Wisconsin Legislature: DHS 132.45(6)(b)

f. Summary of restorative nursing measures which are provided;

g. Summary of the use of physical and chemical restraints.

h. Other non-routine nursing care given;

i. The condition of a resident upon discharge; and

j. The time of death, the physician called, and the person to whom the body was released.

(d) Social service records. Notes regarding pertinent social data and action taken.

(e) Activities records. Documentation of activities programming, a summary of attendance, and quarterly progress notes.

(f) Rehabilitative services.

1. An evaluation of the rehabilitative needs of the resident; and

2. Progress notes detailing treatment given, evaluation, and progress.

(h) Dental services. Records of all dental services.

(i) Diagnostic services. Records of all diagnostic tests performed during the resident’s stay in the facility.

(j) Plan of care. Plan of care required by s. DHS 132.60 (8).

(k) Authorization or consent. A photocopy of any court order or other document authorizing another person to speak or act on behalf of the resident and any resident consent form required under this chapter, except that if the authorization or consent form exceeds one page in length an accurate summary may be substituted in the resident record and the complete authorization or consent form shall in this case be maintained as required under sub. (6) (i). The summary shall include:

1. The name and address of the guardian or other person having authority to speak or act on behalf of the resident;

2. The date on which the authorization or consent takes effect and the date on which it expires;

3. The express legal nature of the authorization or consent and any limitations on it; and

4. Any other factors reasonably necessary to clarify the scope and extent of the authorization or consent.

(L) Discharge or transfer information. Documents, prepared upon a resident’s discharge or transfer from the facility, summarizing, when appropriate:

1. Current medical findings and condition;

2. Final diagnoses;

3. Rehabilitation potential;

4. A summary of the course of treatment;

5. Nursing and dietary information;

6. Ambulation status;

7. Administrative and social information; and

8. Needed continued care and instructions.

(6) Other records. The facility shall retain:

(a) Dietary records. All menus and therapeutic diets;

(b) Staffing records. Records of staff work schedules and time worked;

(d) Resident census. At least a weekly census of all residents, indicating numbers of residents requiring each level of care;

(e) Professional consultations. Documentation of professional consultations by:

1. A dietitian, if required by s. DHS 132.63 (2) (b);

2. A registered nurse, if required by s. DHS 132.62 (2); and

3. Others, as may be used by the facility;

(f) Inservice and orientation programs. Subject matter, instructors and attendance records of all inservice and orientation programs;

(g) Transfer agreements. Transfer agreements, unless exempt under s. DHS 132.53 (4);

(h) Funds and property statement. The statement prepared upon a resident’s discharge or transfer from the facility that accounts for all funds and property held by the facility for the resident.

(i) Court orders and consent forms. Copies of court orders or other documents, if any, authorizing another person to speak or act on behalf of the resident.

History: Cr. Register, July, 1982, No. 319, eff. 8-1-82; am. (1) (3) (c) (5) (intro.), (b) 1. intro. and e., 2. a. and d., 3., (c) 1. and 2., (d) 1., (e), (f) 1. and (g), (6) (g), renum. (4) (a) to (e), (5) (e) and (6) (h) to be (4) (c) to (g), (5) (L) and (6) (i) and am. (5) (L), cr. (4) (a) and (b), (5) (e) and (6) (h), Register, January, 1987, No. 373, eff. 2-1-87; CR 04-053: r. and recr. (3) and (5) (d), am. (4) (g) 2. and (5) (e), r. (5) (g) Register October 2004 No. 586, eff. 11-1-04; CR 06-053: r. (4) (a), (b) and (d), (e) and (f) 1. and 3., am. (4) (f) 2. (g) 1., (5) (b) 3. and 5., (c) 4. g., and (6) (h), renum. (4) (f) 2., 4. and 5. to be (4) (f) 1., 2. and 3., Register August 2007 No. 620, eff. 9-1-07.

DHS 132.46 Quality assessment and assurance.

(1) Committee maintenance and composition. A facility shall maintain a quality assessment and assurance committee for the purpose of identifying and addressing quality of care issues. The committee shall be comprised of at least all of the following individuals:

(a) The director of nursing services.

(b) The medical director or a physician designated by the facility.

(2) Committee responsibilities. The quality assessment and assurance committee shall do all of the following:

(a) Meet at least quarterly to identify quality of care issues with respect to which quality assessment and assurance activities are necessary.

(b) Identify, develop and implement appropriate plans of action to correct identified quality deficiencies.

(3) Confidentiality. The department may not require disclosure of the records of the quality assessment and assurance committee except to determine compliance with the requirements of this section. This paragraph does not apply to any record otherwise specified in this chapter or s. 50.04 (3), 50.07 (1) (c) or 146.82 (2) (a) 5., Stats.

History: CR 04-053: cr. Register October 2004 No. 586, eff. 11-1-04.

Subchapter V — Admissions, Retentions and Removals

DHS 132.51 Limitations on admissions and programs.

(1) License limitations.

(a) Bed capacity. No facility may house more residents than the maximum bed capacity for which it is licensed. Persons participating in a day care program are not residents for purposes of this chapter.

(b) Care levels.

1. No person who requires care greater than that which the facility is licensed to provide may be admitted to or retained in the facility.

2. No resident whose condition changes to require care greater than that which the facility is licensed to provide shall be retained.

(2) Other limitations on admissions.

(a) Persons requiring unavailable services. Persons who require services which the facility does not provide or make available shall not be admitted or retained.

(b) Communicable diseases.

1. ‘Communicable disease management.’ The nursing home shall have the ability to appropriately manage persons with communicable disease the nursing home admits or retains based on currently recognized standards of practice.

2. ‘Reportable diseases.’ Facilities shall report suspected communicable diseases that are reportable under ch. DHS 145 to the local public health officer or to the department’s bureau of communicable disease.

Note: For a copy of ch. DHS 145 which includes a list of the communicable diseases which must be reported, write the Bureau of Public Health, P.O. Box 309, Madison, WI 53701 (phone 608-267-9003). There is no charge for a copy of ch. DHS 145. The referenced publications,“Guideline for Isolation Precautions in Hospitals and Guideline for Infection Control in Hospital Personnel” (HHS Publication No. (CSC) 83-8314) and “Universal Precautions for Prevention of . . . Bloodborne Pathogens in Health Care Settings”, may be purchased from the Superintendent of Documents, Washington D.C. 20402, and is available for review in the office of the Department’s Division of Quality Assurance and the Legislative Reference Bureau.

1. Notwithstanding s. DHS 132.13 (1), in this paragraph, “abusive” describes a resident whose behavior involves any single or repeated act of force, violence, harassment, deprivation or mental pressure which does or reasonably could cause physical pain or injury to another resident, or mental anguish or fear in another resident.

2. Residents who are known to be destructive of property, self-destructive, disturbing or abusive to other residents, or suicidal, shall not be admitted or retained, unless the facility has and uses sufficient resources to appropriately manage and care for them.

(d) Developmental disabilities.

1. No person who has a developmental disability may be admitted to a facility unless the facility is certified as an intermediate care facility for individuals with intellectual disabilities, except that a person who has a developmental disability and who requires skilled nursing care services may be admitted to a skilled nursing facility.

2. Except in an emergency, no person who has a developmental disability may be admitted to a facility unless the county department under s. 46.23, 51.42, or 51.437, Stats., of the individual’s county of residence has recommended the admission.

(e) Mental illness. Except in an emergency, no person who is under age 65 and has a mental illness as defined in s. 51.01 (13), Stats., may be admitted to a facility unless the county department under s. 46.23, 51.42 or 51.437, Stats., of the individual’s county of residence has recommended the admission.

(f) Minors.

1. No person under the age of 18 years may be admitted, unless approved for admission by the department.

2. Requests for approval to admit a person under the age of 18 years shall be made in writing and shall include:

a. A statement from the referring physician stating the medical, nursing, rehabilitation, and special services required by the minor;

b. A statement from the administrator certifying that the required services can be provided;

c. A statement from the attending physician certifying that the physician will be providing medical care; and

d. A statement from the persons or agencies assuming financial responsibility.

(g) Admissions 7 days a week. No facility may refuse to admit new residents solely because of the day of the week.

(3) Day care services. A facility may provide day care services to persons not housed by the facility, provided that:

(a) Day care services do not interfere with the services for residents;

(b) Each day care client is served upon the certification by a physician or physician’s assistant that the client is free from tuberculosis infection; and

(c) Provision is made to enable day care clients to rest. Beds need not be provided for this purpose, and beds assigned to residents may not be provided for this purpose.

Note: For administration of medications to day care clients, see s. DHS 132.60 (5) (d) 6.; for required records, see s. DHS 132.45 (4) (c).

History: Cr. Register, July, 1982, No. 319, eff. 8-1-82; emerg. r. and recr. (2) (d) and (3), eff. 9-15-86; r. and recr. (2) (d) am. (1) (b) 1., (2) (e) 1. and 2. intro., (3) (a) and (b), (4) (c), Register, January, 1987, No. 373, eff. 2-1-87; am. (2) (b) 2. and 3. (d) 2., r. (2) (d) 3. and (3), renum. (2) (e), (f) and (4) to be (2) (f), (g) and (3), cr. (2) (e), Register, February, 1989, No. 398, eff. 3-1-89; correction in (2) (b) 3. made under s. 13.93 (2m) (b) 7., Stats., Register, August, 2000, No. 536; CR 03-033: r. and recr. (2) (b) 1. Register December 2003 No. 576, eff. 1-1-04: CR 04-053: r. and recr. (2) (b) and am. (2) (c) Register October 2004 No. 586, eff. 11-1-04; correction in (2) (b) 2. made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637; 2019 Wis. Act 1: am. (2) (d) 1. Register May 2019 No. 761, eff. 6-1-19.

DHS 132.52 Procedures for admission.

(2) Physician’s orders. No person may be admitted as a resident except upon:

(a) Order of a physician;