(9) “Chemical restraint” means a psychotropic medication used for discipline or convenience, and not required to treat medical symptoms.
(a) The health care agent under an activated power of attorney for health care under ch. 155, Wis. Stats. (b) A person appointed as a durable power of attorney under ch. 244,Wis. Stats. (12) “Operator” means an individual or business entity to whom a certification is granted and is legally responsible for the operation of the ADCC.
(13) “Medication administration” means the direct injection, ingestion or other application of a prescription or over−the− counter drug or device to a participant by a practitioner, the practitioner’s authorized agent, ADCC caregivers or the participant, at the direction of the practitioner. Medication administration does not include reminders to take medication.
(14) “Misappropriation of property” has the meaning as given in s. DHS 13.03 (12). (15) “Neglect” has the meaning as given in s. 46.90 (1) (f), Wis. Stat. (16) “Nursing care” means nursing procedures, other than personal or supportive care, that a registered nurse or a licensed practical nurse performs directly on or to a participant.
(17) “Occupant” means any person who lives and sleeps in the ADCC, but who is not a participant.
(18) “Participant” means an adult who attends the ADCC during listed hours of operation and receives care, treatment or services.
(19) “Participant group” means individuals who need similar services because of a common disability, condition or status. Participant groups include individuals:
(a) With functional impairments that commonly accompany advanced age.
(b) With irreversible dementia, such as Alzheimer's disease.
(c) Who have a developmental disability as given in s. 51.01 (5), Wis. Stat. (d) Who are emotionally disturbed or who have a mental illness as given in s. 51.01 (13) (a), Wis. Stat. (e) With physical disabilities.
(f) With traumatic brain injury.
(20) “Physical restraint” means any manual method, article, device, or garment interfering with the free movement of the participant or the normal functioning of a portion of the participant’s body or normal access to a portion of the participant’s body, and which the participant is unable to remove easily, or confinement of a participant in a locked room.
(21) “Program Director” means an employee, including the operator, or an employee designated by the operator, who is responsible for the management and day-to-day operation of the ADCC.
(22) “Psychotropic medication” means a prescription drug, as given in s. 450.01 (20), Wis. Stat., that is used to treat or manage a psychiatric symptom or challenging behavior. (23) “Qualified Caregiver” means an employee who is at least 18 years of age and has successfully completed all of the applicable orientation and training under s. DHS 105.14.18 and s. DHS 105.14.19. (24) “Seclusion” means physical or social separation of a participant from others by actions of caregivers, but does not include separation to prevent the spread of communicable disease or voluntary cool−down periods in an unlocked room.
(25) “Serious Injury” means an injury from any incident or accident which results in:
(a) Either a temporary or permanent increase in the level of activities of daily living (ADL) assistance needed in one or more ADL categories, such as bathing, eating, oral hygiene, dressing, toileting, incontinence care, mobility and transferring;
(b) A fracture; or
(c) A pronounced decline in communication or cognitive abilities.
(26) “Significant change in a participant’s physical or mental condition” means one or more of the following:
(a) Decline in a participant’s medical condition that results in further impairment.
(b) Decline in 2 or more ADLs.
(c) A pronounced decline in communication or cognitive abilities.
(d) Decline in behavior or mood which requires either a temporary or permanent increase in the level of ADL assistance needed in one or more ADL categories, such as bathing, eating, oral hygiene, dressing, toileting, incontinence care, mobility and transferring.
(27) “Standard precautions”are a set of infection control practices used to prevent transmission of diseases that can be acquired by contact with blood, body fluids, non-intact skin (including rashes), and mucous membranes. These measures are used when providing care to all individuals, whether or not they appear infectious or symptomatic.
(28) “Supervision” means oversight of a participant’s daily functioning, keeping track of a participant’s whereabouts and providing guidance and intervention when needed by a participant.
(29) “Transferor” means the current operator in a change of ownership process who will voluntarily relinquish the current certification.
(30) “Transferee” means the recipient of a property or business in a change ownership process who will submit application for a new certification.
(31) “Utensils” means dishes, silverware and pots and pans used for storing, preparing, serving or consuming food.
(32) “Volunteer” means any person who provides services for participants without compensation.
DHS 105.14.03 Variance and waiver. (1) In this section:
(a) “Variance” means the granting of an alternate means of meeting a requirement in this chapter.
(b) “Waiver” means the granting of an exemption from a requirement of this chapter.
(2) Exception to a Requirement. (a) The department may grant a waiver or variance if the department determines that the proposed waiver or variance will not jeopardize the health, safety, welfare or rights of any participant.
(b) A written request for a waiver or variance shall be sent to the department and include justification that the waiver or variance will not adversely affect the health, safety or welfare of any participant for the requested action.
(c) A written request for a variance shall include a description of an alternative means planned to meet the intent of the requirement.
(3) The department may rescind a waiver or variance if any of the following occurs:
(a) The department determines the waiver or variance has adversely affected the health, safety, well-being or welfare of the participants.
(b) The ADCC fails to comply with any of the conditions of the waiver or variance as granted.
Subchapter II – Certification
DHS 105.14.04 Application requirements. (1) No person may receive reimbursement under s. 46.27 (11) Wis. Stat. for the provision of services to participants in an adult day care center unless the adult day care center is certified by the department. A person who assumes ownership interest in a certified ADCC, regardless of whether the transfer includes title to the real estate, or changes the location of the ADCC shall complete an application as required under sub. (2). (2) An application for certification shall be on a form provided by the department and shall be accompanied by all of the following:
(a) A program description as specified under s. DHS 105.14.05. (b) A floor plan specifying dimensions of the ADCC, exits and planned room usage.
(c) A fire inspection report.
(d) All required fees.
(e) A balance sheet.
(f) Evidence that the applicant has 60 days of projected operating funds in reserve.
(g) Proof of transportation liability insurance (if applicable).
(h) Well water test results (if applicable).
(i) Program evaluation plan.
(j) Any additional information requested by the department.
(3) An ADCC may not be located on a parcel of land zoned for industrial or manufacturing use.
DHS 105.14.05 Program description. (1) CONTENT. The program description shall accurately include all of the following:
(a) The name of the operator, the program director and the caregiver position in charge when the operator or program director is away from the ADCC.
(b) The participant capacity of the ADCC.
(c) A definition of the program goals; the days and hours of operation; a description of the services provided or made available to participants.
(d) A description of any limits the program establishes for providing service to participants with specific care needs.
(e) A fee schedule that pertains to the perspective participant which includes: The daily charge; additional fees for specific services, goods, or supplies that are not included in the daily charge, i.e., transportation, baths, personal cares, and the method for notifying participants or legal representatives of fee changes.
(f) A procedure for informing the participant’s legal representative, family, or caregiver of any major change in the participant’s general functioning or medical condition.
(g) A procedure for documenting any incident occurring at the site which would affect the health, safety or welfare of a participant.
(i) The participant group to be served. If serving more than one participant group, the program description shall include an explanation acceptable to the department of how the participant groups are compatible with one another.
(j) A grievance procedure for investigating and resolving complaints made by a participant, legal representative, family member, caregiver, or other interested persons about the services provided by the ADCC which includes informing such persons of appropriate local, county and/or state agency contacts.
(k) The criteria for voluntary and involuntary discharge of a participant from the program as defined in s. DHS 105.14.25 Discharge. (2) AVAILABILITY. (a) Before finalizing an agreement to provide care, the ADCC shall provide its program description to each person seeking services or to the person’s legal representative.
(b) The program description shall be provided to caregivers and any other person upon request.
DHS 105.14.06 Fit and qualified. (1) ELIGIBILITY. An applicant may not be certified unless the department determines the applicant is fit and qualified to operate an ADCC.
(2) STANDARDS. In determining whether a person is fit and qualified, the department shall consider all of the following:
(a) Compliance history. Compliance history with Wisconsin or any other state’s licensing or certification requirements and with any federal certification requirements, including any license revocation or denial.
(b) Criminal history. Arrest and criminal records, including any of the following:
1. Crimes or acts involving abuse, neglect or mistreatment of a person or misappropriation of property of a person.
2. Crimes or acts subject to elder abuse reporting under s. 46.90, Wis. Stat.
