See Fiscal Estimate & Economic Impact Analysis.
Effect on small business
Based on the foregoing analysis, the rules are anticipated to have little to no economic impact on small businesses.
Agency contact person
Statement on quality of agency data
The data used by the Department to prepare these proposed rules and analysis comply with § 227.14 (2m), Wis. Stats. Place where comments are to be submitted and deadline for submission
Comments may be submitted to the agency contact person that is listed above until the deadline given in the upcoming notice of public hearing. The notice of public hearing and deadline for submitting comments will be published in the Wisconsin Administrative Register and to the department’s website, at https://www.dhs.wisconsin.gov/rules/permanent.htm. Comments may also be submitted through the Wisconsin Administrative Rules Website, at: https://docs.legis.wisconsin.gov/code/chr/active. RULE TEXT
SECTION 1. DHS 131.13 (3) is repealed and recreated to read:
DHS 131.13 (3) “Attending physician" means a person who is either a doctor of medicine or osteopathy legally authorized to practice medicine and surgery under ch. 448, Stats., physician assistant or a nurse practitioner who meets the training, education, and experience requirements specified in s. DHS 105.20 (1) and the person is identified by the patient, at the time he or she elects to receive hospice care, as having the greatest overall role in the determination and delivery of the individual’s medical care.
SECTION 2. DHS 131.13 (11m), (12m), and (20m) are created to read: DHS 131.13 (11m) “Nonambulatory” means unable to walk.
DHS 131.13 (12m) “Nursing assistant" means a person who is employed primarily to provide direct care services to residents but is not registered or licensed under ch. 441, Stats. DHS 131.13 (20m) “Semiambulatory” means able to walk with difficulty or able to walk only with the assistance of an aid, such as crutches, a cane, or a walker.
SECTION 3. DHS 131.18 (2) (a) 4. and 7. are amended to read:
DHS 131.18 (2) (a) 4. If the patient moves beyond out of the geographical area served by the hospice or into a facility that does not have a contract with the hospice.
DHS 131.18 (2) (a) 7. For the patient’s safety and welfare or the safety and welfare of others, if the hospice determines that the behavior of the patient or other persons in the patient’s home is disruptive, abusive, or uncooperative to the extent that delivery of care to the patient or the ability of the hospice to operate effectively is seriously impaired.
SECTION 4. DHS 131.18 (3) is repealed and recreated to read:
DHS 131.18 (3) NOTICE. (a) When a patient is being discharged for a reason given in sub. (2) (a) 1.,2., 3., 4., 5., 7., or 8., the hospice shall give written notice of the discharge to the patient or patient's representative, if any, a family representative and the attending physician. DHS 131.18 (3) (b) When a patient is being discharged for the reason given in sub. (2) (a) 6., the hospice shall give written notice of the discharge at least 14 days prior to the date of discharge, and indicate a proposed date for pre-discharge planning. The written notice shall be given to the patient or patient's representative, if any, a family representative and the attending physician. SECTION 5. DHS 131.18 (4) and (title), DHS 131.20DHS 131.20(1) (1) (a), DHS 131.21 (2) (d), DHS 131.25 (6) (a) 1., (b), and DHS 131.35 (1) and (4) are amended to read: DHS 131.18 (4) Planning conference. The hospice shall conduct the pre-discharge planning conference with the patient or the patient's representative and review the need for discharge, assess the effect of discharge on the patient, discuss alternative placements and develop a comprehensive discharge plan.
DHS 131.20DHS 131.20(1) (1) DHS 131.20(1)(a)(a) If the hospice determines that it has the general capability to meet the prospective patient's described needs, then before services are provided, a registered nurse shall perform an initial assessment of the person's condition and immediate needs and shall describe in writing the person's current status, including physical condition, present pain status, emotional status, pertinent psychosocial and spiritual concerns and coping ability of the prospective patient and family support system, and shall determine the appropriateness or inappropriateness of admission to the hospice based on the assessment. DHS 131.21 (2) (d) The registered nurse shall immediately record and sign a physician's oral orders and shall obtain the physician's counter-signature within 20 working days.
DHS 131.25 (6) (a) 1. Coordinated by an individual recognized by the governing body to possess who possesses the capacity by training and experience to provide for the bereavement needs of families, including the ability to organize a program of directed care services provided to family members.
DHS 131.25 (6) (b) Dietary counseling. Dietary counseling services shall be provided only as authorized by the hospice and in conjunction with the plan of care. The services shall be provided by a registered dietician dietitian or an individual who has documented equivalency in education or training. Dietary services shall be supervised and evaluated by a registered dietician dietitian or other individual qualified under this paragraph who may delegate acts to other employees. Dietary counseling services shall consist of all of the following:
DHS 131.35 (1)DHS 131.35(1) “Existing construction" or “existing facility" means a building which is in place or is being constructed with plans approved by the department prior to October 1, 2010 the effective date of this rule. DHS 131.35(4)DHS 131.35 (4) “New construction" means construction for the first time of any building or addition to an existing building, the plans for which are approved on or after October 1, 2010. the effective date of this rule.
SECTION 7. DHS 131.37 (5) (a) is amended to read:
DHS 131.37 (5) (a) Design and location. Patient bedrooms shall be designed and equipped for the comfort and privacy of the patient and shall be equipped with or conveniently located near toilet and bathing facilities.
DHS 131.37 (5) (b) 1. A patient bedroom may accommodate no more than 3 2 patients except that in new construction a patient bedroom may accommodate no more than 2 persons. Patients of the opposite sex may not be required to occupy the same sleeping room. DHS 131.37 (5) (d) Semiambulatory and nonambulatory patients. For rooms with semiambulatory or nonambulatory patients, mobility space at the end and one side of each bed may not be not less than 4 feet. Adequate accessible space for storage of a patient's wheelchair or other adaptive or prosthetic equipment shall be provided and shall be readily accessible to the patient. In this paragraph, “semiambulatory" means able to walk with difficulty or able to walk only with assistance of an aid such as crutches, a cane or a walker, and “nonambulatory" means not able to walk at all. DHS 131.37 (5) (e) 3. Closet or wardrobe space with clothes racks and shelves in the bedroom. Closets or wardrobes shall have an enclosed space of not less than 15 inches wide by 18 inches deep by 5 feet in height for each patient. DHS 131.37 (7) (a) Minimum size. Every living and sleeping room shall have one or more outside-facing windows with a total sash area of at least 8% of the floor area of the room. The openable area of a window shall be equal to not less than 4% of the floor area of the room. DHS 131.37 (7) (c) Storm windows and Window screens. All openable windows serving in habitable rooms shall be provided with storm windows in winter, except insulated windows, and openable windows serving habitable rooms shall be provided with have insect-proof screens in summer. SECTION 14. DHS 131.37 (8) (b) and (c) are repealed and recreated to read:
DHS 131.37 (8) (b) Extension cords shall not be used in lieu of permanent wiring.
DHS 131.37 (8) (c) Exposed wiring is prohibited.
SECTION 15. DHS 131.37 (8) (d) and (e) are repealed.
DHS 131.37 (16) (c) The use of portable space heaters is prohibited except for permanently wired electric heaters which have an automatic thermostatic control and are attached to a wall.
DHS 131.37 (17) (a) 3. All bath and toilet areas shall be well lighted. Bath and toilet rooms shall be provided with at least one electrical fixture to provide artificial light.
SECTION 19. DHS 131.37 (18) (b) is amended to read:
DHS 131.37 (18) (b) Hot water at from taps accessible to patients may not exceed 110º 115º F.
SECTION 21. DHS 131.38 (1) is renumbered to DHS 131.38 (intro.) DHS 131.39 (1) Fire Inspection. The licensee of the hospice shall do all of the following:
DHS 131.39 (1) (a) The hospice shall obtain an annual inspection of the facility by the local fire authority or certified fire inspector and shall retain fire inspection reports for 2 years. DHS 131.39 (1) (b) The hospice shall provide to the local fire authority a copy of the facility written plan of orderly evacuation of patients in the event of fire. DHS 131.39 (5) (c) 1.Smoke detectors shall be installed, tested and maintained in accordance with the manufacturer's recommendations, except that they shall be tested not less than once a month. NFPA 72-2013 edition. Smoke detectors powered by the hospice electrical system shall be tested according to the manufacturer’s recommendation but no less than once a month. The hospice shall maintain a written record of tests for the previous 2 years. DHS 131.39 (5) (c) 1. (Note) Copies of the 2012 Life Safety Code and related codes may be obtained from the National Fire Protection Association, 1 Batterymarch Park, Quincy, MA 02169. SECTION 27. DHS 131.39 (5) (c) 2. and (Note) are repealed.
DHS 131.39 (6) (a) Hospice facilities licensed after June 1, 1992 which were not previously licensed shall install at least one heat detector integrated with the smoke detection system at each of the following locations: DHS 131.39 (6) (b) Smoke and heat detectors installed under this section shall be listed by a nationally recognized testing laboratory that maintains periodic inspection of production of tested equipment and the listing of which states that the equipment meets nationally recognized standards or has been tested and found suitable for use in a specified manner. SECTION 29. DHS 131.39 (8) and DHS 131.40 to DHS 131.42 are created to read:
