Chapter DHS 83

Ch. DHS 83 Note Note: Chapter HSS 3 as it existed on June 30, 1996 was repealed and a new chapter HFS 83 was created effective July 1, 1996 and corrections were made under s. 13.93 (2m) (b) 1., 6. and 7., Stats., Register, July, 1996, No. 487. Corrections made under s. 13.93 (2m) (b) 6., 7. and 14., Stats., Register, November, 1996, No. 491. Corrections made under s. 13.93 (2m) (b) 6. and 7., Stats., Register, October, 1999, No. 526. Chapter HFS 83 was renumbered to chapter DHS 83 under s. 13.92 (4) (b) 1., Stats., and corrections made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635. Chapter DHS 83 as it existed on March 31, 2009 was repealed and a new chapter DHS 83 was created effective April 1, 2009, and corrections made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637.

subch. I of ch. DHS 83 Subchapter I — General Provisions

DHS 83.01 DHS 83.01 Authority and purpose.

DHS 83.01(1) (1) This chapter is promulgated under the authority of s. 50.02 (2), Stats., to develop and establish regulations and standards for the care, treatment or services, and health, safety, rights, welfare, and comfort of residents in CBRFs.

DHS 83.01(2) (2) The chapter is intended to ensure all CBRFs provide a living environment for residents that is as homelike as possible and is the least restrictive of each resident’s freedom; and that care and services a resident needs are provided in a manner that protects the rights and dignity of the resident and that encourages the resident to move toward functional independence in daily living or to maintain independent functioning to the highest possible extent.

DHS 83.01 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

DHS 83.02 DHS 83.02 Definitions. In this chapter:

DHS 83.02(1) (1) “Abuse” has the meaning given in s. 46.90 (1), Stats.

DHS 83.02(2) (2) “Accessible” means barriers are not present that prevent a person from entering, leaving or functioning within a CBRF without physical help.

DHS 83.02(3) (3) “Activities of daily living” means bathing, eating, oral hygiene, dressing, toileting and incontinence care, mobility and transferring from one surface to another such as from a bed to a chair.

DHS 83.02(4) (4) “Administrator” means an employee, including the licensee, or an employee designated by the licensee, who is responsible for the management and day-to-day operation of the CBRF.

DHS 83.02(5) (5) “Adult” means an individual who is at least 18 years of age.

DHS 83.02(5m) (5m) “Advanced practice nurse” has the meaning given in s. N 8.02 (1).

DHS 83.02(6) (6) “Ambulatory” means the ability to walk without difficulty or help.

DHS 83.02(7) (7) “Apartment” means a living space with separate living, toileting and sleeping areas.

DHS 83.02(8) (8) “Applicant” means the person seeking licensure of a CBRF.

DHS 83.02(9) (9) “Area of refuge” means a room or stairwell landing for residents who cannot negotiate stairs, used for safe, temporary refuge in a fire or other emergency to await instruction or assistance.

DHS 83.02(10) (10) “Assessment” means gathering and analyzing information about a prospective or existing resident’s needs and abilities.

DHS 83.02(11) (11) “Basement” means that portion of a building that is partly or completely below grade.

DHS 83.02(12) (12) “Care, treatment or services” means the provision of personal care, supervision, supervision of medication administration, management, or assistance to a resident by the CBRF, an employee, or by a person, agency or corporation affiliated with or under contract to the operator that is above the level of room and board.

DHS 83.02(13) (13) “Caregiver” has the meaning given in s. 50.065 (1) (ag), Stats.

DHS 83.02(14) (14) “Case manager” means a person who plans, coordinates and oversees the care of a resident.

DHS 83.02(15) (15) “Chemical restraint” means a psychotropic medication used for discipline or convenience, and not required to treat medical symptoms.

DHS 83.02(16) (16) “Client group” means individuals who need similar services because of a common disability, condition or status. Client groups include individuals:

DHS 83.02(16)(a) (a) With functional impairments that commonly accompany advanced age.

DHS 83.02(16)(b) (b) With irreversible dementia, such as Alzheimer’s disease.

DHS 83.02(16)(c) (c) Who have a developmental disability as given in s. 51.01 (5), Stats.

DHS 83.02(16)(d) (d) Who are emotionally disturbed or who have a mental illness as given in s. 51.01 (13) (a), Stats.

DHS 83.02(16)(e) (e) Who are alcoholic as given in s. 51.01 (1), Stats., or who are drug dependent as defined in s. 51.01 (8), Stats.

DHS 83.02(16)(f) (f) With physical disabilities.

DHS 83.02(16)(g) (g) Who are pregnant and in need of counseling services.

DHS 83.02(16)(h) (h) Under the legal custody of a government correctional agency or under the legal jurisdiction of a criminal court.

DHS 83.02(16)(i) (i) Diagnosed as terminally ill.

DHS 83.02(16)(j) (j) With traumatic brain injury.

DHS 83.02(16)(k) (k) With acquired immunodeficiency syndrome (AIDS).

DHS 83.02(17) (17) “Common dining and living space” means areas of the CBRF that are available to all residents for living and dining.

DHS 83.02(18) (18) “Community-based residential facility” or “CBRF” has the meaning given in s. 50.01 (1g), Stats.

DHS 83.02(19) (19) “Department” means the Wisconsin department of health services.

DHS 83.02(20) (20) “Dietary supplement” means a product taken by mouth that contains a dietary ingredient such as vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, glandulars, and metabolites.

DHS 83.02(21) (21) “Dietitian” means a person certified under subch. V of ch. 448, Stats.

DHS 83.02(22) (22) “Employee” means any person who works for a CBRF or for an entity that is affiliated with the CBRF or that is under contract to the CBRF, who is under direct control of the CBRF or corporation affiliated with the CBRF and who receives compensation subject to state and federal employee withholding taxes.

DHS 83.02(23) (23) “Habitable floor” means any floor level used by residents or other occupants of the CBRF, for sleeping, living, cooking or dining, including a basement.

DHS 83.02(24) (24) “Habitable room” means any room used for sleeping, living, cooking or dining, excluding enclosed places such as closets, pantries, hallways, laundries, storage spaces, utility rooms and administrative offices.

DHS 83.02(25) (25) “Horizontal evacuation” means egress travel from one building to an area in another building on approximately the same level, or egress travel through or around a wall or partition which affords safety from fire and smoke to an area on approximately the same level in the same building.

DHS 83.02(26) (26) “Intermediate level nursing care” means care that is required by a person who has a long-term illness or disability who has reached a relatively stable condition.

DHS 83.02(27) (27) “Involuntary administration of psychotropic medication” means any one of the following:

DHS 83.02(27)(a) (a) Placing psychotropic medication in an individual’s food or drink with knowledge that the individual protests receipt of the psychotropic medication.

DHS 83.02(27)(b) (b) Forcibly restraining an individual to enable administration of psychotropic medication.

DHS 83.02(27)(c) (c) Requiring an individual to take psychotropic medication as a condition of receiving privileges or benefits.

DHS 83.02(28) (28) “Legal representative” means a person who is any of the following:

DHS 83.02(28)(a) (a) The health care agent under an activated power of attorney for health care under ch. 155, Stats.

DHS 83.02(28)(b) (b) A person appointed as a durable power of attorney under ch. 244, Stats.

DHS 83.02(28)(c) (c) A guardian as given in s. 54.01 (10) to (12), Stats.

DHS 83.02(29) (29) “Medication administration” means the direct injection, ingestion or other application of a prescription or over-the-counter drug or device to a resident by a practitioner, the practitioner’s authorized agent, CBRF employees or the resident, at the direction of the practitioner. Medication administration does not include reminders to take medication.

DHS 83.02(30) (30) “Misappropriation of property” has the meaning as given in s. DHS 13.03 (12).

DHS 83.02(31) (31) “Neglect” has the meaning as given in s. 46.90 (1) (f), Stats.

DHS 83.02(32) (32) “New construction” means construction for the first time of any building or addition to an existing building on or after the effective date of this chapter.

DHS 83.02(33) (33) “NFPA” means the National Fire Protection Association.

DHS 83.02(34) (34) “Non-ambulatory” means a person who is unable to walk, but who may be mobile with the help of a wheelchair or other mobility devices.

DHS 83.02(35) (35) “Nursing care” means nursing procedures, other than personal care, that a registered nurse or a licensed practical nurse performs directly on or to a resident.

DHS 83.02(36) (36) “Other occupant” means any person who lives and sleeps in the CBRF, but who is not a resident of the CBRF.

DHS 83.02(37) (37) “Personal care” means assistance with activities of daily living, but does not include nursing care.

DHS 83.02(38) (38) “Pharmacist” means an individual licensed under ch. 450, Stats.

DHS 83.02(39) (39) “Physical restraint” means any manual method, article, device, or garment interfering with the free movement of the resident or the normal functioning of a portion of the resident’s body or normal access to a portion of the resident’s body, and which the resident is unable to remove easily, or confinement of a resident in a locked room.

DHS 83.02(40) (40) “Practitioner” means a person licensed in Wisconsin to prescribe and administer drugs or licensed in another state and recognized by this state as a person authorized to prescribe and administer drugs.

DHS 83.02(41) (41) “Psychotropic medication” means a prescription drug, as given in s. 450.01 (20), Stats., that is used to treat or manage a psychiatric symptom or challenging behavior.

DHS 83.02(42) (42) “Qualified resident care staff” means an employee who has successfully completed all of the applicable training and orientation under subch. IV.

DHS 83.02(43) (43) “Relative” means a spouse, parent, stepparent, child, stepchild, sibling, grandchild, grandparent, aunt, uncle, niece, or nephew.

DHS 83.02(44) (44) “Remodeling” means to make over or rebuild a portion of a building, structure or room, thereby modifying its structural strength, fire hazard character, exiting, heating and ventilating systems, electrical system, fire alarm, and fire protection systems, call system, internal circulation or use as previously approved by the department. Construction of interior walls shall be considered remodeling. Remodeling does not include minor repairs necessary for the maintenance of a building such as replacing like components of existing systems, redecorating existing walls or replacing floor finishes.

DHS 83.02(45) (45) “Reside” means the intent to remain in the CBRF permanently or continuously for more than 28 consecutive days.

DHS 83.02(46) (46) “Resident” means a person unrelated to the licensee or administrator who resides in the CBRF and who receives care, treatment or services in addition to room and board.

DHS 83.02(47) (47) “Resident care staff” means the licensee and all employees who have one or more of the following responsibilities for residents: supervising a resident’s activities or whereabouts, managing or administering a resident’s medications, providing personal care or treatments for a resident, planning or conducting training or activity programming for a resident. Resident care staff does not include volunteers and employees who work exclusively in the food service, maintenance, laundry service, housekeeping, transportation, or security or clerical areas, and employees that do not work on the premises of the CBRF.

DHS 83.02(48) (48) “Respite care” means a person’s temporary placement in a CBRF for no more than 28 consecutive days for care, treatment or services as established by the primary care provider.

DHS 83.02(49) (49) “Room” means a space that is completely enclosed by walls and a ceiling.

DHS 83.02(50) (50) “Seclusion” means physical or social separation of a resident from others by actions of employees, but does not include separation to prevent the spread of communicable disease or voluntary cool-down periods in an unlocked room.

DHS 83.02(51) (51) “Semi-ambulatory” means a person is able to walk with difficulty or only with the assistance of an aid such as crutches, cane or a walker.

DHS 83.02(52) (52) “Significant change in a resident’s physical or mental condition” means one or more of the following:

DHS 83.02(52)(a) (a) Decline in a resident’s medical condition that results in further impairment of a long term nature.

DHS 83.02(52)(b) (b) Decline in 2 or more activities of daily living.

DHS 83.02(52)(c) (c) A pronounced decline in communication or cognitive abilities.

DHS 83.02(52)(d) (d) Decline in behavior or mood to the point where relationships have become problematic.

DHS 83.02(52)(e) (e) Significant improvement in any of the conditions in pars. (a) to (d).

DHS 83.02(53) (53) “Standard precautions” means measures taken to reduce the risk of transmission of infection from contact with blood, body fluids or other moist body substances including all mucous membranes, non-intact skin, blood, all body fluids, secretions, and excretions except sweat, whether or not they contain visible blood.

DHS 83.02(54) (54) “Supervision” means oversight of a resident’s daily functioning, keeping track of a resident’s whereabouts and providing guidance and intervention when needed by a resident.

DHS 83.02(55) (55) “Terminal illness” means a medical prognosis issued in writing by a physician or other qualified medical professional that an individual’s life expectancy is less than 12 months.

DHS 83.02(56) (56) “Therapeutic diet” means a food regimen ordered by a physician or other medical professional directed by the physician.

DHS 83.02(57) (57) “Unit dose” means medications packaged by a pharmacist in blister cards, punch cards, strip packaging, medication reminder boxes or other similar packaging where the medication dose is packaged in a pre-selected dose.

DHS 83.02(58) (58) “Utensils” means dishes, silverware and pots and pans used for preparing, serving or consuming food.

DHS 83.02(59) (59) “Volunteer” means any person who provides services for residents without compensation, except for reimbursement of expenses related to services provided at the CBRF.