, Stats., establishes specific rights for CBRF residents and prescribes mechanisms to resolve resident complaints and to hold the CBRF licensee accountable for violating resident rights. Other statutes, such as s. 51.61
and chs. 54
, Stats., and ch. DHS 94
may further clarify or condition a particular resident's right, depending on the legal status of the resident or a service received by the resident. The licensee shall comply with all applicable statutes and rules.
The licensee shall protect the civil rights of residents as these rights are defined in the U.S. Constitution, the Wisconsin Constitution, the Civil Rights Act of 1964, Title VIII of the Civil Rights Act of 1968, Section 504 of the Rehabilitation Act of 1973, the Fair Housing Amendments Act of 1988, the Americans with Disabilities Act of 1990, and all other applicable federal and state statutes.
(2) Explanation of resident rights, grievance procedure and house rules. DHS 83.32(2)(a)(a)
Before the admission agreement is signed by the resident or the resident's legal representative or at the time of admission, the CBRF shall provide a copy of and explain resident rights, the grievance procedure under s. DHS 83.33
and the house rules to the person being admitted, the person's legal representative,
and family members of the person. The resident or the resident's legal representative shall be asked to sign a statement to acknowledge the receipt of an explanation of resident rights. The CBRF shall document the date and to whom the information was provided.
The CBRF shall post copies of resident rights, grievance procedure and house rules in a prominent public place available to residents, employees and guests.
(3) Rights of residents.
Any form of coercion to discourage or prevent a resident or the resident's legal representative from exercising any of the rights under this subchapter is prohibited. Any form of retaliation against a resident or the resident's legal representative for exercising any of the rights in this subchapter, or against an employee or any other person who assists a resident or the resident's legal representative in the exercise of any of the resident rights in this subchapter, is prohibited. The rights established under this subsection do not apply to a resident in the legal custody of a government correctional agency, except as determined by a government correctional agency. In addition to the rights under s. 50.09
, Stats., each resident shall have all of the following rights:
Make and receive telephone calls within reasonable limits and in privacy. The CBRF shall provide at least one non-pay telephone for resident use. The CBRF may require residents who make long distance calls to do so at the resident's own expense.
Confidentiality of health and personal information and records, and the right to approve or refuse release of that information to any individual outside the CBRF, except when the resident is transferred to another facility or as required by law or third-party payment contracts and except as provided in s. 146.82 (2)
, Stats. The CBRF shall make the record available to the resident or the resident's legal representative for review. Copies of the record shall be made available within 30 days, if requested in writing, at a cost no greater than the cost of reproduction.
Free from labor.
Not be required by the CBRF to perform labor that is of any financial benefit to the CBRF. The CBRF may require personal housekeeping of the resident without compensation if it is for therapeutic purposes and is part of, and clearly identified in the resident's individual service plan.
Freedom from mistreatment.
Be free from physical, sexual and mental abuse and neglect, and from financial exploitation and misappropriation of property.
Freedom from chemical restraints.
Be free from all chemical restraints.
Freedom from physical restraints.
Be free from physical restraints except upon prior review and approval by the department upon written authorization from the resident's primary physician or advanced practice nurse prescriber as defined in s. N 8.02 (2)
. The department may place conditions on the use of a restraint to protect the health, safety, welfare and rights of the resident.
Receive all prescribed medications in the dosage and at intervals prescribed by a practitioner. The resident has the right to refuse medication unless the medication is court ordered.
Prompt and adequate treatment.
Receive prompt and adequate treatment that is appropriate to the resident's needs.
Participate in the planning of care and treatment, be fully informed of care and treatment options and have the right to refuse any form of care or treatment unless the care or treatment has been ordered by a court.
Make decisions relating to care, activities, daily routines and other aspects of life which enhance the resident's self reliance and support the resident's autonomy and decision making.
Least restrictive environment.
Have the least restrictive conditions necessary to achieve the purposes of the resident's admission. The CBRF may not impose a curfew, rule or other restriction on a resident's freedom of choice.
Recording, filming, photographing.
Not be recorded, filmed or photographed without informed, written consent by the resident or resident's legal representative. The CBRF may take a photograph for identification purposes. The department may photograph, record or film a resident pursuant to an inspection or investigation under s. 50.03 (2)
, Stats., without his or her written informed consent.
Live in a safe environment. The CBRF shall safeguard residents from environmental hazards to which it is likely the residents will be exposed, including both conditions that are hazardous to anyone and conditions that are hazardous to the resident because of the residents' conditions or disabilities.
DHS 83.32 History
History: CR 07-095
: cr. Register January 2009 No. 637
, eff. 4-1-09; correction in (1) (a) made under 13.92 (4) (b) 7., Stats., Register January 2009 No. 637
A CBRF shall have a written grievance procedure and shall provide a copy to each resident and the resident's legal representative before or at the time of admission. The grievance procedure shall specify all of the following:
A resident or any individual on behalf of the resident may file a grievance with the CBRF, the department, the resident's case manager, if any, the board on aging and long term care, Disability Rights Wisconsin, Inc., or any other organization providing advocacy assistance. The resident and the resident's legal representative shall have the right to advocate throughout the grievance procedure. The written grievance procedure shall include the name, address and phone number of organizations providing advocacy for the client groups served, and the name, address and phone number of the department's regional office that licenses the CBRF.
Any person investigating the facts associated with a grievance shall not have had any involvement in the issue leading to the grievance.
Any form of coercion to discourage or prevent any individual from filing a grievance or in retaliation for having filed a grievance is prohibited.
The CBRF shall provide a written summary of the grievance, the findings and the conclusions and any action taken to the resident or the resident's legal representative and the resident's case manager.
The CBRF shall maintain a copy of the investigation.
The CBRF shall follow the grievance procedures under s. DHS 94.40
for any resident placed or funded by a county department of social services under s. 46.21
, Stats., a county department of human services under s. 46.23
, Stats., a county department of community programs, under s. 51.42
, Stats., a county department of developmental disabilities services under s. 51.437
, Stats., or for any resident who is receiving protective services or protective placement under ch. 55, Stats.
The CBRF shall assist residents with grievance procedures as required under this section.
The CBRF shall post in a conspicuous location in the CBRF a poster provided by the board on aging and long term care ombudsman program, concerning the long-term care ombudsman program under s. 16.009 (2) (b)
, Stats. The poster shall include the name, address and telephone number of the ombudsman's office. This requirement does not apply to those facilities exclusively licensed to serve clients under the jurisdiction of a government correctional agency.
DHS 83.33 History
History: CR 07-095
: cr. Register January 2009 No. 637
, eff. 4-1-09; correction in (2) made under s. 13.92 (4) (b) 7.
, Stats., Register January 2009 No. 637
Except for a resident in the custody of a government correctional agency, the CBRF may not obtain, hold, or spend a resident's funds without written authorization from the resident or the resident's legal representative. The resident or the resident's legal representative may limit or revoke authorization at any time by writing a statement that shall specify the effective date of the limitation or revocation.
Upon written authorization, a CBRF may hold no more than $200 cash for use by the resident. The CBRF may not commingle residents' funds with the funds or property of the CBRF, the licensee, employees, or relatives of the licensee or employees.
The CBRF shall have a legible, accurate accounting method for tracking residents' cash and shall include a record of any deposits, disbursements and earnings made to or on behalf of the resident. The CBRF shall provide a receipt to the resident or the resident's legal representative for all expenditures in excess of $20.
The CBRF shall provide a written report of the resident's account to the resident or the resident's legal representative at least every 6 months. Upon written request from the resident or resident's legal representative, the CBRF shall provide a written monthly account of any financial transactions.
(3) Funds in excess of $200.
A CBRF receiving more than $200 of personal funds from a resident shall deposit funds in excess of $200 in an interest-bearing account in the resident's name in a savings institution insured by an agency of, or a corporation chartered by, this state or the United States.
(4) Final accounting.
Within 14 days after a resident is discharged, the CBRF shall provide to the resident or the resident's legal representative a written final accounting of all the resident's funds held by the CBRF and shall disburse any remaining money to the resident or to the resident's legal representative.
No CBRF licensee, administrator or employee may do any of the following:
Sell to or purchase from a resident or prospective resident, real or personal property.
Be appointed as power of attorney for any resident unless related to the resident by blood or adoption.
No CBRF, nor any employee on behalf of the CBRF, may accept donations from any resident, except those made by a competent resident or made with the knowledge of the resident's legal representative acting within the scope of their authority and only for the benefit of the CBRF.
No employee may accept personal gifts, including monetary gifts, from a resident.
If a CBRF collects a security deposit, the funds shall be deposited in an interest-bearing account insured by an agency of, or a corporation chartered by, this state or the United States.
The amount of the security deposit shall not exceed one month's fees for services.
The CBRF shall keep the security deposit account separate from other funds of the CBRF.
Within 30 days after the resident's discharge, the security deposit and any interest earned shall be paid to the person who made the security deposit. Interest paid shall be the actual interest earned.
(7) Transfer of financial responsibility.
When a change of ownership of the CBRF occurs, the transferor shall:
Notify the transferee in writing of any financial relationships between the transferor and residents.
Notify each resident or legal representative in writing where any financial relationship exists between the transferor and residents of the pending transfer.
A CBRF handling residents' funds under this section is subject to an accounting audit as ordered by the department. The accounting audit shall be completed by a certified public accountant paid for by the CBRF.
DHS 83.34 History
History: CR 07-095
: cr. Register January 2009 No. 637
, eff. 4-1-09.
DHS 83.35 Assessment, individual service plan and evaluations. DHS 83.35(1)(a)(a)
The CBRF shall assess each resident's needs, abilities, and physical and mental condition before admitting the person to the CBRF, when there is a change in needs, abilities or condition, and at least annually. The assessment shall include all areas listed under par. (c)
. This requirement includes individuals receiving respite care in the CBRF. For emergency admissions the CBRF shall conduct the assessment within 5 days after admission.
The CBRF shall base the assessment on the current diagnostic, medical and social history obtained from the person's health care providers, case manager and other service providers. Other service providers may include a psychiatrist, psychologist, licensed therapist, counselor, occupational therapist, physical therapist, pharmacist or registered nurse. The administrator or designee shall hold a face-to-face interview with the person and the person's legal representative, if any, and family members, as appropriate, to determine what the person views as his or her needs, abilities, interests, and expectations.
Areas of assessment.
The assessment, at a minimum, shall include all of the following areas applicable to the resident:
Physical health, including identification of chronic, short-term and recurring illnesses, oral health, physical disabilities, mobility status and the need for any restorative or rehabilitative care.
Medications the resident takes and the resident's ability to control and self-administer medications.
Nursing procedures the resident needs and the number of hours per week of nursing care the resident needs.
Mental and emotional health, including the resident's self-concept, motivation and attitudes, symptoms of mental illness and participation in treatment and programming.
Behavior patterns that are or may be harmful to the resident or other persons, including destruction of property.
Capacity for self-care, including the need for any personal care services, adaptive equipment or training.
Capacity for self-direction, including the ability to make decisions, to act independently and to make wants or needs known.
Social participation, including interpersonal relationships, communication skills, leisure time activities, family and community contacts and vocational needs.
The CBRF shall prepare a written report of the results of the assessment and shall retain the assessment in the resident's record.
(2) Temporary service plan.
Upon admission, the CBRF shall prepare and implement a written temporary service plan to meet the immediate needs of the resident, including persons admitted for respite care, until the individual service plan under sub. (3)
is developed and implemented.
Within 30 days after admission and based on the assessment under sub. (1)
, the CBRF shall develop a comprehensive individual service plan for each resident. The individual service plan shall include all of the following:
Establish measurable goals with specific time limits for attainment.
Specify methods for delivering needed care and who is responsible for delivering the care.
The CBRF shall involve the resident and the resident's legal representative, as appropriate, in developing the individual service plan and the resident or the resident's legal representative shall sign the plan acknowledging their involvement in, understanding of and agreement with the plan. If a resident has a medical prognosis of terminal illness, a hospice program or home health care agency, as identified in s. DHS 83.38 (2)
shall, in cooperation with the CBRF, coordinate the development of the individual service plan and its approval under s. DHS 83.38 (2) (b)
. The resident's case manager, if any, and any health care providers, shall be invited to participate in the development of the service plan.
The CBRF shall implement and follow the individual service plan as written.
Individual service plan review.
Annually or when there is a change in a resident's needs, abilities or physical or mental condition, the individual service plan shall be reviewed and revised based on the assessment under sub. (1)
. All reviews of the individual service plan shall include input from the resident or legal representative, case manager, resident care staff, and other service providers as appropriate. The resident or resident's legal representative shall sign the individual service plan, acknowledging their involvement in, understanding of and agreement with the individual service plan.
Documentation of review.
The CBRF shall document any changes made as a result of the comprehensive individual service plan review.
All employees who provide resident care and services shall have continual access to the resident's assessment and individual service plan.
(4) Satisfaction evaluation.
At least annually, the CBRF shall provide the resident and the resident's legal representative the opportunity to complete an evaluation of the resident's level of satisfaction with the CBRF's services. The evaluation shall be completed on either a department form or a form developed by the CBRF and approved by the department.
DHS 83.35 Note
The CBRF Resident Satisfaction Evaluation form, F62372, can be found at http://dhs.wisconsin.gov/forms/DQAnum.asp
or by contacting the Division of Quality Assurance Regional Office listed in Appendix A.
(5) Evaluation of resident evacuation limitations. DHS 83.35(5)(a)(a) Initial evaluation.
The CBRF shall evaluate each resident within 3 days of the resident's admission to determine whether the resident is able to evacuate the CBRF within 2 minutes in an unsprinklered CBRF and 4 minutes in a sprinklered CBRF without any help or verbal or physical prompting, and what type of limitations that resident may have that prevent the resident from evacuating the CBRF within the applicable period of time. A form provided by the department shall be used for the evaluation. The resident's evaluation shall be retained in the resident's record.