“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.
If the department receives a credible complaint that a pharmacy located in a hospital has violated its duty to dispense contraceptive drugs and devices under s. 450.095 (2)
, the department shall refer the complaint to the department of safety and professional services.
The secretary or his or her designee may grant a variance to or a waiver from any of the requirements for hospitals if all of the following apply:
The secretary or his her designee determines that the variance or waiver is necessary to protect the public health, safety, or welfare or to support the efficient and economic operation of the hospital.
A variance or waiver granted under par. (a)
may be for a stated term. If a variance or waiver is for a stated term, the secretary or his her designee may extend the variance or waiver upon request by the hospital if he or she determines that an extension is necessary to protect the public health, safety, or welfare or to support the efficient and economic operation of the hospital.
See also ch. DHS 124
, Wis. adm. code.
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
Notification to accrediting organization.
The department shall notify a national accrediting organization that has accredited a hospital and the board of governors of the injured patients and families compensation fund under s. 619.04 (3)
if the department has done any of the following:
Suspended or revoked the hospital's approval under s. 50.35
Issued an order to the hospital.
Recommended to the federal centers for medicare and medicaid services that the hospital be decertified from the federal medicare program under 42 USC 1395
or the federal medicaid program under 42 USC 1396
for failure to meet a condition of participation under the program.
Emergency contraception for sexual assault victims. 50.375(1)(a)
“Emergency contraception" means a drug, medicine, oral hormonal compound, mixture, preparation, instrument, article, or device that is approved by the federal food and drug administration and that prevents a pregnancy after sexual intercourse. “Emergency contraception" does not include a drug, medicine, oral hormonal compound, mixture, preparation, instrument, article, or device of any nature that is prescribed to terminate the pregnancy of a female.
“Victim" means a female who alleges or for whom it is alleged that she suffered sexual assault and who, as a result of the sexual assault, presents as a patient at a hospital that provides emergency services.
A hospital that provides emergency services to a victim shall do all of the following:
Provide to the victim medically and factually accurate and unbiased written and oral information about emergency contraception and its use and efficacy.
Orally inform the victim of all of the following:
Her option to receive emergency contraception at the hospital.
Her option to report the sexual assault to a law enforcement agency.
Any available options for her to receive an examination to gather evidence regarding the sexual assault.
Except as specified in sub. (4)
, immediately provide to the victim upon her request emergency contraception, in accordance with instructions approved by the federal food and drug administration. If the medication is taken in more than one dosage, the hospital shall provide all subsequent dosages to the victim for later self administration.
A hospital that provides emergency care shall ensure that each hospital employee who provides care to a victim has available medically and factually accurate and unbiased information about emergency contraception.
No hospital may be required to provide emergency contraception to a victim who is pregnant, as indicated by a test for pregnancy.
The department shall respond to any complaint received by the department concerning noncompliance by a hospital with the requirements of subs. (2)
and shall periodically review hospital procedures to determine whether a hospital is in compliance with the requirements.
History: 2007 a. 102
Whoever violates a requirement under s. 50.375 (2)
may be required to forfeit not less than $2,500 nor more than $5,000 for each violation.
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)
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.
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 secretary of administration for deposit in the school fund.
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.
History: 2007 a. 102
; 2009 a. 2