2. An alternative to a rule, which may involve a new concept, method, procedure or technique, new equipment, new personnel qualifications or the conduct of a pilot project, is in the interests of better care or management.
SECTION 5. DHS 124 Subchapter II and (title) are repealed and recreated to read:
Subchapter II -- Requirements
DHS 124.05 Statements of deficiency and plans of correction.
(1) Based upon an inspection and investigation by the department under s. 50.36 (4), Stats., the department may issue a statement of deficiency notifying the hospital of noncompliance with a requirement of ch. 50, Stats., or department rules. (2) The hospital shall submit a plan of correction to the department within 10 calendar days, including holidays and weekends, after receiving a statement of deficiency. The plan of correction shall include a reasonable fixed time period within which deficiencies are to be corrected.
(3) After the plan of correction is submitted, the department shall determine whether the corrections proposed by the hospital would result in compliance with the requirements of ch. 50, Stats., and department rules, and notify the hospital of the department’s determination. If the department determines the corrections proposed by the hospital would not result in compliance, the department’s notice shall describe the deficiency of the plan of correction. DHS 124.06 Patient rights and responsibilities in critical access hospitals.
(1) Every critical access hospital shall have written policies on patient rights and responsibilities, established by the governing body, which shall provide all of the following:
(a) The patient may not be denied appropriate care because of the patient’s race, creed, color, national origin, ancestry, religion, sex, sexual orientation, marital status, age, newborn status, handicap or source of payment.
(b) The patient shall be treated with consideration, respect and recognition of the patient’s individuality and personal needs, including the need for privacy in treatment.
(c) The patient’s medical record, including all computerized medical information, shall be kept confidential as required by law.
(d) The patient, or a person authorized to act on behalf of the patient in making health care related decisions, shall have access to the patient’s medical record as permitted by law.
(e) The patient shall be entitled to know who has overall responsibility for the patient’s care.
(f) The patient, or any person authorized to act on behalf of the patient in making health care related decisions, shall receive information about the patient’s illness, course of treatment and prognosis for recovery.
(g) The patient shall have the opportunity to participate to the fullest extent possible in planning for the patient’s care and treatment.
(h) The patient or his or her designated representative shall be given, at the time of admission, a copy of the critical access hospital’s policies on patient rights and responsibilities.
(i) Except in emergencies, the consent of the patient or a person authorized to act on behalf of the patient in making health care related decisions shall be obtained before treatment is administered.
(j) The patient may refuse treatment to the extent permitted by law and shall be informed of the medical consequences of the refusal.
(k) The informed consent of the patient or a person authorized to act on behalf of the patient in making health care related decisions shall be obtained before the patient participates in any form of research.
(L) Except in emergencies, the patient may not be transferred to another facility without being given a full explanation for the transfer, without provision being made for continuing care and without acceptance by the receiving institution.
(m) The patient shall be permitted to examine, and to receive an explanation of, any bill that the patient receives from the critical access hospital, and the patient shall receive, upon request, information relating to financial assistance available through the critical access hospital.
(n) The patient shall be informed of the patient’s responsibility to comply with the rules of the critical access hospital, cooperate in the patient’s own treatment, provide a complete and accurate medical history, be respectful of other patients, staff and property, and provide required information concerning payment of charges.
(o) The patient shall be informed in writing about the critical access hospital’s policies and procedures for initiation, review and resolution of patient complaints, including the address where complaints may be filed with the department.
(p) The patient may designate persons who are permitted to visit the patient during the patient’s stay at the critical access hospital.
(2) A patient who receives treatment at a critical access hospital for mental illness, a developmental disability, alcohol abuse or drug abuse shall have, in addition, the rights listed under s. 51.61, Stats., and ch. DHS 94. (3) Critical access hospital staff assigned to direct patient care shall be informed of and demonstrate their understanding of the policies on patient rights and responsibilities through orientation and appropriate in-service training activities.
(Note) Access to the records of a patient receiving treatment for mental illness, a developmental disability, alcohol abuse or drug abuse is governed by s. 51.30 (4), Stats. DHS 124.07 Maternity and neonatal care.
(1) DEFINITIONS. In this section:
(a) “Neonatal” means pertaining to the first 28 days following birth.
(b) “Perinatal” means pertaining to the mother, fetus or infant, in anticipation of and during pregnancy and through the first 28 days following birth.
(c) “Nurse-midwife” means an individual licensed under s. 441.15, Stats., and ch. N 4. (2) PERSONNEL.
(a) A registered nurse shall be responsible for the admission assessment of the maternity patient in labor and continuing assessment and support of the mother and fetus during labor, delivery and the early postpartum period.
(b) A registered nurse shall be responsible for the admission assessment of the newborn infant and continuing assessment until the newborn infant is stabilized as defined by current, accepted standards of practice.
(c) Hospitals with maternity units shall have a qualified anesthesia provider available at all times to provide emergency care to maternity patients.
(3) ADMISSION AND PATIENT PLACEMENT.
(a) The hospital shall establish and implement written policies for maternity and non-maternity patients who may be admitted to the maternity unit, including a policy that delineates medical staff responsibility for the admission of maternity patients in non-emergency situations.
(b) The hospital’s infection prevention policies shall address patient placement and visitation in the maternity unit.
(c) The hospital shall establish and implement written policies for admission of newborn infants, including newborn infants born outside the hospital, and criteria for identifying conditions for directly admitting or readmitting newborn infants to the newborn nursery or neonatal intensive care unit for further treatment and follow-up care. For an infant delivered outside the hospital, admission may be made directly to the newborn nursery or neonatal intensive care unit if the admission complies with infection control policies adopted by the hospital to protect patients from communicable disease or infection.
(4) TRANSFER. A maternity service shall do all of the following:
(a) Provide adequate facilities, personnel, and equipment and support services for the care of high-risk infants, including premature infants, or a plan for transfer of these infants to a neonatal or pediatric intensive care unit.
(b) Establish and implement written policies and procedures for inter-hospital transfer of perinatal and neonatal patients.
(c) Establish and implement written policies for the transfer of infants from one hospital to another hospital.
(d) Personnel and equipment for the transfer of infants from one hospital to another hospital shall be available to each hospital's maternity service. The execution of transfer is a joint responsibility of the sending and receiving hospitals.
(5) DELIVERY.
(a) If cesarean deliveries are not performed in the maternity unit, equipment for neonatal stabilization and resuscitation shall be available during delivery.
(b) Delivery rooms shall be used only for delivery and operating procedures related to deliveries unless permitted by a written safety risk assessment that facilitates safe delivery of care.
(6) TESTS FOR CONGENITAL DISORDERS. The hospital shall establish and implement written policies that address the screening and testing of newborns for congenital and metabolic disorders consistent with s. 253.13, Stats., and ch. DHS 115.
