DHS 83.05(2)(g)
(g) Any additional information requested by the department.
DHS 83.05 Note
Note: A copy of the application form, F60287, can be obtained at
http://dhs.wisconsin.gov/forms/DQAnum.asp or by contacting the Division of Quality Assurance Regional Office listed in Appendix A.
DHS 83.05(3)
(3) The applicant shall provide evidence to the department that the license applicant has made a good faith effort to establish a community advisory committee under s.
50.03 (4) (g), Stats.
DHS 83.05(4)
(4) A CBRF may not be located on a parcel of land zoned for commercial, industrial or manufacturing use.
DHS 83.05 History
History: CR 07-095: cr.
Register January 2009 No. 637, eff. 4-1-09..
DHS 83.06(1)(1)
Content. The program statement shall accurately include all of the following:
DHS 83.06(1)(a)
(a) The name of the licensee, the administrator and the staff position in charge when the licensee or administrator is away from the CBRF.
DHS 83.06(1)(b)
(b) Employee availability, including 24 hour staffing patterns and the availability of a licensed nurse, if any.
DHS 83.06(1)(e)
(e) The client group to be served. If serving more than one client group, the program statement shall include an explanation acceptable to the department of how the client groups are compatible with one another.
DHS 83.06(1)(f)
(f) A complete description of the program goals and services consistent with the needs of residents.
DHS 83.06(1)(g)
(g) Limitations of services, including the criteria for determining who may reside in the CBRF.
DHS 83.06(2)(a)(a) Before finalizing an agreement to provide care, the CBRF shall provide its program statement to each person seeking placement or to the person's legal representative. CBRFs serving only clients of a government correctional agency are exempt from this paragraph.
DHS 83.06(2)(b)
(b) The program statement shall be available to employees, to residents and to any other person upon request.
DHS 83.06(3)
(3)
Change in program statement. Any change in the program statement content under sub.
(1) shall be submitted to the department at least 30 days before its effective date.
DHS 83.06 History
History: CR 07-095: cr.
Register January 2009 No. 637, eff. 4-1-09.
DHS 83.07(1)(1)
Eligibility. An applicant may not be licensed unless the department determines the applicant is fit and qualified to operate a CBRF.
DHS 83.07(2)
(2)
Standards. In determining whether a person is fit and qualified, the department shall consider all of the following:
DHS 83.07(2)(a)
(a)
Compliance history. Compliance history with Wisconsin or any other state's licensing requirements and with any federal certification requirements, including any license revocation or denial.
DHS 83.07(2)(b)
(b)
Criminal history. Arrest and criminal records, including any of the following:
DHS 83.07(2)(b)1.
1. Crimes or acts involving abuse, neglect or mistreatment of a person or misappropriation of property of the person.
DHS 83.07(2)(b)3.
3. Crimes or acts related to the manufacture, distribution, prescription, use, or dispensing of a controlled substance.
DHS 83.07(2)(b)4.
4. Fraud or substantial or repeated violations of applicable laws and rules in the operation of any health care facility or in the care of dependent persons.
DHS 83.07(2)(b)5.
5. A conviction or pending criminal charge which substantially relates to the care of adults or minors, to the funds or property of adults or minors, or to the operation of a residential or health care facility.
DHS 83.07(2)(c)1.
1. Financial history and financial viability of the owner or related organization.
DHS 83.07(2)(c)2.
2. Outstanding debts or amounts due to the department or other government agencies, including unpaid forfeitures and fines.
DHS 83.07 History
History: CR 07-095: cr.
Register January 2009 No. 637, eff. 4-1-09.
DHS 83.08(1)(a)(a) Within 70 days after receipt of a complete application, the department shall either approve or deny the license. The initial license issued by the department to an applicant may be a probationary license.
DHS 83.08(1)(b)
(b) A probationary or regular license issued by the department shall be only for the premises and persons named in the application. A license may not be transferred or assigned.
DHS 83.08(1)(c)
(c) A probationary license may be valid for up to 12 months, unless sooner revoked.
DHS 83.08(1)(d)
(d) A regular license is valid until suspended or revoked by the department.
DHS 83.08(2)
(2)
License denial. The department shall deny a probationary or regular license to any applicant who does not substantially comply with any provision of this chapter or ch.
50, Stats., or who is not fit and qualified as specified in s.
DHS 83.07 or who has failed to pay any fee or any outstanding amounts due to the department. The department shall provide the reasons for denial and the process for appeal of the denial in a written notice to the applicant.
DHS 83.08(3)
(3)
License revocation. The department may revoke a license for any of the reasons and under the conditions specified under s.
50.03 (5g) (d) to
(g), Stats.
DHS 83.08 History
History: CR 07-095: cr.
Register January 2009 No. 637, eff. 4-1-09.
DHS 83.09
DHS 83.09 Biennial report and fees. Every 24 months, on a date determined by the department, the licensee shall submit a biennial report on the form provided by department, and shall submit payment of the license continuation fees.
DHS 83.09 History
History: CR 07-095: cr.
Register January 2009 No. 637, eff. 4-1-09.
DHS 83.10(1)(a)(a) The transferor shall notify the department within 30 days before the final change of ownership of a CBRF and shall include the name and contact information of the transferee.
DHS 83.10(1)(b)
(b) The transferor remains responsible for the operation of the CBRF until the department issues a license to the transferee, unless the CBRF voluntarily closes, and relocates all residents.
DHS 83.10(1)(c)
(c) The transferor shall disclose to the transferee any existing department waiver, variance or outstanding deficiencies. The transferee shall apply for continuation of any existing waivers or variances, if necessary.
DHS 83.10(1)(e)
(e) The transferor shall remain liable for all forfeitures assessed against the facility which is imposed for violations occurring prior to transfer of ownership.
DHS 83.10(1)(f)
(f) The transferor shall notify residents or resident's legal representatives no less than 7 days in advance of the transfer of ownership.
DHS 83.10(2)(a)(a) When there is a change of ownership, the transferee shall notify the department of the transfer, and shall submit a complete application as required under s.
DHS 83.05 at least 30 days prior to final transfer date.
DHS 83.10(2)(b)
(b) If there is less than 30 days notice given to residents of transfer of ownership, neither the transferor nor the transferee may enforce any advanced notice requirements for discharge as specified in any resident's admission agreement.
DHS 83.10(3)(a)(a) The department shall issue a license only for the premises and persons named in the license application. A license may not be transferred or reassigned.
DHS 83.10(3)(b)
(b) The licensee shall notify the department in writing at least 30 days before the effective date of any of the following changes:
DHS 83.10(3)(b)1.
1. Removing, adding or substituting an individual as a partner in the association, dissolving the existing partnership and creating a new partnership.
DHS 83.10(3)(b)2.
2. Removing, adding, or substituting any member in a limited liability company.
DHS 83.10(3)(b)3.
3. Making a change in a corporate structure under which the same corporation no longer continues to be responsible for making operational decisions or for the consequences of those decisions.
DHS 83.10 History
History: CR 07-095: cr.
Register January 2009 No. 637, eff. 4-1-09.
DHS 83.11(1)(1)
Any CBRF that intends to close shall notify the department in writing at least 30 days before closing and comply with the requirements under s.
50.03 (5m), Stats., and s.
DHS 83.31.
DHS 83.11(2)
(2) If a CBRF is closing, intends to close, or changes its type or level of service or means of reimbursement and will relocate 5 residents or 5% of the CBRF's residents, whichever is greater, the CBRF shall follow the procedures under s.
50.03 (14), Stats.
DHS 83.11(3)
(3) The CBRF shall surrender the license to the department when the CBRF closes.
DHS 83.11 History
History: CR 07-095: cr.
Register January 2009 No. 637, eff. 4-1-09.
DHS 83.12
DHS 83.12 Investigation, notification, and reporting requirements. DHS 83.12(1)(a)(a)
Resident death related to physical restraint, psychotropic medication or suicide. No later than 24 hours after the death of a resident, the CBRF shall report the death to the department if there is reasonable cause to believe the death was related to the use of a physical restraint or psychotropic medication, or was a suicide.
DHS 83.12(1)(b)
(b)
Resident death related to an accident or injury. When a resident dies as a result of an incident or accident not related to the use of a physical restraint, psychotropic medication, or suicide, the CBRF shall send a report to the department within 3 working days of the resident's death.
DHS 83.12(1)(c)
(c)
Resident death due to natural causes. A CBRF is not required to report a death to the department if the death is the result of natural causes, and none of the circumstances surrounding the death involve a condition under par.
(a) or
(b).
DHS 83.12(2)
(2)
Investigating and reporting abuse, neglect or misappropriation of property. DHS 83.12(2)(a)1.1. When a CBRF receives a report of an allegation of abuse or neglect of a resident, or misappropriation of property, the CBRF shall take immediate steps to ensure the safety of all residents.
DHS 83.12(2)(a)2.
2. The CBRF shall investigate and document any allegation of abuse or neglect of a resident, or misappropriation of property by a caregiver. If the CBRF's investigation concludes that the alleged abuse, or neglect of a resident or misappropriation of property meets the definition of abuse or neglect of a resident, or of misappropriation of property, the CBRF shall report the incident to the department on a form provided by the department, within 7 calendar days from the date the CBRF knew or should have known about the abuse, neglect, or misappropriation of property. The CBRF shall maintain documentation of any investigation.
DHS 83.12 Note
Note: For copies of the report form, contact the Division of Quality Assurance, Office of Caregiver Quality at P.O. Box 2969, Madison WI 53701-2969 or at dhs.wisconsin.gov/caregiver/index.htm.
DHS 83.12(2)(b)
(b)
Non-caregiver or resident. When there is an allegation of abuse or neglect of a resident, or misappropriation of property by a non-caregiver or resident, the CBRF shall follow the elder abuse reporting requirements under s.
46.90, Stats., or the adult at risk requirements under s.
55.043, Stats., whichever is applicable.
DHS 83.12(2)(c)
(c)
Other reporting. Filing a report under sub.
(1) or
(2) does not relieve the licensee or other person of any obligation to report an incident to any other authority, including law enforcement and the coroner.
DHS 83.12(3)(a)2.
2. The source of an injury to a resident that cannot be adequately explained by the resident.
DHS 83.12(3)(a)3.
3. An injury to a resident that appears suspicious because of the extent of the injury or the location of the injury on the resident.
DHS 83.12(3)(b)
(b) The CBRF shall maintain documentation of each investigation of an injury referenced under par.
(a). The CBRF shall report the incident as required under sub.
(2).
DHS 83.12(4)
(4)
Other reporting and notification requirements. A CBRF shall send a written report to the department within 3 working days after any of the following occurs:
DHS 83.12(4)(a)
(a) Any time a resident's whereabouts are unknown, except those instances when a resident who is competent chooses not to disclose his or her whereabouts or location to the CBRF, the CBRF shall notify the local law enforcement authority immediately upon discovering that a resident is missing. This reporting requirement does not apply to residents under the jurisdiction of government correctional agencies or persons recovering from substance abuse.
DHS 83.12(4)(b)
(b) Any time law enforcement personnel are called to the CBRF as a result of an incident that jeopardizes the health, safety, or welfare of residents or employees. The CBRF's report to the department shall provide a description of the circumstances requiring the law enforcement intervention
. This reporting requirement does not apply to residents under the jurisdiction of government correctional agencies.
