Chapter DHS 83

DHS 83.28(4)(b)4. 4. The CBRF shall maintain the screening documentation for each respite care person.

DHS 83.28(5) (5) Temporary service plan. Upon admission, the CBRF shall develop a temporary service plan as required under s. DHS 83.35 (2).

DHS 83.28(6) (6) Resident rights, grievance procedure and house rules. Before or at the time of admission, the CBRF shall provide and explain resident rights, the house rules of the CBRF as required under s. DHS 83.32 (2), and the grievance procedure, including written information regarding the names, addresses and telephone numbers of all resident advocacy groups serving the client groups in the facility, including the long term care ombudsman program and the protection and advocacy services of Disability Rights Wisconsin, Inc.

DHS 83.28(7) (7) Advanced directives. At the time of admission, the CBRF shall determine if the resident has executed an advanced directive. An advanced directive describes, in writing, the choices about treatments the resident may or may not want and about how health care decisions should be made for the resident if the resident becomes incapacitated and cannot express their wishes. A copy of the document shall be maintained in the resident record as required under s. DHS 83.42 (1) (s). A CBRF may not require an advanced directive as a condition of admission or as a condition of receiving any health care service. An advanced directive may be a living will, power of attorney for health care, or a do-not-resuscitate order under ch. 154 or 155, Stats., or other authority as recognized by the courts of this state.

DHS 83.28 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; CR 10-091: am. (7) Register December 2010 No. 660, eff. 1-1-11.

DHS 83.29 DHS 83.29 Admission agreement.

DHS 83.29(1) (1) Services and charges.

DHS 83.29(1)(a) (a) Definition. In this section, “entrance fee” means a payment required for admission to the CBRF that is in addition to the fees for services and security deposit.

DHS 83.29(1)(b) (b) Written information regarding services and charges. Before or at the time of admission, the CBRF shall provide written information regarding services available and the charges for those services to each resident, including persons admitted for respite care, or the resident’s legal representative. This information shall include any charges for services not covered by the daily or monthly rate, any entrance fees, assessment fees and security deposit.

DHS 83.29(1)(c) (c) Written notice of any change in services or in charges. The CBRF shall give the resident or the resident’s legal representative a 30-day written notice of any change in services available or in charges for services that will be in effect for more than 30 days.

DHS 83.29(2) (2) admission agreement requirements. The admission agreement shall be given in writing and explained orally in the language of the prospective resident or legal representative. Admission is contingent on a person or that person’s legal representative signing and dating an admission agreement. The admission agreement shall include all of the following:

DHS 83.29(2)(a) (a) An accurate description of the basic services provided, the rate charged for those services and the method of payment.

DHS 83.29(2)(b) (b) Information about all additional services offered, but not included in the basic services. The CBRF shall provide a written statement of the fees charged for each of these services.

DHS 83.29(2)(c) (c) The method for notifying residents of a change in charges for services.

DHS 83.29(2)(d) (d) Terms for resident notification to the CBRF of voluntary discharge. This paragraph does not apply to a resident in the custody of a government correctional agency.

DHS 83.29(2)(e) (e) Terms for refunding charges for services paid in advance, entrance fees, or security deposits in the case of transfer, death or voluntary or involuntary discharge.

DHS 83.29(2)(f) (f) A statement that the amount of the security deposit may not exceed one month’s fees for services, if a security deposit is collected.

DHS 83.29(2)(g) (g) Terms for holding and charging for a resident’s room during a resident’s temporary absence. This paragraph does not apply to a resident in the custody of a government correctional agency.

DHS 83.29(2)(h) (h) Reasons and notice requirements for involuntary discharge or transfer, including transfers within the CBRF. This paragraph does not apply to a resident in the custody of a government correctional agency.

DHS 83.29(3) (3) Refunds.

DHS 83.29(3)(a) (a) The CBRF shall return all refunds due a resident under the terms of the admission agreement within 30 days after the date of discharge.

DHS 83.29(3)(b) (b) During the first 6 months following the date of initial admission, the CBRF shall refund the entire entrance fee when the resident is discharged or when the resident meets the terms for notification to the CBRF of voluntary discharge as contained in the CBRF’s admission agreement.

DHS 83.29(4) (4) Conflict with this chapter. No statement of the admission agreement may be in conflict with any part of this chapter, unless the department has granted a waiver or variance of a provision of this chapter.

DHS 83.29 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

DHS 83.30 DHS 83.30 Family care information and referral. If the secretary of the department has certified that a resource center, as defined under s. DHS 10.13 (42), is available for the facility under s. DHS 10.71, the CBRF shall provide information to prospective residents and refer residents and prospective residents to an aging and disability resource center as required under s. 50.035 (4m) and (4n), Stats., and s. DHS 10.73.

DHS 83.30 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; corrections made under 13.92 (4) (b) 7., Stats., Register January 2009 No. 637; CR 23-046: am. Register April 2024 No. 820, eff. 5-1-24.

DHS 83.31 DHS 83.31 Discharge or transfer.

DHS 83.31(1) (1) Applicability. This section applies to all resident discharges except for persons in respite care.

DHS 83.31(2) (2) Emergency or temporary transfers. If a condition or action of a resident requires the emergency transfer of the resident to a hospital, nursing home or other facility for treatment not available from the CBRF, the CBRF may not involuntarily discharge the resident unless the requirements under sub. (4) are met.

DHS 83.31(3) (3) Discharge or transfer initiated by resident.

DHS 83.31(3)(a) (a) Any competent resident may initiate transfer or discharge at any time in accordance with the terms of the admission agreement if the resident is not in the custody of a government correctional agency, committed under s. 51.20, Stats., or under a court-ordered protective placement under s. 55.12, Stats.

DHS 83.31(3)(b) (b) If a resident found incompetent under ch. 54, Stats., protests the resident’s admission or continued stay, the licensee or designee shall immediately notify the legal representative and the county protective services agency to obtain a determination about whether to discharge the resident under s. 55.055 (3), Stats.

DHS 83.31(4) (4) Discharge or transfer initiated by CBRF.

DHS 83.31(4)(a) (a) Notice and discharge requirements.

DHS 83.31(4)(a)1. 1. Before a CBRF involuntarily discharges a resident, the licensee shall give the resident or legal representative a 30 day written advance notice. The notice shall explain to the resident or legal representative the need for and possible alternatives to the discharge. Termination of placement initiated by a government correctional agency does not constitute a discharge under this section.

DHS 83.31(4)(a)2. 2. The CBRF shall provide assistance in relocating the resident and shall ensure that a living arrangement suitable to meet the needs of the resident is available before discharging the resident.

DHS 83.31(4)(b) (b) Reasons for involuntary discharge. The CBRF may not involuntarily discharge a resident except for any of the following reasons:

DHS 83.31(4)(b)1. 1. Nonpayment of charges, following reasonable opportunity to pay.

DHS 83.31(4)(b)2. 2. Care is required that is beyond the CBRF’s license classification.

DHS 83.31(4)(b)3. 3. Care is required that is inconsistent with the CBRF’s program statement and beyond that which the CBRF is required to provide under the terms of the admission agreement and this chapter.

DHS 83.31(4)(b)4. 4. Medical care is required that the CBRF cannot provide.

DHS 83.31(4)(b)5. 5. There is imminent risk of serious harm to the health or safety of the resident, other residents or employees, as documented in the resident’s record.

DHS 83.31(4)(b)6. 6. As provided under s. 50.03 (5m), Stats.

DHS 83.31(4)(b)7. 7. As otherwise permitted by law.

DHS 83.31(4)(c) (c) Notice requirements. Every notice of involuntary discharge shall be in writing to the resident or resident’s legal representative and shall include all of the following:

DHS 83.31(4)(c)1. 1. A statement setting forth the reason and justification for discharge listed under par. (b).

DHS 83.31(4)(c)2. 2. A statement that the resident or the resident’s legal representative may ask the department to review the involuntary discharge by sending a written request within 10 days of receipt of the discharge statement to the department’s regional office with a copy to the CBRF. The notice shall state that the request must provide an explanation why the discharge should not take place.

DHS 83.31(4)(c)3. 3. The name, address and telephone number of the department’s regional office director.

DHS 83.31(4)(c)4. 4. The name, address and telephone number of the regional office of the board on aging and long term care’s ombudsman program. For residents with developmental disability or mental illness, the notice shall include the name, address and telephone number of the protection and advocacy agency designated under s. 51.62 (2) (a), Stats.

DHS 83.31(4)(d) (d) Department review of discharge.

DHS 83.31(4)(d)1. 1. A resident may request department review of an involuntary discharge within 10 days of receipt of such notice. If a timely request is sent to the department, the CBRF may not proceed with an involuntary discharge until the department has completed its review and notified the resident or the resident’s legal representative and the CBRF of the department’s decision.

DHS 83.31(4)(d)2. 2. Within 7 days after receiving the copy of the letter requesting the review, the CBRF may provide to the department’s regional office, additional information justifying the discharge.

DHS 83.31(4)(d)3. 3. The department shall complete its review within 10 days after the CBRF submits additional information under subd. 2., if any, and will notify in writing the resident or the resident’s legal representative and the CBRF of the department’s decision.

DHS 83.31 Note Note: See Appendix A for the addresses and phone numbers of the Department’s Division of Quality Assurance, Bureau of Assisted Living regional offices.

DHS 83.31(4)(e) (e) Coercion and retaliation prohibited. Any form of coercion to discourage or prevent a resident or legal representative from requesting a department review of any notice of involuntary discharge is prohibited. Any form of retaliation against a resident or legal representative for requesting a department review, or against an employee who assists in submitting a request for department review or otherwise provides assistance with a request for review, is prohibited.

DHS 83.31(5) (5) Removal or disposal of resident’s belongings. If a resident or the resident’s representative does not remove the resident’s belongings within 30 days after discharge, the CBRF may dispose of the belongings. This subsection does not apply to a resident who absconds from the CBRF and who is under the custody of a government correctional agency or under the legal jurisdiction of a criminal court and for whom there is an apprehension order.

DHS 83.31(6) (6) Disbursement of funds.

DHS 83.31(6)(a) (a) The CBRF shall return all refunds due a resident within 30 days of the date of discharge as required under s. DHS 83.29 (3).

DHS 83.31(6)(b) (b) The CBRF shall return all resident funds held by the CBRF to the resident or the resident’s legal representative within 14 days after discharge as required under s. DHS 83.34 (4).

DHS 83.31(7) (7) Information provided at the time of transfer or discharge. At the time of a resident’s transfer or discharge, the CBRF shall inform the resident or the resident’s legal representative and the resident’s new place of residence that all of the following information is available in writing upon request:

DHS 83.31(7)(a) (a) Facility information. The name and address of the CBRF, the dates of admission, and discharge or transfer, and the name and address of a person to contact for additional information.

DHS 83.31(7)(b) (b) Medical providers. Names and addresses of the resident’s physician, dentist and other medical care providers.

DHS 83.31(7)(c) (c) Emergency contacts. Names and addresses of the resident’s relatives or legal representative to contact in case of emergency.

DHS 83.31(7)(d) (d) Other contacts. Names and addresses of the resident’s significant social or community contacts.

DHS 83.31(7)(e) (e) Assessment and individual service plan. The resident’s assessment and individual service plan, or a summary of each.

DHS 83.31(7)(f) (f) Medical needs. The resident’s current medications and dietary, nursing, physical and mental health needs, if not included in the assessment or individual service plan.

DHS 83.31(7)(g) (g) Reason for discharge or transfer. The reason for the resident’s discharge or transfer.

DHS 83.31 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

subch. VI of ch. DHS 83 Subchapter VI — Resident Rights and Protections

DHS 83.32 DHS 83.32 Rights of residents.

DHS 83.32(1) (1) Legal rights.

DHS 83.32(1)(a) (a) Section 50.09, Stats., establishes specific rights for CBRF residents and prescribes mechanisms to resolve resident complaints and to hold the CBRF licensee accountable for violating resident rights. Other statutes, such as s. 51.61 and chs. 54, 55, 155 and 304, Stats., and ch. DHS 94 may further clarify or condition a particular resident’s right, depending on the legal status of the resident or a service received by the resident. The licensee shall comply with all applicable statutes and rules.

DHS 83.32(1)(b) (b) The licensee shall protect the civil rights of residents as these rights are defined in the U.S. Constitution, the Wisconsin Constitution, the Civil Rights Act of 1964, Title VIII of the Civil Rights Act of 1968, Section 504 of the Rehabilitation Act of 1973, the Fair Housing Amendments Act of 1988, the Americans with Disabilities Act of 1990, and all other applicable federal and state statutes.

DHS 83.32(2) (2) Explanation of resident rights, grievance procedure and house rules.

DHS 83.32(2)(a) (a) Before the admission agreement is signed by the resident or the resident’s legal representative or at the time of admission, the CBRF shall provide a copy of and explain resident rights, the grievance procedure under s. DHS 83.33 and the house rules to the person being admitted, the person’s legal representative, and family members of the person. The resident or the resident’s legal representative shall be asked to sign a statement to acknowledge the receipt of an explanation of resident rights. The CBRF shall document the date and to whom the information was provided.

DHS 83.32(2)(b) (b) The CBRF shall post copies of resident rights, grievance procedure and house rules in a prominent public place available to residents, employees and guests.

DHS 83.32(3) (3) Rights of residents. Any form of coercion to discourage or prevent a resident or the resident’s legal representative from exercising any of the rights under this subchapter is prohibited. Any form of retaliation against a resident or the resident’s legal representative for exercising any of the rights in this subchapter, or against an employee or any other person who assists a resident or the resident’s legal representative in the exercise of any of the resident rights in this subchapter, is prohibited. The rights established under this subsection do not apply to a resident in the legal custody of a government correctional agency, except as determined by a government correctional agency. In addition to the rights under s. 50.09, Stats., each resident shall have all of the following rights:

DHS 83.32(3)(a) (a) Communications. Make and receive telephone calls within reasonable limits and in privacy. The CBRF shall provide at least one non-pay telephone for resident use. The CBRF may require residents who make long distance calls to do so at the resident’s own expense.

DHS 83.32(3)(b) (b) Confidentiality. Confidentiality of health and personal information and records, and the right to approve or refuse release of that information to any individual outside the CBRF, except when the resident is transferred to another facility or as required by law or third-party payment contracts and except as provided in s. 146.82 (2) and (3), Stats. The CBRF shall make the record available to the resident or the resident’s legal representative for review. Copies of the record shall be made available within 30 days, if requested in writing, at a cost no greater than the cost of reproduction.

DHS 83.32(3)(c) (c) Free from labor. Not be required by the CBRF to perform labor that is of any financial benefit to the CBRF. The CBRF may require personal housekeeping of the resident without compensation if it is for therapeutic purposes and is part of, and clearly identified in the resident’s individual service plan.

DHS 83.32(3)(d) (d) Freedom from mistreatment. Be free from physical, sexual and mental abuse and neglect, and from financial exploitation and misappropriation of property.

DHS 83.32(3)(e) (e) Freedom from seclusion. Be free from seclusion.

DHS 83.32(3)(f) (f) Freedom from chemical restraints. Be free from all chemical restraints.

DHS 83.32(3)(g) (g) Freedom from physical restraints. Be free from physical restraints except upon prior review and approval by the department upon written authorization from the resident’s primary physician or advanced practice nurse prescriber as defined in s. N 8.02 (2). The department may place conditions on the use of a restraint to protect the health, safety, welfare and rights of the resident.

DHS 83.32(3)(h) (h) Receive medication. Receive all prescribed medications in the dosage and at intervals prescribed by a practitioner. The resident has the right to refuse medication unless the medication is court ordered.

DHS 83.32(3)(i) (i) Prompt and adequate treatment. Receive prompt and adequate treatment that is appropriate to the resident’s needs.

DHS 83.32(3)(j) (j) Treatment options. Participate in the planning of care and treatment, be fully informed of care and treatment options and have the right to refuse any form of care or treatment unless the care or treatment has been ordered by a court.

DHS 83.32(3)(k) (k) Self-determination. Make decisions relating to care, activities, daily routines and other aspects of life which enhance the resident’s self reliance and support the resident’s autonomy and decision making.

DHS 83.32(3)(L) (L) Least restrictive environment. Have the least restrictive conditions necessary to achieve the purposes of the resident’s admission. The CBRF may not impose a curfew, rule or other restriction on a resident’s freedom of choice.