Chapter DHS 83

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.

DHS 83.32(3)(m) (m) Recording, filming, photographing. Not be recorded, filmed or photographed without informed, written consent by the resident or resident’s legal representative. The CBRF may take a photograph for identification purposes. The department may photograph, record or film a resident pursuant to an inspection or investigation under s. 50.03 (2), Stats., without his or her written informed consent.

DHS 83.32(3)(n) (n) Safe environment. Live in a safe environment. The CBRF shall safeguard residents from environmental hazards to which it is likely the residents will be exposed, including both conditions that are hazardous to anyone and conditions that are hazardous to the resident because of the residents’ conditions or disabilities.

DHS 83.32 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; correction in (1) (a) made under 13.92 (4) (b) 7., Stats., Register January 2009 No. 637.

DHS 83.33 DHS 83.33 Grievance procedure.

DHS 83.33(1) (1) A CBRF shall have a written grievance procedure and shall provide a copy to each resident and the resident’s legal representative before or at the time of admission. The grievance procedure shall specify all of the following:

DHS 83.33(1)(a) (a) A resident or any individual on behalf of the resident may file a grievance with the CBRF, the department, the resident’s case manager, if any, the board on aging and long term care, Disability Rights Wisconsin, Inc., or any other organization providing advocacy assistance. The resident and the resident’s legal representative shall have the right to advocate throughout the grievance procedure. The written grievance procedure shall include the name, address and phone number of organizations providing advocacy for the client groups served, and the name, address and phone number of the department’s regional office that licenses the CBRF.

DHS 83.33(1)(b) (b) Any person investigating the facts associated with a grievance shall not have had any involvement in the issue leading to the grievance.

DHS 83.33(1)(c) (c) Any form of coercion to discourage or prevent any individual from filing a grievance or in retaliation for having filed a grievance is prohibited.

DHS 83.33(1)(d) (d) The CBRF shall provide a written summary of the grievance, the findings and the conclusions and any action taken to the resident or the resident’s legal representative and the resident’s case manager. The CBRF shall maintain a copy of the investigation.

DHS 83.33(2) (2) The CBRF shall follow the grievance procedures under s. DHS 94.40 for any resident placed or funded by a county department of social services under s. 46.21 or 46.22, Stats., a county department of human services under s. 46.23, Stats., a county department of community programs, under s. 51.42, Stats., a county department of developmental disabilities services under s. 51.437, Stats., or for any resident who is receiving protective services or protective placement under ch. 55, Stats.

DHS 83.33(3) (3) The CBRF shall assist residents with grievance procedures as required under this section.

DHS 83.33(4) (4) The CBRF shall post in a conspicuous location in the CBRF a poster provided by the board on aging and long term care ombudsman program, concerning the long-term care ombudsman program under s. 16.009 (2) (b), Stats. The poster shall include the name, address and telephone number of the ombudsman’s office. This requirement does not apply to those facilities exclusively licensed to serve clients under the jurisdiction of a government correctional agency.

DHS 83.33 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; correction in (2) made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637.

DHS 83.34 DHS 83.34 Resident funds.

DHS 83.34(1) (1) Authorization. Except for a resident in the custody of a government correctional agency, the CBRF may not obtain, hold, or spend a resident’s funds without written authorization from the resident or the resident’s legal representative. The resident or the resident’s legal representative may limit or revoke authorization at any time by writing a statement that shall specify the effective date of the limitation or revocation.

DHS 83.34(2) (2) Funds under $200.

DHS 83.34(2)(a) (a) Upon written authorization, a CBRF may hold no more than $200 cash for use by the resident. The CBRF may not commingle residents’ funds with the funds or property of the CBRF, the licensee, employees, or relatives of the licensee or employees.

DHS 83.34(2)(b) (b) The CBRF shall have a legible, accurate accounting method for tracking residents’ cash and shall include a record of any deposits, disbursements and earnings made to or on behalf of the resident. The CBRF shall provide a receipt to the resident or the resident’s legal representative for all expenditures in excess of $20.

DHS 83.34(2)(c) (c) The CBRF shall provide a written report of the resident’s account to the resident or the resident’s legal representative at least every 6 months. Upon written request from the resident or resident’s legal representative, the CBRF shall provide a written monthly account of any financial transactions.

DHS 83.34(3) (3) Funds in excess of $200. A CBRF receiving more than $200 of personal funds from a resident shall deposit funds in excess of $200 in an interest-bearing account in the resident’s name in a savings institution insured by an agency of, or a corporation chartered by, this state or the United States.

DHS 83.34(4) (4) Final accounting. Within 14 days after a resident is discharged, the CBRF shall provide to the resident or the resident’s legal representative a written final accounting of all the resident’s funds held by the CBRF and shall disburse any remaining money to the resident or to the resident’s legal representative.

DHS 83.34(5) (5) Limitations.

DHS 83.34(5)(a) (a) No CBRF licensee, administrator or employee may do any of the following:

DHS 83.34(5)(a)1. 1. Sell to or purchase from a resident or prospective resident, real or personal property.

DHS 83.34(5)(a)2. 2. Accept or borrow money from a resident or prospective resident.

DHS 83.34(5)(a)3. 3. Be appointed as power of attorney for any resident unless related to the resident by blood or adoption.

DHS 83.34(5)(a)4. 4. Accept gifts from a resident except for gifts of nominal value.

DHS 83.34(5)(b) (b) No CBRF, nor any employee on behalf of the CBRF, may accept donations from any resident, except those made by a competent resident or made with the knowledge of the resident’s legal representative acting within the scope of their authority and only for the benefit of the CBRF. No employee may accept personal gifts, including monetary gifts, from a resident.

DHS 83.34(6) (6) Security deposit.

DHS 83.34(6)(a) (a) If a CBRF collects a security deposit, the funds shall be deposited in an interest-bearing account insured by an agency of, or a corporation chartered by, this state or the United States.

DHS 83.34(6)(b) (b) The amount of the security deposit shall not exceed one month’s fees for services.

DHS 83.34(6)(c) (c) The CBRF shall keep the security deposit account separate from other funds of the CBRF.

DHS 83.34(6)(d) (d) Within 30 days after the resident’s discharge, the security deposit and any interest earned shall be paid to the person who made the security deposit. Interest paid shall be the actual interest earned.

DHS 83.34(7) (7) Transfer of financial responsibility. When a change of ownership of the CBRF occurs, the transferor shall:

DHS 83.34(7)(a) (a) Notify the transferee in writing of any financial relationships between the transferor and residents.

DHS 83.34(7)(b) (b) Notify each resident or legal representative in writing where any financial relationship exists between the transferor and residents of the pending transfer.

DHS 83.34(8) (8) Audit. A CBRF handling residents’ funds under this section is subject to an accounting audit as ordered by the department. The accounting audit shall be completed by a certified public accountant paid for by the CBRF.

DHS 83.34 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

subch. VII of ch. DHS 83 Subchapter VII — Resident Care and Services

DHS 83.35 DHS 83.35 Assessment, individual service plan and evaluations.

DHS 83.35(1) (1) Assessment.

DHS 83.35(1)(a) (a) Scope. The CBRF shall assess each resident’s needs, abilities, and physical and mental condition before admitting the person to the CBRF, when there is a change in needs, abilities or condition, and at least annually. The assessment shall include all areas listed under par. (c). This requirement includes individuals receiving respite care in the CBRF. For emergency admissions the CBRF shall conduct the assessment within 5 days after admission.

DHS 83.35(1)(b) (b) Information gathering. The CBRF shall base the assessment on the current diagnostic, medical and social history obtained from the person’s health care providers, case manager and other service providers. Other service providers may include a psychiatrist, psychologist, licensed therapist, counselor, occupational therapist, physical therapist, pharmacist or registered nurse. The administrator or designee shall hold a face-to-face interview with the person and the person’s legal representative, if any, and family members, as appropriate, to determine what the person views as his or her needs, abilities, interests, and expectations.

DHS 83.35(1)(c) (c) Areas of assessment. The assessment, at a minimum, shall include all of the following areas applicable to the resident:

DHS 83.35(1)(c)1. 1. Physical health, including identification of chronic, short-term and recurring illnesses, oral health, physical disabilities, mobility status and the need for any restorative or rehabilitative care.

DHS 83.35(1)(c)2. 2. Medications the resident takes and the resident’s ability to control and self-administer medications.

DHS 83.35(1)(c)3. 3. Presence and intensity of pain.

DHS 83.35(1)(c)4. 4. Nursing procedures the resident needs and the number of hours per week of nursing care the resident needs.

DHS 83.35(1)(c)5. 5. Mental and emotional health, including the resident’s self-concept, motivation and attitudes, symptoms of mental illness and participation in treatment and programming.

DHS 83.35(1)(c)6. 6. Behavior patterns that are or may be harmful to the resident or other persons, including destruction of property.

DHS 83.35(1)(c)7. 7. Risks, including, choking, falling, and elopement.

DHS 83.35(1)(c)8. 8. Capacity for self-care, including the need for any personal care services, adaptive equipment or training.

DHS 83.35(1)(c)9. 9. Capacity for self-direction, including the ability to make decisions, to act independently and to make wants or needs known.

DHS 83.35(1)(c)10. 10. Social participation, including interpersonal relationships, communication skills, leisure time activities, family and community contacts and vocational needs.

DHS 83.35(1)(d) (d) Assessment documentation. The CBRF shall prepare a written report of the results of the assessment and shall retain the assessment in the resident’s record.

DHS 83.35(2) (2) Temporary service plan. Upon admission, the CBRF shall prepare and implement a written temporary service plan to meet the immediate needs of the resident, including persons admitted for respite care, until the individual service plan under sub. (3) is developed and implemented.

DHS 83.35(3) (3) Comprehensive individual service plan.

DHS 83.35(3)(a) (a) Scope. Within 30 days after admission and based on the assessment under sub. (1), the CBRF shall develop a comprehensive individual service plan for each resident. The individual service plan shall include all of the following:

DHS 83.35(3)(a)1. 1. Identify the resident’s needs and desired outcomes.