Wisconsin Legislature: DHS 132.70(4)(c)

7. A therapeutic recreation specialist who is a graduate of an accredited program or who has a bachelor’s degree in a specialty area such as art, dance, music, physical education or recreation therapy; or

8. A human services professional who has a bachelor’s degree in a human services field other than a field under subds. 1. to 7., such as rehabilitation counseling, special education or sociology.

(3) Active treatment programming. All residents who are developmentally disabled shall receive active treatment. Active treatment shall include the resident’s regular participation, in accordance with the IPP, in professionally developed and supervised activities, experiences and therapies.

(4) Resident care planning.

(b) Development and content of the individual program plan.

1. Except in the case of a person admitted for short-term care, within 30 days following the date of admission, the interdisciplinary team, with the participation of the staff providing resident care, shall review the preadmission evaluation and physician’s plan of care and shall develop an IPP based on the new resident’s history and an assessment of the resident’s needs by all relevant disciplines, including any physician’s evaluations or orders.

2. The IPP shall include:

a. Evaluation procedures for determining whether the methods or strategies are accomplishing the care objectives; and

b. A written interpretation of the preadmission evaluation in terms of any specific supportive actions, if appropriate, to be undertaken by the resident’s family or legal guardian and by appropriate community resources.

1. The care provided by staff from each of the disciplines involved in the resident’s treatment shall be reviewed by the professional responsible for monitoring delivery of the specific service.

2. Individual care plans shall be reassessed and updated at least quarterly by the interdisciplinary team, with more frequent updates if an individual’s needs warrant it, and at least every 30 days by the QIDP to review goals.

3. Reassessment results and other necessary information obtained through the specialists’ assessments shall be disseminated to other resident care staff as part of the IPP process.

4. Documentation of the reassessment results, treatment objectives, plans and procedures, and continuing treatment progress reports shall be recorded in the resident’s record.

(d) Implementation. Progress notes shall reflect the treatment and services provided to meet the goals stated in the IPP.

Note: See ch. DHS 134 for rules governing residential care facilities that primarily serve developmentally disabled persons who require active treatment.

History: Cr. Register, January, 1987, No. 373, eff. 2-1-87; am. (2) (a), (b), (3), (4) (a), (b), (c) 1., 2. intro. and a. and (d), renum. (2) (c) to (d) and am. (intro.) and 3., cr. (2) (c), Register, February, 1989, No. 398, eff. 3-1-89; correction in (2) (d) 4. made under s. 13.93 (2m) (b) 7., Stats., Register, August, 2000, No. 536; CR 06-053: cons., renum. and am. (3) (a) (intro.) and 1. (intro.) to be (3), r. (3) (a) 1. a. and b., 2., and (b), (4) (a), (b) 2. a. to c. and (c) 1., 2. and 3., renum. (4) (b) 2. d. and e. and (c) 1. a. to d. to be (4) (b) 2. a. and b. and (c) 1. to 4., Register August 2007 No. 620, eff. 9-1-07; corrections in (2) (d) 4. and 5. made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637; 2019 Wis. Act 1: am. (2) (d) (intro.), (4) (c) 2. Register May 2019 No. 761, eff. 6-1-19.

DHS 132.70 Special requirements when persons are admitted for short-term care.

(1) Scope. A facility may admit persons for short-term care. A facility that admits persons for short-term care may use the procedures included in this section rather than the procedures included in ss. DHS 132.52 and 132.60 (8). Short-term care is for either respite or recuperative purposes. The requirements in this section apply to all facilities that admit persons for short-term care when they admit, evaluate or provide care for these persons. Except as specified in this section, all requirements of this chapter, including s. DHS 132.51, apply to all facilities that admit persons for short-term care.

(2) Procedures for admission. Respite care. For a person admitted to a facility for respite care, the following admission and resident care planning procedures may be carried out in place of the requirements under ss. DHS 132.52 and 132.60 (8):

(a) A registered nurse or physician shall complete a comprehensive resident assessment of the person prior to or on the day of admission. This comprehensive assessment shall include evaluation of the person’s medical, nursing, dietary, rehabilitative, pharmaceutical, dental, social and activity needs. The consulting or staff pharmacist shall participate in the comprehensive assessment. As part of the comprehensive assessment, when the registered nurse or physician has identified a need for a special service, staff from the discipline that provides the service shall, on referral from the registered nurse or physician, complete a history and assessment of the person’s prior health and care in that discipline. The comprehensive resident assessment shall include:

1. A summary of the major needs of the person and of the care to be provided;

2. The attending physician’s plans for discharge.

(b) The registered nurse, with verbal agreement of the attending physician, shall develop a written plan of care for the person being admitted prior to or at the time of admission. The plan of care shall be based on the comprehensive resident assessment under par. (a), the physician’s orders, and any special assessments under par. (a).

(c) The facility shall send a copy of the comprehensive resident assessment, the physician’s orders and the plan of care under par. (b) to the person’s attending physician. The attending physician shall sign the assessment and the plan of care within 48 hours after the person is admitted.

(3) Admission information.

(a) This subsection takes the place of s. DHS 132.31 (1) (d) 1. for persons admitted for respite care or recuperative care.

(b) No person may be admitted to a facility for respite care or recuperative care without signing or the person’s guardian or designated representative signing an acknowledgement of having received a statement before or on the day of admission that indicates the expected length of stay, with a note that the responsibility for care of the resident reverts to the resident or other responsible party following expiration of the designated length of stay.

(4) Medications.

(c) Respite care residents and recuperative care residents may bring medications into the facility as permitted by written policy of the facility.

(7) Records.

(a) Contents. The medical record for each respite care resident and each recuperative care resident shall include, in place of the items required under s. DHS 132.45 (5):

1. The resident care plan prepared under sub. (2) (b).

2. Admission nursing notes identifying pertinent problems to be addressed and areas of care to be maintained;

3. For recuperative care residents, nursing notes addressing pertinent problems identified in the resident care plan and, for respite care residents, nursing notes prepared by a registered nurse or licensed practical nurse to document the resident’s condition and the care provided;

4. Physicians’ orders;

5. A record of medications;

6. Any progress notes by physicians or health care specialists that document resident care and progress;

7. For respite care residents, a record of change in condition during the stay at the facility; and

8. For recuperative care residents, the physician’s discharge summary with identification of resident progress, and, for respite care residents, the registered nurse’s discharge summary with notes of resident progress during the stay.

(b) Location and accessibility. The medical record for each short-term care resident shall be kept with the medical records of other residents and shall be readily accessible to authorized representatives of the department.

History: Cr. Register, January, 1987, No. 373, eff. 2-1-87; am. (1), (2) (a) (intro.) and (b) (intro.), Register, February, 1989, No. 398, eff. 3-1-89; CR 06-053: r. (2) (a) 1. b., (b), (3) (b) 2. to 9., (4) (a) and (b), (5) and (6), renum. (2) (a) (intro.), 1. (intro.), 2. and 3. to be (2) (intro.), (a) (intro.), (b) and (c), am. (2) (a) (intro.) and (b) and (7) (a) 1., cons., renum., and am. (3) (b) (intro.) and 1. to be (3) (b), Register August 2007 No. 620, eff. 9-1-07; correction in (2) (c) made under s. 13.93 (2m) (b) 7., Stats., Register August 2007 No. 620.

Subchapter VII — Physical Environment

DHS 132.71 Furniture, equipment and supplies.

(1) Furniture in resident care areas.

(b) Bedding.

1. Each resident shall be provided at least one clean, comfortable pillow. Additional pillows shall be provided if requested by the resident or required by the resident’s condition.

2. Each bed shall have a mattress pad.

3. A moisture-proof mattress cover and pillow cover shall be provided to keep each mattress and pillow clean and dry.

a. A supply of sheets and pillow cases sufficient to keep beds clean, dry, and odor-free shall be stocked. At least 2 sheets and 2 pillow cases shall be furnished to each resident each week.

b. Beds occupied by bedfast or incontinent residents shall be provided draw sheets.

6. Each bed shall have a clean, washable bedspread.

a. At least one chair shall be in each room for each bed. A folding chair shall not be used. If requested by the resident or guardian, a wheel-chair or geri-chair may be substituted.

b. An additional chair with arms shall be available upon request.

4. Adequate compartment or drawer space shall be provided in each room for each resident to store personal clothing and effects and to store, as space permits, other personal possessions in a reasonably secure manner.

5. A sturdy and stable table that can be placed over the bed or armchair shall be provided to every resident who does not eat in the dining area.

(d) Towels, washcloths, and soap.

1. Clean towels and washcloths shall be provided to each resident as needed. Towels shall not be used by more than one resident between launderings.

2. An individual towel rack shall be installed at each resident’s bedside or at the lavatory.

3. Single service towels and soap shall be provided at each lavatory for use by staff.

(e) Window coverings. Every window shall be supplied with flame retardant shades, draw drapes or other covering material or devices which, when properly used and maintained, shall afford privacy and light control for the resident.

(2) Resident care equipment.

(a) Personal need items. When a resident because of his or her condition needs a mouthwash cup, a wash basin, a soap dish, a bedpan, an emesis basin, or a standard urinal and cover, that item shall be provided to the resident. This equipment may not be interchanged between residents until it is effectively washed and sanitized.

(c) First aid supplies. Each nursing unit shall be supplied with first aid supplies, including bandages, sterile gauze dressings, bandage scissors, tape, and a sling tourniquet.

(d) Other equipment. Other equipment, such as wheelchairs with brakes, footstools, commodes, foot cradles, footboards, under-the-mattress bedboards, walkers, trapeze frames, transfer boards, parallel bars, reciprocal pulleys, suction machines, patient lifts, and Stryker or Foster frames, shall be used as needed for the care of the residents.

(7) Oxygen.

(a) No oil or grease shall be used on oxygen equipment.

(b) When placed at the resident’s bedside, oxygen tanks shall be securely fastened to a tip-proof carrier or base.

(d) When in use at the resident’s bedside, cannulas, hoses, and humidifier bottles shall be maintained and used in accordance with current standards of practice and manufacturers’ recommendations.

(e) Disposable inhalation equipment shall be maintained and used in accordance with current standards of practice and manufacturers’ recommendations.

(f) With other inhalation equipment such as intermittent positive pressure breathing equipment, the entire resident breathing circuit, including nebulizers and humidifiers, shall be maintained and used in accordance with current standards of practice and manufacturers’ recommendations.

History: Cr. Register, July, 1982, No. 319, eff. 8-1-82; am. (1) (e), (2) (a) and (3), Register, January, 1987, No. 373, eff. 2-1-87; CR 06-053: r. (1) (a), (b) 5., (c) 1. and 3., (2) (b) and (3) to (6), Register August 2007 No. 620, eff. 9-1-07; 2015 Wis. Act 107: am. (7) (d) to (f) Register November 2015 No. 719, eff. 12-1-15.

DHS 132.72 Housekeeping services.

(1) Requirement. Facilities shall develop and implement written policies that ensure a safe and sanitary environment for personnel and residents at all times.

(2) Cleaning.

(e) Combustibles in storage areas. Attics, cellars and other storage areas shall be kept safe and free from dangerous accumulations of combustible materials. Combustibles such as cleaning rags and compounds shall be kept in closed metal containers.

(f) Grounds. The grounds shall be kept free from refuse, litter, and waste water. Areas around buildings, sidewalks, gardens, and patios shall be kept clear of dense undergrowth.

(3) Poisons. All poisonous compounds shall be clearly labeled as poisonous and, when not in use, shall be stored in a locked area separate from food, kitchenware, and medications.

(4) Garbage. Storage containers. All garbage and rubbish shall be stored in leakproof, nonabsorbent containers with close-fitting covers, and in areas separate from those used for the preparation and storage of food. Containers shall be cleaned regularly. Paperboard containers shall not be used.

(6) Pest control.

(b) Provision of service. Pest control services shall be provided in accordance with the requirements of s. 94.705, Stats.

(c) Screening of windows and doors. All windows and doors used for ventilation purposes shall be provided with wire screening of not less than number 16 mesh or its equivalent and shall be properly installed and maintained to prevent entry of insects. Screen doors shall be self-closing and shall not interfere with exiting. Properly installed airflow curtains or fans may be used in lieu of screens.

History: Cr. Register, July, 1982, No. 319, eff. 8-1-82; am. (2) (b), (c) and (e), (6) (c), Register, January, 1987, No. 373, eff. 2-1-87; CR 06-053: r. (2) (a) to (d), (4) (b), (5) and (6) (a), renum. (4) (a) to be (4), Register August 2007 No. 620, eff. 9-1-07.

Subchapter VIII — Life Safety, Design and Construction

DHS 132.81 Scope and definitions.