The patient may refuse treatment to the extent permitted by law and shall be informed of the medical consequences of the refusal.
The informed consent of the patient or a person authorized to act on behalf of the patient in making health care related decisions shall be obtained before the patient participates in any form of research.
Except in emergencies, the patient may not be transferred to another facility without being given a full explanation for the transfer, without provision being made for continuing care and without acceptance by the receiving institution.
The patient shall be permitted to examine, and to receive an explanation of, any bill that the patient receives from the critical access hospital, and the patient shall receive, upon request, information relating to financial assistance available through the critical access hospital.
The patient shall be informed of the patient's responsibility to comply with the rules of the critical access hospital, cooperate in the patient's own treatment, provide a complete and accurate medical history, be respectful of other patients, staff and property, and provide required information concerning payment of charges.
The patient shall be informed in writing about the critical access hospital's policies and procedures for initiation, review and resolution of patient complaints, including the address where complaints may be filed with the department.
The patient may designate persons who are permitted to visit the patient during the patient's stay at the critical access hospital.
A patient who receives treatment at a critical access hospital for mental illness, a developmental disability, alcohol abuse or drug abuse shall have, in addition, the rights listed under s. 51.61
, Stats., and ch. DHS 94
Critical access hospital staff assigned to direct patient care shall be informed of and demonstrate their understanding of the policies on patient rights and responsibilities through orientation and appropriate in-service training activities.
DHS 124.06 History
Cr. Register, January, 1988, No. 385
, eff. 2-1-88; CR 19-135: r. and recr. Register June 2020 No. 774, eff. 7-1-20.
Maternity and neonatal care. DHS 124.07(1)(a)
“Neonatal” means pertaining to the first 28 day
s following birth.
“Perinatal” means pertaining to the mother, fetus or infant, in anticipation of and during pregnancy
and through the first 28 day
s following birth.
A registered nurse shall be responsible for the admission assessment of the maternity
patient in labor and continuing assessment and support of the mother and fetus during labor, delivery and the early
A registered nurse shall be responsible for the admission assessment of the newborn infant and continuing assessment until the newborn infant is stabilized as defined by current, accepted standards of practice.
Hospitals with maternity units shall have a qualified anesthesia provider available at all times to provide emergency care to maternity patients.
Admission and patient placement.
Hospitals with maternity units shall do all of the following:
The hospital shall establish and implement written policies for maternity and non-maternity patients who may
be admitted to the maternity
unit, including a policy
that delineates medical staff responsibility
for the admission of maternity patients in non-emergency situations.
The hospital's infection prevention policies shall address patient placement and visitation in the maternity
The hospital shall establish and implement written policies for admission of newborn infants, including newborn infants born outside the hospital, and criteria for identify
ing conditions for directly admitting or readmitting newborn infants to the newborn nursery or neonatal intensive care unit for further treatment and follow-up care. For an infant delivered outside the hospital, admission may
be made directly
to the newborn nursery or neonatal intensive care unit if the admission complies with infection control policies adopted by the hospital to protect patients from communicable disease or infection.
unit shall do all of the following:
Provide adequate facilities, personnel, and equipment and support services for the care of high-risk infants, including premature infants, or a plan for transfer of these infants to a neonatal or pediatric intensive care unit.
Establish and implement written policies and procedures for inter-hospital transfer of perinatal and neonatal patients.
Establish and implement written policies for the transfer of infants from one hospital to another hospital.
Have available personnel and equipment to transfer infants to another hospital. The execution of transfer is a joint responsibility
of the sending and receiving hospitals.
Hospitals with maternity units shall do all of the following:
If cesarean deliveries are not performed in the maternity unit, equipment for neonatal stabilization and resuscitation shall be available during delivery
Delivery rooms shall be used only for delivery and operating procedures related to deliveries unless permitted by a written safety risk assessment that facilitates safe delivery of care.
Tests for congenital disorders.
The hospital shall establish and implement written policies that address the screening and testing of newborns for congenital and metabolic disorders consistent with s. 253.13
, Stats., and ch. DHS 115
The hospital shall establish and implement written policies that address infant identification and security
An infant may
be discharged onl
to a parent who has lawful custod
of the infant or to an individual who is legall
authorized to receive the infant. If the infant is discharged to a legall
authorized individual, that individual shall provide identification and, if applicable, the identification of the agency the individual represents. The hospital shall record the identity
of the legall
authorized individual to whom the infant is discharged.
sician or a nurse-midwife may
order the administration of a labor-inducing medication.
sician or a nurse-midwife or a registered nurse who has adequate training and experience may administer a labor-inducing medication.
A registered nurse shall be present when administration of a labor-inducing medication is initiated and shall remain immediately
available to monitor maternal and fetal well-being. Hospitals shall develop and implement policies allowing the registered nurse to discontinue the labor-inducing medication if circumstances warrant discontinuation and no standing orders by a physician or a nurse-midwife are in place authorizing their discontinuation.
A registered nurse shall closely
monitor and document the administration of a labor-inducing medication. Monitoring shall include monitoring of the fetus and monitoring of uterine contraction during administration of a labor-inducing medication.
sician or nurse-midwife, who prescribed the labor-inducing medication, or another phy
sician or nurse-midwife, shall be readil
available during its administration so that, if needed, he or she will arrive at the patient's bedside within 30 minutes after being notified.
A separate room apart from the newborn nursery shall be provided when circumcisions are performed according to religious rites. A phy
sician's assistant or registered nurse shall be present during the performance of the religious rite. Aseptic techniques shall be used when an infant is circumcised.
DHS 124.07 History
Cr. Register, January, 1988, No. 385
, eff. 2-1-88; CR 19-135: r. and recr. Register June 2020 No. 774, eff. 7-1-20; renum. (1) (b) to (d) under s. 13.92 (4) (b) 1., Stats., Register June 2020.
In this section, “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.
The department may directly assess a forfeiture for each violation of a requirement under s. 50.375 (2)
, Stats., for care of a victim by a hospital that provides emergency services. The department may assess the forfeitures as follows:
DHS 124.08 Note
Section 50.375 (2)
, Stats., requires a hospital that provides emergency services to a victim to 1) provide to the victim medically and factually accurate and unbiased written and oral information about emergency contraception and its use and efficacy; 2) orally inform the victim of
her option to receive emergency contraception at the hospital,
her option to report the sexual assault to a law enforcement agency,
and any available options for her to receive an examination to gather evidence regarding the sexual assault; and 3) except as specified in s. 50.375 (4)
, Stats., 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.
DHS 124.08 Note
Section 50.375 (3)
, Stats., requires a hospital that provides emergency care to ensure that each hospital employee who provides care to a victim has available medically and factually accurate and unbiased information about emergency contraception.
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. (4)
pursuant to s. 50.377 (3)
Pursuant to s. 50.377 (4)
, Stats., all forfeitures shall be paid to the department within 10 days after receipt of a notice of assessment or, if the forfeiture is contested under sub. (5)
, 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.
Pursuant to s. 50.377 (3)
, Stats., a hospital may contest an assessment of a forfeiture by the department under sub. (2)
by sending, within 10 days after receipt of notice under sub. (3)
, a written request for a hearing under s. 227.44
, Stats., to the division of hearings and appeals. 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
, Stats. 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.
DHS 124.08 History
History: CR 19-135: renum. from DHS 124.24 (3) Register June 2020 No. 774, eff. 7-1-20; correction in (1), (3) to (5) made under s. 13.92 (4) (b) 7., Stats., Register June 2020 No. 774. DHS 124.09
Freestanding emergency departments. DHS 124.09(1)(1)
In this subchapter, “freestanding emergency department” means a dedicated location that is physically separate from a hospital campus that offers inpatient overnight care, with services and staff organized primarily for the purpose of delivering emergency medical services without requiring a previously scheduled appointment.
A freestanding emergency department must comply with subs. (3)
, and (5)
and have provider-based status under 42 CFR 413.65
as a department of a hospital that offers inpatient overnight care.
A freestanding emergency department shall be under the direction of the emergency services department of a Wisconsin licensed hospital.
A freestanding emergency department shall provide emergency services 24 hours a day, 7 days a week, 365 days a year, on an outpatient basis.
A freestanding emergency department shall be identifiable to a patient.
The exterior entrance of a freestanding emergency department shall be at grade level, well-marked, and illuminated, with a covered ambulance bay.
The freestanding emergency department equipment shall be readily available, serviced, maintained and adequate to provide comprehensive emergency care.
There shall be sufficient qualified medical, nursing, and ancillary personnel available to the freestanding emergency departments at all times to manage the number and severity of emergency department cases anticipated by the location. At all times, freestanding emergency departments shall have on-site the following minimum staffing, equipment and services necessary to evaluate and treat patients:
One physician, who through education, training, and experience specializes in emergency medicine.
One registered nurse, who through education, training, and experience specializes in emergency nursing.
A person authorized to perform radiological services pursuant to ch. 462
, Stats., shall be available at the freestanding emergency department, as follows:
Radiologist interpretation of CT scans and ultrasounds shall be available within one hour.
The freestanding emergency department shall develop and implement a written policy for timely interpretation of plain film studies.
Services available within the freestanding emergency department shall be appropriate for the care of emergency medical cases anticipated by the location.
The freestanding emergency department shall provide pharmacy and respiratory services appropriate for the care of emergency medical cases anticipated by the location.
Services and supplies available within the freestanding emergency department shall be appropriate for the care of emergency medical cases anticipated by the freestanding emergency department.
Written policies regarding the availability and utilization of social services shall be established.
A freestanding emergency department shall:
Establish written policies and procedures governing ambulance delivery of patients that are consistent with the local emergency medical service system.
Communicate these policies to the local emergency medical services system to ensure appropriate routing of emergency cases by emergency medical technicians.
Establish written policies regarding patient transfers to other medical facilities. The policies shall address transfers by ambulance and, if the freestanding emergency department determines it is appropriate for that location, by helicopter.