensed and, if necessary, make adjustments to the payment, notify the facility of changes in the payment owing and send the facility an invoice for the additional amount due or send the facility a refund.
The department shall levy, enforce and collect the assessment under this section and shall develop and distribute forms necessary for levying and collection.
The department shall promulgate rules that establish procedures and requirements for levying the assessment under this section.
An affected facility may contest an action by the department under this section by submitting a written request for a hearing to the department within 30 days after the date of the department's action.
Any order or determination made by the department under a hearing as specified in par. (a)
is subject to judicial review as prescribed under ch. 227
See also ch. DHS 15
, Wis. adm. code.
Hospital regulation and approval act.
shall constitute the “Hospital Regulation and Approval Act".
History: 1975 c. 413
; Stats. 1975 s. 50.32.
See also ch. DHS 124
, Wis. adm. code.
“Conditions for Medicare participation for hospitals" means the conditions of participation specified under 42 CFR 482
or, with respect to critical access hospitals, 42 CFR 485
“Critical access hospital" means a hospital that is designated by the department as meeting the requirements of 42 USC 1395i-4
(c) (2) (B) and is federally certified as meeting the requirements of 42 USC 1395i-4
“Governmental unit" means the state, any county, town, city, village, or other political subdivision or any combination thereof, department, division, board or other agency of any of the foregoing.
“Hospital" means any building, structure, institution or place devoted primarily to the maintenance and operation of facilities for the diagnosis, treatment of and medical or surgical care for 3 or more nonrelated individuals hereinafter designated patients, suffering from illness, disease, injury or disability, whether physical or mental, and including pregnancy and regularly making available at least clinical laboratory services, and diagnostic X-ray services and treatment facilities for surgery, or obstetrical care, or other definitive medical treatment.
“Hospital" may include, but not in limitation thereof by enumeration, related facilities such as outpatient facilities, nurses', interns' and residents' quarters, training facilities and central service facilities operated in connection with hospitals.
“Hospital" includes “special hospitals" or those hospital facilities that provide a limited type of medical or surgical care, including orthopedic hospitals, children's hospitals, critical access hospitals, mental hospitals, psychiatric hospitals or maternity hospitals.
“Hospital-associated service” means a health care service that meets all of the following conditions:
The service is of the same type as those furnished by a hospital in an inpatient or outpatient facility.
The service is of a type for which a payment could be claimed as a hospital service under the federal Medicare program, 42 USC 1395
The service is provided at a location other than in a facility approved by the department under s. 50.35
The service is provided in a home setting before January 1, 2022.
“Requirements for hospitals" means all of the rules, standards, and requirements described in or promulgated under ss. 50.32
that apply to hospitals, including the standards described under s. 50.36 (1)
The purpose of ss. 50.32
is to provide for the development, establishment and enforcement of rules and standards for the construction, maintenance and operation of hospitals which, in the light of advancing knowledge, will promote safe and adequate care and treatment of patients in such hospitals.
History: 1975 c. 413
; Stats. 1975 s. 50.34.
Application and approval.
Application for approval to maintain a hospital shall be made to the department on forms provided by the department. On receipt of an application, the department shall, except as provided in s. 50.498
, issue a certificate of approval if the applicant and hospital facilities meet the requirements for hospitals. The department shall issue a single certificate of approval for the University of Wisconsin Hospitals and Clinics Authority that applies to all of the Authority's inpatient and outpatient hospital facilities that meet the requirements for hospitals and for which the Authority requests approval. For a free-standing pediatric teaching hospital, the department shall issue a single certificate of approval that applies to all of the hospital's inpatient and outpatient hospital facilities that meet the requirements for hospitals and for which the hospital requests approval. Except as provided in s. 50.498
, this approval shall be in effect until, for just cause and in the manner herein prescribed, it is suspended or revoked. The certificate of approval may be issued only for the premises and persons or governmental unit named in the application and is not transferable or assignable. The department shall withhold, suspend, or revoke approval for a failure to comply with s. 165.40 (6) (a) 1.
, but, except as provided in s. 50.498
, otherwise may not withhold, suspend, or revoke approval unless for a substantial failure to comply with the requirements for hospitals after giving a reasonable notice, a fair hearing, and a reasonable opportunity to comply. Failure by a hospital to comply with s. 50.36 (3m)
shall be considered to be a substantial failure to comply under this section.
History: 1975 c. 413
; Stats. 1975 s. 50.35; 1989 a. 37
; 1997 a. 93
; 2009 a. 2
; 2013 a. 236
Every 12 months, on a schedule determined by the department, an approved hospital shall submit an annual report in the form and containing the information that the department requires, including payment of the fee required under s. 50.135 (2) (a)
. If a complete annual report is not timely filed, the department shall issue a warning to the holder of the certificate for approval. The department may revoke approval for failure to timely and completely report within 60 days after the report date established under the schedule determined by the department.
History: 1997 a. 27
Rules and standards. 50.36(1)(1)
The department may use and enforce the conditions in 42 CFR 482.60
as standards that apply to psychiatric hospitals, which are hospitals primarily engaged in providing psychiatric services for the diagnosis and treatment of persons who have mental illness. Beginning on July 1, 2016, except as otherwise provided under ss. 50.32
, the department shall use and enforce the conditions for Medicare participation for hospitals as the minimum standards that apply to hospitals. The department shall interpret the conditions for Medicare participation for hospitals using guidelines adopted by the federal centers for medicare and medicaid services, unless the department determines that a different interpretation is reasonably necessary to protect public health and safety. The department may promulgate, adopt, amend, and enforce additional rules and standards for the construction, maintenance, and operation of hospitals that the department determines are necessary to provide safe and adequate care and treatment of hospital patients and to protect the health and safety of the patients and employees. The building codes and construction standards of the department of safety and professional services shall apply to all hospitals to the extent that they are not incompatible with any building codes or construction standards required by the conditions for Medicare participation for hospitals. Except for the construction codes and standards of the department of safety and professional services 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.
Notwithstanding sub. (1)
and except as provided pars. (b)
, all of the following apply:
Beginning on July 1, 2016, the department may not enforce any of the rules contained in s. DHS 124.40
or subch. II
, or IV
of ch. DHS 124
, Wis. Adm. Code, in effect on April 10, 2014.
The department shall, within the scope of the department's rule-making authority under sub. (1)
, promulgate rules to repeal and recreate ch. DHS 124
, Wis. Adm. Code.
does not apply beginning on the date that a permanent rule promulgated under ch. 227
that repeals and recreates ch. DHS 124
, Wis. Adm. Code, takes effect as provided in s. 227.22
Effective date note
NOTE: Chapter DHS 124, Wis. Adm. Code, was substantially revised eff. 7-1-20 by CR 19-135. Among other changes, CR 19-135 repealed ss. DHS 124.24 (3) and 124.40 and subchs. III and IV of ch. DHS 124, Wis. Adm. Code, and repealed and recreated subch. II of ch. DHS 124, Wis. Adm. Code.
Notwithstanding sub. (3L)
, the department shall conduct plan reviews of all capital construction and remodeling projects of hospitals to ensure that the plans comply with any applicable building code requirements under ch. 101
and with any physical plant requirements under this chapter or under rules promulgated under this chapter.
The department shall promulgate rules that establish a fee schedule for its services in conducting the plan reviews under par. (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.
A hospital may grant any practitioner the opportunity to be a member of the hospital staff and obtain hospital staff privileges if the membership or privileges are not prohibited under sub. (1)
and are consistent with the practitioner's scope of practice.
If, as a result of peer investigation or written notice thereof, a hospital staff member who is licensed by the medical examining board or podiatry 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 podiatry 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.
If, as a result of peer investigation or written notice thereof, a hospital staff member who is licensed by the medical examining board or podiatry 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 podiatry 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.
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:
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. 323.10
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. 323.10
The health care provider has staff privileges at another hospital.
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)
If a hospital has a policy on who may accompany or visit a patient, the hospital shall extend the same right of accompaniment or visitation to a patient's domestic partner under ch. 770
as is accorded the spouse of a patient under the policy.
A hospital accredited by an approved national accrediting organization pursuant to 42 USC 1395bb
(a) (1) is exempt from routine inspections and investigations to determine compliance with and is considered to be in compliance with the requirements for hospitals. The department may inspect an accredited hospital to investigate a complaint or comply with the request of the federal centers for medicare and medicaid services, including a request to validate the findings of the accrediting organization.
The department shall require a hospital that is accredited as a hospital by a national accrediting organization pursuant to 42 USC 1395bb
(a) (1) to submit to the department evidence of current accreditation. Any evidence of accreditation and other accreditation-related correspondence or other materials submitted by or on behalf of a hospital 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.
Except as provided in sub. (3L)
, the department shall make or cause to be made such inspections and investigation, as are reasonably deemed necessary to obtain compliance with the requirements for hospitals. 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 the requirements for hospitals. If the department takes enforcement action against a hospital for a violation of the requirements for hospitals, and the department subsequently conducts an on-site inspection of the hospital to review the hospital's action to correct the violation, the department may, unless the hospital is operated by the state, impose a $200 inspection fee on the hospital.
Before providing emergency services in a hospital, medical and nursing personnel shall have proficiency in the use of an automated external defibrillator, as defined in s. 256.15 (1) (cr)
, achieved through instruction provided by an individual, organization, or institution of higher education that is approved under s. 46.03 (38)
to provide such instruction.
If the federal centers for medicare and medicaid services has approved a hospital to provide any hospital-associated service, the department may apply to and enforce upon the hospital as the state standard for the hospital-associated service any rule or standard that is required by the centers for medicare and medicaid services for the service. This subsection does not apply on or after January 1, 2022.