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DHS 83.24(2) (2)General exemptions. A practitioner, licensed pharmacist, registered nurse or licensed practical nurse is exempt from training specified in ss. DHS 83.20 (2) (a), (c) and (d), 83.21 and 83.22.
DHS 83.24(3) (3)Exemptions from standard precautions training. Except as stated in subs. (1) and (2), the following individuals are exempt from training in standard precautions:
DHS 83.24(3)(a) (a) Emergency medical technicians.
DHS 83.24(3)(b) (b) Employees who can provide documentation that they have had training from a regulated health care entity in the practice of standard precautions within the previous year.
DHS 83.24(3)(c) (c) A nurse aide certified after 1999 and in good standing on the Wisconsin Nurse Aide Registry.
DHS 83.24(4) (4)Exemptions from fire safety training. Except as stated under sub. (1), firefighters are exempt from training in fire safety.
DHS 83.24(5) (5)Exemptions from first aid and choking training. Except as stated in subs. (1) and (2), the following individuals are exempt from training in first aid and choking:
DHS 83.24(5)(a) (a) Emergency medical technicians.
DHS 83.24(5)(b) (b) Student nurses who have successfully completed related training.
DHS 83.24(6) (6)Exemptions from medication administration and management training. Except as stated under subs. (1) and (2), the following individuals are exempt from medication administration and management training:
DHS 83.24(6)(a) (a) Nurse aides who have completed a medication aide training program and are in good standing on the Wisconsin Nurse Aide Registry.
DHS 83.24(6)(b) (b) Student nurses currently enrolled in a nursing program that has successfully completed a medication administration course.
DHS 83.24(6)(c) (c) Other licensed health care persons whose licensure and scope of practice allows medication administration.
DHS 83.24 Note Note: See ch. DHS 129 for medication aide training standards.
DHS 83.24(7) (7)Exemptions from client group training, resident rights training, and challenging behavior training. Except as specified under subs. (1) and (2), all of the following individuals are exempt from client group training, resident rights training and challenging behavior training:
DHS 83.24(7)(a) (a) Licensed nursing home administrators.
DHS 83.24(7)(b) (b) Substance abuse counselors as defined under s. SPS 160.02 (26).
DHS 83.24(7)(c) (c) Employees with a degree in social work, psychology or a similar human services field.
DHS 83.24(7)(d) (d) Student nurses who have successfully completed related courses.
DHS 83.24(7)(e) (e) A nurse aide in good standing on the Wisconsin Nurse Aide Registry.
DHS 83.24(8) (8)Exemption from provision of personal care training. A nurse aide in good standing on the Wisconsin Nurse Aide Registry is exempt from provision of personal care training.
DHS 83.24(9) (9)Exemptions from assessment and individual service plan development training. Except under subs. (1) and (2), the following individuals are exempt from assessment and individual service plan development training:
DHS 83.24(9)(a) (a) Licensed nursing home administrators.
DHS 83.24(9)(b) (b) Substance abuse counselors as defined under s. SPS 160.02 (26).
DHS 83.24(9)(c) (c) Employees with a degree in social work, psychology or a similar human services field.
DHS 83.24(9)(d) (d) Student nurses who have successfully completed related courses.
DHS 83.24(10) (10)Exemptions from dietary training. Except under subs. (1) and (2), the following individuals are exempt from training in determining dietary needs, menu planning, food preparation and sanitation:
DHS 83.24(10)(a) (a) Registered dietitians.
DHS 83.24(10)(b) (b) Employees whose only responsibility is delivering meals.
DHS 83.24(10)(c) (c) Employees who have completed an associate in applied science degree in culinary arts.
DHS 83.24(10)(d) (d) A certified dietary manager.
DHS 83.24 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; correction in (7) (b), (9) (b) made under s. 13.92 (4) (b) 7., Stats., Register December 2011 No. 672.
DHS 83.25 DHS 83.25Continuing education. The administrator and resident care staff shall receive at least 15 hours per calendar year of continuing education beginning with the first full calendar year of employment. Continuing education shall be relevant to the job responsibilities and shall include, at a minimum, all of the following:
DHS 83.25(1) (1) Standard precautions.
DHS 83.25(2) (2) Client group related training.
DHS 83.25(3) (3) Medications.
DHS 83.25(4) (4) Resident rights.
DHS 83.25(5) (5) Prevention and reporting of abuse, neglect and misappropriation.
DHS 83.25(6) (6) Fire safety and emergency procedures, including first aid.
DHS 83.25 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.
DHS 83.26 DHS 83.26Documentation.
DHS 83.26(1) (1) The CBRF shall maintain documentation of all employee training under s. DHS 83.21 and task specific training under s. DHS 83.22 and shall include the name of the employee, the name of the instructor, the dates of training, a description of the course content, and the length of the training.
DHS 83.26(2) (2) Employee orientation and hours of continuing education shall be documented in the employee's file.
DHS 83.26 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.
subch. V of ch. DHS 83 Subchapter V — Admission, Retention and Discharge
DHS 83.27 DHS 83.27Limitations on admissions and retentions.
DHS 83.27(1)(1)License capacity.
DHS 83.27(1)(a)(a) No CBRF may have more residents, including respite care residents, than the maximum bed capacity on its license.
DHS 83.27(1)(b) (b) The CBRF may not have more than 4 residents, or 10% of the licensed capacity, whichever is greater, who need more than 3 hours of nursing care per week or care above intermediate level nursing care for not more than 30 days unless the facility has obtained a waiver from the department or the department has received a request for a waiver from the CBRF and the department's decision is pending.
DHS 83.27(2) (2)Admission and retention limitations. A CBRF may not admit or retain any of the following persons:
DHS 83.27(2)(a) (a) A person who has an ambulatory or cognitive status that is not compatible with the license classification under s. DHS 83.04 (2).
DHS 83.27(2)(b) (b) A person who is destructive of property or self, or who is physically or mentally abusive to others, unless the CBRF has sufficient resources to care for such an individual and is able to protect the resident and others.
DHS 83.27(2)(c) (c) A person who has physical, mental, psychiatric or social needs that are not compatible with the client group as described in the CBRF's program statement.
DHS 83.27(2)(d) (d) A person who needs more than 3 hours of nursing care per week except for a temporary condition needing more than 3 hours of nursing care per week for no more than 30 days. If the CBRF requests a waiver or variance, the department may grant a waiver or variance to this requirement, as described under s. DHS 83.03, if the following conditions are met:
DHS 83.27(2)(d)1. 1. The resident's clinical condition is stable and predictable, does not change rapidly, and medical orders are unlikely to involve frequent changes or complex modifications and the resident's clinical condition is one that may be treatable, or the resident has a long-term condition needing more than 3 hours of nursing care per week for more than 30 days.
DHS 83.27(2)(d)2. 2. The resident is otherwise appropriate for the level of care provided in the CBRF.
DHS 83.27(2)(d)3. 3. The services needed to treat the resident's condition are available in the CBRF.
DHS 83.27(2)(e) (e) A person whose condition requires 24-hour supervision by a registered nurse or licensed practical nurse.
DHS 83.27(2)(f) (f) A person whose condition requires care above intermediate level nursing care.
DHS 83.27(2)(g) (g) A person who requires a chemical or physical restraint except as authorized under s. 50.09 (1) (k), Stats.
DHS 83.27(2)(h) (h) A person who is incapacitated, as defined under s. 50.06 (1), Stats., unless the person has a health care agent under a valid and properly activated power of attorney for health care under ch. 155, Stats., or a court appointed guardian under ch. 54, Stats., except for the admission of an incapacitated individual who does not have such a legal representative, and who is admitted directly from the hospital according to the provision of s. 50.06, Stats.
DHS 83.27(2)(i) (i) A person who resides in a CBRF licensed for 16 or more residents, and has been found incompetent under ch. 54, Stats., and does not have a court-ordered protective placement under s. 55.12, Stats.
DHS 83.27(3) (3)Admission of minors. The CBRF may not admit a person under 18 years of age without written approval of the department and only if any of the following apply:
DHS 83.27(3)(a) (a) The CBRF is also licensed under ch. DCF 57 as a group foster care home or under ch. DCF 52 as a residential care center for children and youth.
DHS 83.27(3)(b) (b) The minor has been waived to an adult court under s. 938.18, Stats.
DHS 83.27(3)(c) (c) The minor is the child of an adult resident. When the minor child of an adult resident resides in a CBRF, all of the following shall apply:
DHS 83.27(3)(c)1. 1. The adult resident retains custody and control of the child.
DHS 83.27(3)(c)2. 2. The CBRF shall have written policies related to the presence of minors in the CBRF, including policies on parental responsibility, school attendance and any care, treatment or services provided to the minors by the CBRF.
DHS 83.27 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; corrections in (3) (a) made under 13.92 (4) (b) 7., Stats., Register January 2009 No. 637.
DHS 83.28 DHS 83.28Admission procedures.
DHS 83.28(1) (1)Assessment. The CBRF shall assess each resident before admission as required under s. DHS 83.35 (1).
DHS 83.28(2) (2)Services and charges. Before or at the time of admission, the CBRF shall provide written information regarding services available and charges for those services as required in s. DHS 83.29 (1).
DHS 83.28(3) (3)Admission agreement. Before or at the time of admission, the CBRF shall provide the admission agreement as required under s. DHS 83.29 (2).
DHS 83.28(4) (4)Health screening.
DHS 83.28(4)(a)(a) Resident health screening.
DHS 83.28(4)(a)1.1. Within 90 days before or 7 days after admission, a physician, physician assistant, clinical nurse practitioner or a licensed registered nurse shall screen each person admitted to the CBRF for clinically apparent communicable disease, including tuberculosis, and document the results of the screening.
DHS 83.28(4)(a)2. 2. Screening for tuberculosis and all immunizations shall be conducted using centers for disease control and prevention standards.
DHS 83.28(4)(a)3. 3. The CBRF shall maintain the screening documentation in each resident's record.
DHS 83.28(4)(b) (b) Respite care health screening.
DHS 83.28(4)(b)1.1. Within 90 days before or 7 days after admission for persons in respite care who will reside in the CBRF for more than 7 days, a physician, physician assistant, clinical nurse practitioner or a licensed registered nurse shall screen each respite care person for clinically apparent communicable disease, including tuberculosis, and document the results of the screening.
DHS 83.28(4)(b)2. 2. If the person did not provide evidence of health screening required under subd. 1., prior to the second admission in a calendar year of a person in respite care, a physician, physician assistant, clinical nurse practitioner or a licensed registered nurse shall screen each respite care person for clinically apparent communicable disease, including tuberculosis, and document the results of the screening.
DHS 83.28(4)(b)3. 3. Screening for tuberculosis and all immunizations shall be conducted using centers for disease control and prevention standards.
DHS 83.28(4)(b)4. 4. The CBRF shall maintain the screening documentation for each respite care person.
DHS 83.28(5) (5)Temporary service plan. Upon admission, the CBRF shall develop a temporary service plan as required under s. DHS 83.35 (2).
DHS 83.28(6) (6)Resident rights, grievance procedure and house rules. Before or at the time of admission, the CBRF shall provide and explain resident rights, the house rules of the CBRF as required under s. DHS 83.32 (2), and the grievance procedure, including written information regarding the names, addresses and telephone numbers of all resident advocacy groups serving the client groups in the facility, including the long term care ombudsman program and the protection and advocacy services of Disability Rights Wisconsin, Inc.
DHS 83.28(7) (7)Advanced directives. At the time of admission, the CBRF shall determine if the resident has executed an advanced directive. An advanced directive describes, in writing, the choices about treatments the resident may or may not want and about how health care decisions should be made for the resident if the resident becomes incapacitated and cannot express their wishes. A copy of the document shall be maintained in the resident record as required under s. DHS 83.42 (1) (s). A CBRF may not require an advanced directive as a condition of admission or as a condition of receiving any health care service. An advanced directive may be a living will, power of attorney for health care, or a do-not-resuscitate order under ch. 154 or 155, Stats., or other authority as recognized by the courts of this state.
DHS 83.28 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; CR 10-091: am. (7) Register December 2010 No. 660, eff. 1-1-11.
DHS 83.29 DHS 83.29Admission agreement.
DHS 83.29(1) (1)Services and charges.
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Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date the chapter was last published.