Chapter DHS 83

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.

DHS 83.05 Note Note: A copy of the application form, F60287, can be obtained at http://dhs.wisconsin.gov/forms/DQAnum.asp or by contacting the Division of Quality Assurance Regional Office listed in Appendix A.

DHS 83.05(3) (3) The applicant shall provide evidence to the department that the license applicant has made a good faith effort to establish a community advisory committee under s. 50.03 (4) (g), Stats.

DHS 83.05(4) (4) A CBRF may not be located on a parcel of land zoned for commercial, industrial or manufacturing use.

DHS 83.05 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09..

DHS 83.06 DHS 83.06 Program statement.

DHS 83.06(1) (1) Content. The program statement shall accurately include all of the following:

DHS 83.06(1)(a) (a) The name of the licensee, the administrator and the staff position in charge when the licensee or administrator is away from the CBRF.

DHS 83.06(1)(b) (b) Employee availability, including 24 hour staffing patterns and the availability of a licensed nurse, if any.

DHS 83.06(1)(c) (c) The resident capacity of the CBRF.

DHS 83.06(1)(d) (d) The class of the CBRF under s. DHS 83.04 (2).

DHS 83.06(1)(e) (e) The client group to be served. If serving more than one client group, the program statement shall include an explanation acceptable to the department of how the client groups are compatible with one another.

DHS 83.06(1)(f) (f) A complete description of the program goals and services consistent with the needs of residents.

DHS 83.06(1)(g) (g) Limitations of services, including the criteria for determining who may reside in the CBRF.

DHS 83.06(1)(h) (h) Respite care services, if provided.

DHS 83.06(2) (2) Availability.

DHS 83.06(2)(a) (a) Before finalizing an agreement to provide care, the CBRF shall provide its program statement to each person seeking placement or to the person’s legal representative. CBRFs serving only clients of a government correctional agency are exempt from this paragraph.

DHS 83.06(2)(b) (b) The program statement shall be available to employees, to residents and to any other person upon request.

DHS 83.06(3) (3) Change in program statement. Any change in the program statement content under sub. (1) shall be submitted to the department at least 30 days before its effective date.

DHS 83.06 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

DHS 83.07 DHS 83.07 Fit and qualified.

DHS 83.07(1) (1) Eligibility. An applicant may not be licensed unless the department determines the applicant is fit and qualified to operate a CBRF.

DHS 83.07(2) (2) Standards. In determining whether a person is fit and qualified, the department shall consider all of the following:

DHS 83.07(2)(a) (a) Compliance history. Compliance history with Wisconsin or any other state’s licensing requirements and with any federal certification requirements, including any license revocation or denial.

DHS 83.07(2)(b) (b) Criminal history. Arrest and criminal records, including any of the following:

DHS 83.07(2)(b)1. 1. Crimes or acts involving abuse, neglect or mistreatment of a person or misappropriation of property of the person.

DHS 83.07(2)(b)2. 2. Crimes or acts subject to elder abuse reporting under s. 46.90, Stats.

DHS 83.07(2)(b)3. 3. Crimes or acts related to the manufacture, distribution, prescription, use, or dispensing of a controlled substance.

DHS 83.07(2)(b)4. 4. Fraud or substantial or repeated violations of applicable laws and rules in the operation of any health care facility or in the care of dependent persons.