DHS 134.67(5)(c)2.2. Records shall be kept of all medications returned for credit. Any medication under subd. 1. not returned for credit shall be destroyed in the facility and a record of the destruction shall be prepared which shall be signed and dated by 2 or more personnel who witnessed the destruction and who are licensed or registered in the health care field. DHS 134.67(5)(d)2.2. Medications in the possession of a resident which, if ingested or brought into contact with the nasal or eye mucosa would produce toxic or irritant effects, shall be stored and used by a resident only in accordance with the health, safety and welfare of all residents. DHS 134.67(6)(a)(a) Scope. When a unit-dose drug delivery system is used, the requirements of this subsection shall apply in addition to those of sub. (5). DHS 134.67(6)(b)1.1. The individual medication in a unit dose system shall be labeled with the drug name, strength, expiration date and lot or control number. DHS 134.67(6)(b)2.2. A resident’s medication tray or drawer in a unit dose system shall be labeled with the resident’s name and room number. DHS 134.67(6)(b)3.3. Each medication shall be dispensed separately in single unit dose packaging exactly as ordered by the physician and in a manner that ensures the stability of the medication. DHS 134.67(6)(b)4.4. An individual resident’s supply of medications shall be placed in a separate, individually labeled container, transferred to the living unit and placed in a locked cabinet or cart. This supply may not exceed 4 days for any one resident. DHS 134.67(6)(b)5.5. If not delivered to the facility by the pharmacist, the pharmacist’s agent shall transport unit dose drugs in locked containers. DHS 134.67(6)(b)6.6. Individual medications shall remain in the identifiable unit dose package until directly administered to the resident. Transferring between containers is prohibited. DHS 134.67(6)(b)7.7. Unit dose carts or cassettes shall be kept in a locked area when not in use. DHS 134.67 HistoryHistory: Cr. Register, June, 1988, No. 390, eff. 7-1-88; CR 04-053: r. and recr. (2), r. (4) (b) and (5) (c) 3. Register October 2004 No. 586, eff. 11-1-04. DHS 134.68DHS 134.68 Laboratory, radiologic and blood services. DHS 134.68(1)(a)(a) Facilities shall provide or promptly obtain laboratory, radiologic and other diagnostic services needed by residents. DHS 134.68(1)(b)(b) Any laboratory and radiologic services provided by a facility shall meet the applicable requirements for hospitals found in ch. DHS 124. DHS 134.68(1)(c)(c) If a facility does not provide the services required by this section, the facility shall make arrangements for obtaining the services from a physician’s office, hospital, nursing facility, portable x-ray supplier or independent laboratory. DHS 134.68(1)(d)(d) No services under this subsection may be provided without an order of a physician or a physician extender. DHS 134.68(1)(e)(e) A resident’s attending physician shall be notified promptly of the findings of all tests conducted on the resident. DHS 134.68(1)(f)(f) The facility shall assist the resident, if necessary, in arranging for transportation to and from the provider of service. DHS 134.68 NoteNote: For record requirements, see s. DHS 134.47. DHS 134.68(2)(2) Blood and blood products. Any blood-handling and storage facilities at an FDD shall be safe, adequate and properly supervised. DHS 134.68 HistoryHistory: Cr. Register, June, 1988, No. 390, eff. 7-1-88; corrections in (1) (b) and (2) made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637; CR 23-046: am. (2) Register April 2024 No. 820, eff. 5-1-24. DHS 134.70DHS 134.70 Special requirements when persons are admitted for short-term care. DHS 134.70(1)(1) Scope. Facilities that admit persons for short-term care may use the procedures included in this section rather than the procedures included in ss. DHS 134.52 and 134.60 (1). 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. Short-term care is for either respite or recuperative purposes. Except as specified in this section, all requirements of this chapter, including s. DHS 134.51, apply to all facilities that admit persons for short-term care. DHS 134.70(2)(a)(a) 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 134.52 and 134.60 (1): DHS 134.70(2)(a)1.1. 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 provided under sub. (4) (a). 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 and assessment of the person’s prior health and care in that discipline. The comprehensive resident assessment shall include: DHS 134.70(2)(a)1.b.b. A statement from the attending physician that the person is free from tuberculosis and other clinically apparent communicable diseases; and DHS 134.70(2)(a)2.2. 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 subd. 1., the physician’s orders and any special assessments under subd. 1. DHS 134.70(2)(a)3.3. The facility shall send a copy of the comprehensive resident assessment, the physician’s orders and the plan of care under subd. 2. 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. DHS 134.70(2)(b)(b) Recuperative care. For a person admitted to a facility for recuperative care, the following admission and resident care planning procedures may be carried out in place of the requirements under ss. DHS 134.52 and 134.60 (1): DHS 134.70(2)(b)1.1. The person may be admitted only on order of a physician accompanied by information about the person’s medical condition and diagnosis, the physician’s initial plan of care, and either the physician’s written certification that the person is free of tuberculosis and other clinically apparent communicable diseases or an order of a physician for procedures to treat any disease the person may have. DHS 134.70(2)(b)2.2. A registered nurse shall prepare an initial plan of care for nursing services to be implemented on the day of admission, which shall be based on the physician’s initial plan of care under subd. 1. and shall be superseded by the plan of care under subd. 5. DHS 134.70(2)(b)3.3. A physician shall conduct a physical examination of the new resident within 48 hours following admission, unless a physical examination was performed by a physician within 15 days before admission. DHS 134.70(2)(b)4.4. A registered nurse shall complete a comprehensive resident assessment of the person prior to or within 72 hours after admission. The comprehensive assessment shall include evaluation of the person’s nursing, dietary, rehabilitative, pharmaceutical, dental, social and activity needs. The consulting or staff pharmacist shall participate in the comprehensive assessment as provided under sub. (4) (a). As part of the comprehensive assessment, when the registered nurse has identified a need for a special service, staff from the discipline that provides the service shall, on referral from the registered nurse, complete a and assessment of the person’s prior health and care in that discipline. DHS 134.70(2)(b)5.5. The registered nurse, with verbal agreement of the attending physician, shall develop a written plan of care for the new resident within one week after admission. The plan of care shall be based on the comprehensive resident assessment under subd. 4., the physician’s orders, and any special assessment under subd. 4. DHS 134.70(2)(b)6.6. The facility shall send a copy of the comprehensive resident assessment, the physician’s orders and the plan of care under subd. 5. to the new resident’s attending physician. The attending physician shall sign the assessment and the plan of care. DHS 134.70(3)(b)(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 which contains at least the following information: DHS 134.70(3)(b)1.1. An indication of 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; DHS 134.70(3)(b)2.2. An accurate description of the basic services provided by the facility, the rate charged for those services and the method of payment for them; DHS 134.70(3)(b)3.3. Information about all additional services regularly offered but not included in the basic services. The facility shall provide information on where a statement of the fees charged for each of these services can be obtained. These additional services include pharmacy, x-ray, beautician and all other additional services regularly offered to residents or arranged for residents by the facility; DHS 134.70(3)(b)5.5. Terms for refunding advance payments in case of transfer, death or voluntary or involuntary termination of the service agreement; DHS 134.70(3)(b)7.7. The facility’s policy regarding possession and use of personal belongings; DHS 134.70(3)(b)8.8. In the case of a person admitted for recuperative care, the terms for holding and charging for a bed during the resident’s temporary absence; and DHS 134.70(3)(b)9.9. In summary form, the residents’ rights recognized and protected by s. DHS 134.31 and all facility policies and regulations governing resident conduct and responsibilities. DHS 134.70(4)(a)(a) The consulting or staff pharmacist shall review the drug regimen of each person admitted to the facility for respite care or recuperative care as part of the comprehensive resident assessment under sub. (2) (a) 1. or (b) 4. DHS 134.70(4)(b)(b) The consulting or staff pharmacist, who is required under s. DHS 134.67 (3) (b) to visit the facility at least quarterly to review drug regimens and medication practices, shall review the drug regimen of each resident admitted for recuperative care and the drug regimen of each resident admitted for respite care who may still be a resident of the facility at the time of the pharmacist’s visit. DHS 134.70(4)(c)(c) Respite care residents and recuperative care residents may bring medications into the facility as permitted by written policy of the facility. DHS 134.70(5)(5) Physician visits. The requirements under s. DHS 134.66 (2) (b) for physician visits do not apply in the case of a respite care resident, except when the nursing assessment indicates there has been a change in the resident’s condition following admission, in which case the physician shall visit the resident if this appears indicated by the assessment of the resident. DHS 134.70(6)(a)(a) For residents receiving recuperative care, a planning conference shall be conducted at least 10 days before the designated date of termination of the short-term care, except in an emergency, to determine the appropriateness of discharge or need for the resident to stay at the facility. At the planning conference a care plan shall be developed for a resident who is being discharged to home care or to another health care facility. If discharge is not appropriate, the period for recuperative care shall be extended, if it was originally less than 90 days, for up to the 90 day limit, or arrangements shall be made to admit the person to the facility for care that is not short-term, as appropriate. DHS 134.70(7)(a)(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 134.47 (4): DHS 134.70(7)(a)2.2. Admission nursing notes identifying pertinent problems to be addressed and areas of care to be maintained; DHS 134.70(7)(a)3.3. 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; DHS 134.70(7)(a)6.6. Any progress notes by physicians or other persons providing health care to the resident that document resident care and progress; DHS 134.70(7)(a)7.7. For respite care residents, a record of change in condition during the stay at the facility; and DHS 134.70(7)(a)8.8. 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. DHS 134.70(7)(b)(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. DHS 134.70 HistoryHistory: Cr. Register, June, 1988, No. 390, eff. 7-1-88. DHS 134.71DHS 134.71 Furniture, equipment and supplies. DHS 134.71(1)(a)1.1. The facility shall provide each resident with a separate bed of proper size and height for the convenience of the resident. The bed shall be in good repair and have a headboard of sturdy construction. Rollaway beds, day beds, cots, double-beds or folding beds may not be used. DHS 134.71(1)(a)2.2. Each bed shall be provided with a clean, comfortable mattress of appropriate size for the bed. DHS 134.71(1)(a)3.3. When required by the resident’s condition or age, or both, side rails shall be installed for both sides of the bed. DHS 134.71(1)(a)4.4. 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. DHS 134.71(1)(a)6.6. A moisture-proof mattress cover shall be provided for each mattress to keep the mattress clean and dry. A moisture-proof pillow cover shall be provided for each pillow to keep the pillow clean and dry. DHS 134.71(1)(a)7.7. A supply of sheets and pillow cases sufficient to keep beds clean and odor-free shall be stocked. At least 2 sheets and 2 pillow cases shall be furnished to each resident each week. DHS 134.71(1)(a)8.8. A sufficient number of blankets appropriate to the weather and seasonal changes shall be provided. Blankets shall be changed and laundered as necessary to maintain cleanliness.
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Department of Health Services (DHS)
Chs. DHS 110-199; Health
administrativecode/DHS 134.70(2)(a)
administrativecode/DHS 134.70(2)(a)
section
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