Chapter DHS 83

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.

DHS 83.02 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; correction in (30) made under 13.92 (4) (b) 7., Stats., Register January 2009 No. 637; CR 10-091: cr. (5m) Register December 2010 No. 660, eff. 1-1-11; correction in (28) (b) made under s. 13.92 (4) (b) 7., Stats., Register December 2010 No. 660.

DHS 83.03 DHS 83.03 Variance and waiver.

DHS 83.03(1) (1) In this section:

DHS 83.03(1)(a) (a) “Variance” means the granting of an alternate means of meeting a requirement in this chapter.

DHS 83.03(1)(b) (b) “Waiver” means the granting of an exemption from a requirement of this chapter.

DHS 83.03(2) (2) Exception to a requirement.

DHS 83.03(2)(a) (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 resident.

DHS 83.03(2)(b) (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 resident for the requested action.

DHS 83.03(2)(c) (c) A written request for a variance shall include a description of an alternative means planned to meet the intent of the requirement.

DHS 83.03 Note Note: Send a request for a waiver or variance of a requirement of this chapter to the appropriate regional office of the Department’s Division of Quality Assurance listed in Appendix A. Information about the Division of Quality Assurance can be found at: http://dhs.wi.gov/rl_dsl/bqainternet.htm

DHS 83.03(3) (3) The department may rescind a waiver or variance if any of the following occurs:

DHS 83.03(3)(a) (a) The department determines the waiver or variance has adversely affected the health, safety or welfare of the residents.

DHS 83.03(3)(b) (b) The CBRF fails to comply with any of the conditions of the waiver or variance as granted.

DHS 83.03 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

subch. II of ch. DHS 83 Subchapter II — Licensing

DHS 83.04 DHS 83.04 Licensing categories. The department shall license each CBRF as follows:

DHS 83.04(1) (1) Size.

DHS 83.04(1)(a) (a) A CBRF for 5 to 8 residents is a small CBRF.

DHS 83.04(1)(b) (b) A CBRF for 9 to 20 residents is a medium CBRF.

DHS 83.04(1)(c) (c) A CBRF for 21 or more residents is a large CBRF.

DHS 83.04(2) (2) Classification.

DHS 83.04(2)(a) (a) Class A ambulatory. A class A ambulatory CBRF serves only residents who are ambulatory and who are mentally and physically capable of responding to a fire alarm by exiting the CBRF without any help or verbal or physical prompting.

DHS 83.04(2)(b) (b) Class A semi-ambulatory (AS). A class A semi-ambulatory CBRF serves only residents who are ambulatory or semi-ambulatory and who are mentally and physically capable of responding to a fire alarm by exiting the CBRF without any help or verbal or physical prompting.

DHS 83.04(2)(c) (c) Class A non-ambulatory (ANA). A class A non-ambulatory CBRF serves residents who are ambulatory, semi-ambulatory or non-ambulatory and who are mentally and physically capable of responding to a fire alarm by exiting the CBRF without any help or verbal or physical prompting.

DHS 83.04(2)(d) (d) Class C ambulatory (CA). A class C ambulatory CBRF serves only residents who are ambulatory but one or more of whom are not mentally capable of responding to a fire alarm by exiting the CBRF without any help or verbal or physical prompting.

DHS 83.04(2)(e) (e) Class C semi-ambulatory (CS). A class C semi-ambulatory CBRF serves only residents who are ambulatory or semi-ambulatory, but one or more of whom are not physically or mentally capable of responding to a fire alarm by exiting the CBRF without help or verbal or physical prompting.

DHS 83.04(2)(f) (f) Class C non-ambulatory (CNA). A class C non-ambulatory CBRF serves residents who are ambulatory, semi-ambulatory or non-ambulatory, but one or more of whom are not physically or mentally capable of responding to a fire alarm by exiting the CBRF without help or verbal or physical prompting.

DHS 83.04 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

DHS 83.05 DHS 83.05 Application requirements.

DHS 83.05(1) (1) No person may conduct, maintain, operate or permit to be maintained or operated a CBRF unless the CBRF is licensed by the department. A person who assumes ownership interest in a CBRF, regardless of whether the transfer includes title to the real estate, or changes the location of the CBRF shall complete an application as required under sub. (2).

DHS 83.05(2) (2) An application for initial licensure shall be on a form provided by the department and shall be accompanied by all of the following:

DHS 83.05(2)(a) (a) A program statement as specified under s. DHS 83.06 (1).

DHS 83.05(2)(b) (b) A floor plan specifying dimensions of the CBRF, exits and planned room usage.

DHS 83.05(2)(c) (c) A fire inspection form.

DHS 83.05(2)(d) (d) All required fees.

DHS 83.05(2)(e) (e) A balance sheet.

DHS 83.05(2)(f) (f) Evidence that the applicant has 60 days of projected operating funds in reserve.

DHS 83.05(2)(g) (g) Any additional information requested by the department.