Chapter DHS 127

DHS 127.08(3)(a)1.a. a. The requirement from which the waiver or variance is requested.

DHS 127.08(3)(a)1.b. b. The time period for which the waiver or variance is requested.

DHS 127.08(3)(a)1.c. c. The reason or reasons for the request. The center shall provide an explanation of why the requirement from which the center seeks relief results in unreasonable hardship or is infeasible as applied to the rural medical center or a patient or resident of the rural medical center.

DHS 127.08(3)(a)1.d. d. If the request is for a variance, the rural medical center’s proposal of the alternative condition, method, procedure, practice, technique, equipment, personnel qualification, pilot project or other alternative is in the interests of the management of patient or resident care and is as protective as the requirement from which the waiver or variance is being sought.

DHS 127.08(3)(a)2. 2. A request for a waiver or variance may be made at any time.

DHS 127.08(3)(a)3. 3. The department may require additional information from the rural medical center before acting on the request.

DHS 127.08 Note Note: A request for a waiver or variance should be addressed to the Division of Quality Assurance, P.O. Box 2969, Madison, Wisconsin 53701-2969.

DHS 127.08(3)(b) (b) Grants and denials.

DHS 127.08(3)(b)1. 1. The department shall grant or deny in writing each request for a waiver or variance. A notice of denial shall state the department’s findings and reasons for denial and shall indicate that the rural medical center may request a hearing under par. (c). Except when additional information is requested under par. (a) 3., if a notice of denial is not issued within 60 calendar days after the receipt of a complete request, the waiver or variance shall be automatically approved.

DHS 127.08(3)(b)2. 2. The department may limit the duration of any waiver or variance.

DHS 127.08(3)(b)3. 3. The department may impose conditions on a waiver or variance if the department finds that the conditions are necessary to protect the health, safety or welfare of rural medical center patients or residents.

DHS 127.08(3)(b)4. 4. The terms of a waiver or variance may be modified only upon written agreement between the department and the rural medical center.

DHS 127.08(3)(c) (c) Appeal.

DHS 127.08(3)(c)1. 1. A rural medical center may contest the denial of a waiver or variance by requesting a hearing pursuant to ch. 227, Stats. The request for hearing shall be in writing and filed with the department of administration’s division of hearings and appeals within 10 working days after receipt of the notice under par. (b). A request for a hearing is considered filed on the date of its receipt by that office.

DHS 127.08(3)(c)2. 2. The rural medical center shall bear the burden of proving by a preponderance of the evidence that a denial of a waiver or variance was unreasonable.

DHS 127.08 Note Note: A hearing request should be sent or may be delivered to the Department of Administration’s Division of Hearings and Appeals, 5005 University Avenue, Suite 201, Madison, Wisconsin, 53705-5400.

DHS 127.08(3)(d) (d) Revocation. The department may revoke a waiver or variance, subject to appeal rights under par. (c), for any of the following reasons:

DHS 127.08(3)(d)1. 1. The department determines that the waiver or variance adversely affects the health, safety or welfare of the rural medical center’s patients or residents.

DHS 127.08(3)(d)2. 2. The rural medical center failed to comply with the waiver or variance as granted or with a condition of the waiver or variance.

DHS 127.08(3)(d)3. 3. The person representing the rural medical center who received the waiver or variance notifies the department in writing that the center wishes to relinquish the waiver or variance and be subject to the requirement previously waived or varied.

DHS 127.08(3)(d)4. 4. Revocation is required by a change in state law.

DHS 127.08 History History: Cr. Register, February, 1999, No. 518, eff. 3-1-99.

subch. II of ch. DHS 127 Subchapter II — Program and Operational Standards

DHS 127.16 DHS 127.16 Nursing home services. A rural medical center offering or proposing to offer nursing home services shall comply with ch. DHS 132 or 134, as appropriate, and 42 CFR 483, Subpart B. If ch. DHS 132 or 134 conflicts with this chapter, this chapter shall take precedence.

DHS 127.16 History History: Cr. Register, February, 1999, No. 518, eff. 3-1-99; corrections made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637.

DHS 127.17 DHS 127.17 Hospital services. A rural medical center offering or proposing to offer hospital services shall comply with ch. DHS 124 and 42 CFR 482. If ch. DHS 124 conflicts with this chapter, this chapter shall take precedence.

DHS 127.17 History History: Cr. Register, February, 1999, No. 518, eff. 3-1-99; corrections made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637.

DHS 127.18 DHS 127.18 Home health services. A rural medical center offering or proposing to offer home health services shall comply with ch. DHS 133 and 42 CFR 484. If ch. DHS 133 conflicts with this chapter, this chapter shall take precedence.

DHS 127.18 History History: Cr. Register, February, 1999, No. 518, eff. 3-1-99; corrections made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637.

DHS 127.19 DHS 127.19 Hospice services. A rural medical center offering or proposing to offer hospice services shall comply with ch. DHS 131 and 42 CFR 418. If ch. DHS 131 conflicts with this chapter, this chapter shall take precedence.

DHS 127.19 History History: Cr. Register, February, 1999, No. 518, eff. 3-1-99; correction made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637.

DHS 127.20 DHS 127.20 Critical access hospital services. A rural medical center offering or proposing to offer critical access hospital services shall comply with applicable sections of 42 CFR 400, 409, 410, 411, 412, 413, 424, 440, 485, 488, 489 and 498.

DHS 127.20 History History: Cr. Register, February, 1999, No. 518, eff. 3-1-99.

DHS 127.21 DHS 127.21 Rural health clinic services. A rural medical center offering or proposing to offer rural health clinic services shall comply with applicable sections of 42 CFR 405, Subpart X and 42 CFR 491, Subpart A.

DHS 127.21 History History: Cr. Register, February, 1999, No. 518, eff. 3-1-99.

DHS 127.22 DHS 127.22 Rehabilitation, outpatient physical therapy and outpatient occupational therapy services. A rural medical center offering or proposing to offer rehabilitation, outpatient physical therapy or outpatient occupational therapy services shall comply with applicable sections of 42 CFR 405 or 485.

DHS 127.22 History History: Cr. Register, February, 1999, No. 518, eff. 3-1-99.

DHS 127.23 DHS 127.23 Ambulatory surgery center services. A rural medical center offering or proposing to offer ambulatory surgery center services shall comply with applicable sections of 42 CFR 416.

DHS 127.23 History History: Cr. Register, February, 1999, No. 518, eff. 3-1-99.

DHS 127.24 DHS 127.24 End-stage renal disease services. A rural medical center offering or proposing to offer end-stage renal disease services shall comply with applicable sections of 42 CFR 405, Subpart U.

DHS 127.24 History History: Cr. Register, February, 1999, No. 518, eff. 3-1-99.