Chapter DHS 83

DHS 83.42(1)(h) (h) Assessments completed as required under s. DHS 83.35 (1).

DHS 83.42(1)(i) (i) Individual service plan and resident satisfaction evaluation.

DHS 83.42(1)(j) (j) Documentation to accurately describe the resident’s condition, significant changes in condition, changes in treatment and response to treatment.

DHS 83.42(1)(k) (k) Results of the annual resident evacuation evaluation.

DHS 83.42(1)(L) (L) Documentation of sensory impairment of the resident as required under s. DHS 83.48 (7) (b).

DHS 83.42(1)(m) (m) Summary of discharge information as required under s. DHS 83.31 (7).

DHS 83.42(1)(n) (n) Any department-approved resident-specific waiver, variance or approval.

DHS 83.42(1)(o) (o) Physician’s orders or other authorized practitioner’s written orders for nursing care, medications, rehabilitation services and therapeutic diets.

DHS 83.42(1)(p) (p) Current list of the type and dosage of medications or supplements.

DHS 83.42(1)(q) (q) Results of the quarterly psychotropic medication assessments as required in s. DHS 83.37 (1) (h) 1.

DHS 83.42(1)(r) (r) Documentation of administration of all medications, supplements, the person administering the medications or supplements, any side effects observed by the employee or symptoms reported by the resident, the need for PRN medications and the resident’s response, refusal to take medication, omissions of medications, errors in the administration of medications and drug reactions.

DHS 83.42(1)(s) (s) Photocopy of any court order or other document authorizing another person to speak or act on behalf of the resident, or other legal documents as required which affect the care and treatment of a resident.

DHS 83.42(1)(t) (t) Documentation of all other services including rehabilitation services, treatments and therapeutic diets.

DHS 83.42(1)(u) (u) Completed notice of pre-admission assessment requirement under s. DHS 83.30.

DHS 83.42(1)(v) (v) Nursing care procedures and the amount of time spent each week by a registered nurse or licensed practical nurse in performing the nursing care procedures. Only time actually spent by the nurse with the resident may be included in the calculation of nursing care time.

DHS 83.42(1)(w) (w) Plans of care for terminally ill residents.

DHS 83.42(1)(x) (x) Date, time and circumstances of the resident’s death, including the name of the person to whom the body is released.

DHS 83.42(2) (2) The licensee shall ensure all resident records are adequately safeguarded against destruction, loss or unauthorized access or use.

DHS 83.42(3) (3) The employee in charge on each work shift shall have a means to access resident records.

DHS 83.42 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

subch. VIII of ch. DHS 83 Subchapter VIII — Physical Environment

DHS 83.43 DHS 83.43 Furnishings and equipment.

DHS 83.43(1) (1) Environment. The CBRF shall provide a living environment that is safe, clean, comfortable, and homelike. All common dining and living areas shall contain furnishings appropriate to the intended use of the room.

DHS 83.43(2) (2) Bedroom furnishings. If a resident does not provide the resident’s own bedroom furnishings, the CBRF shall provide all of the following:

DHS 83.43(2)(a) (a) A bed of proper size to ensure the resident’s comfort.

DHS 83.43(2)(b) (b) A clean, comfortable mattress covered with a mattress pad and when necessary, waterproof covering.

DHS 83.43(2)(c) (c) A clean, comfortable pillow, bedspread and blankets adequate for the season.

DHS 83.43(2)(d) (d) Clean sheets, pillowcases, towels and washcloths adequate to meet the needs of the resident.

DHS 83.43 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

DHS 83.44 DHS 83.44 Housekeeping services.

DHS 83.44(1) (1) Laundry.

DHS 83.44(1)(a) (a) Laundry area. The CBRF shall make an adequate number of laundry appliances available to residents who choose to do their own laundry. The CBRF shall have a laundry area to sort, process and store clean and soiled laundry and shall handle clean and soiled laundry so as to prevent the spread of infection.

DHS 83.44(1)(b) (b) Storage and transport. The CBRF shall have separate clean and dirty laundry storage areas or containers. Storage containers shall be clean, leak-proof and have a tight fitting lid. The CBRF may not transport, wash or rinse soiled laundry in areas used for food preparation, serving or storage.

DHS 83.44(1)(c) (c) Clothes dryers. The CBRF shall enclose any clothes dryer having a rated capacity of more than 37,000 Btu/hour in a one-hour fire resistive rated enclosure. If the clothes dryer requires a vent, the CBRF shall use dryer vent tubing that is of rigid material with a fire rating that exceeds the temperature rating of the dryer. The dryer vent tubing shall be clean and maintained.

DHS 83.44(2) (2) Cleanliness.

DHS 83.44(2)(a) (a) The CBRF shall keep all rooms clean and shall make reasonable attempts to keep all rooms free from odors.

DHS 83.44(2)(b) (b) All toilet and bathing areas, facilities and fixtures shall be clean and in good working order.

DHS 83.44(2)(c) (c) Every interior floor, wall and ceiling shall be clean and in good repair.

DHS 83.44 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

DHS 83.45 DHS 83.45 Building maintenance and site.

DHS 83.45(1) (1) Maintenance.

DHS 83.45(1)(a) (a) Exterior areas. The CBRF shall maintain the yard, any fences, sidewalks, driveways and parking areas of the CBRF in good repair and free of hazards.

DHS 83.45(1)(b) (b) Building integrity. The CBRF shall be structurally sound without visible evidence of structural failure or deterioration and shall be maintained in good repair.

DHS 83.45(1)(c) (c) Surface drainage. The CBRF shall ensure that each courtyard, yard or other area on the premises of the CBRF is drained or graded to divert water away from the building.

DHS 83.45(1)(d) (d) Hazards. The CBRF shall maintain each building in good repair and free of hazards.

DHS 83.45(1)(e) (e) Systems. The CBRF shall maintain all electrical, mechanical, water supply, plumbing, fire protection and sewage disposal systems in a safe and functioning condition.

DHS 83.45(1)(f) (f) Furnishings. The CBRF shall keep all furnishings clean, safe, and maintained in good repair.

DHS 83.45(2) (2) Storage. The CBRF shall maintain storage areas in a safe, dry and orderly condition.

DHS 83.45(3) (3) Toxic substances. The CBRF shall ensure that cleaning compounds, polishes, insecticides and toxic substances are labeled and stored in a secure area.

DHS 83.45(4) (4) Pest control. The CBRF shall implement safe, effective procedures for control and extermination of insects, rodents and vermin.

DHS 83.45(5) (5) Garbage and refuse. The CBRF shall dispose of garbage and refuse. Garbage and refuse in inside areas shall be kept in leak-proof, non-absorbent closed containers. Garbage and refuse in outside areas shall be in closed containers.

DHS 83.45 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

DHS 83.46 DHS 83.46 Building support systems.

DHS 83.46(1) (1) Heating.

DHS 83.46(1)(a) (a) A CBRF shall maintain comfortable and safe temperatures. The CBRF shall provide tempered air at all times to eliminate cold air drafts. The heating system shall be capable of maintaining temperatures of 74º F. in areas occupied by residents.

DHS 83.46(1)(b) (b) The use of portable space heaters is prohibited except for Underwriters Laboratories listed electric heating equipment that is listed for permanent attachment to the wall. Portable space heaters shall have an automatic thermostatic control and shall be physically attached to a wall.

DHS 83.46(1)(c) (c) The CBRF shall maintain the heating system in a safe and properly functioning condition. The CBRF shall ensure that a heating contractor or local utility company completes all of the following maintenance and makes available to the facility documentation of the maintenance performed:

DHS 83.46(1)(c)1. 1. An oil furnace shall be serviced at least once each year.

DHS 83.46(1)(c)2. 2. A gas furnace shall be serviced at least once every 3 years.

DHS 83.46(1)(c)3. 3. The CBRF shall have a chimney inspected at intervals corresponding with the heating system service under subd. 1. or 2.

DHS 83.46(1)(d) (d) The CBRF may not use a fuel-fired heater on the premises of the CBRF unless the heater is properly vented to the outside.

DHS 83.46(1)(e) (e) Any wood burning stove or fireplace shall have a flue separate from the flue used by a gas or oil fired furnace or boiler. The entire installation shall meet the requirements in NFPA 211. The CBRF shall have the wood burning or fireplace flue cleaned as often as necessary, but at least 2 times during each heating season. The CBRF shall make available documentation of the maintenance performed.

DHS 83.46(1)(f) (f) Combustible materials shall not be placed within 3 feet of any furnace, boiler, water heater, fireplace or other similar equipment.

DHS 83.46(1)(g) (g) The CBRF shall enclose any other open flame combustible fuel-burning device within a one hour fire rated assembly when sharing a common floor with a habitable room. A direct-vent appliance is exempt from this requirement.

DHS 83.46(2) (2) Ventilation.

DHS 83.46(2)(a) (a) All rooms and areas shall be well ventilated. Ventilation is not required in a refrigerated storage room.

DHS 83.46(2)(b) (b) A CBRF may not have transoms, transfer grills or louvers in bedroom walls or doors opening directly to a corridor.

DHS 83.46(3) (3) Public water supply. The CBRF shall use a public water supply when available. If a public water supply is not available, the CBRF shall have a well that is approved by the state department of natural resources. The CBRF shall have the well water tested at least annually by the state laboratory of hygiene or other laboratory approved under ch. NR 149. The CBRF shall maintain documentation of annual testing results.

DHS 83.46(4) (4) Electrical.

DHS 83.46(4)(a) (a) Installation and maintenance. The CBRF shall be supplied with electrical service, wiring, outlets and fixtures, which shall be properly installed and maintained in good and safe working condition.

DHS 83.46(4)(b) (b) Service size. The electrical service shall be of the proper size to handle the connected load.

DHS 83.46(4)(c) (c) Protection.

DHS 83.46(4)(c)1. 1. ‘Fuses and circuit breakers.’ Tamper-proof fuses or circuit breakers not to exceed the ampere capacity of the smallest wire size in the circuit shall protect the branch circuits.

DHS 83.46(4)(c)2. 2. ‘Ground fault interruption.’ Ground fault interrupt protection shall be required for all outlets within 6 feet of a plumbing fixture, all outlets on the exterior of the CBRF and in the garage.

DHS 83.46(4)(d) (d) Minimum number of fixtures and outlets. The CBRF shall have all of the following minimum number of fixtures and outlets:

DHS 83.46(4)(d)1. 1. ‘Light fixtures.’ Every resident bedroom, bathroom, kitchen or kitchenette, dining room, laundry room and furnace room shall contain at least one approved or listed ceiling or wall-type electric light fixture equipped with sufficient lamps or tubes to provide at least 5 foot candles at floor level at the center of room. Where more than one fixture is used or required, the additional fixture or fixtures shall be equally spaced as far as is practical. A switched outlet may be substituted for a ceiling or wall fixture in resident bedrooms and dining rooms.

DHS 83.46(4)(d)2. 2. ‘Minimum outlet ratios.’ Electric duplex outlet receptacles shall be provided as follows:

DHS 83.46(4)(d)2.a. a. Living room, dining room and bedroom, one per 75 square feet of floor area with a minimum of 2.

DHS 83.46(4)(d)2.b. b. Kitchen, one per 8 lineal feet or fraction thereof, of countertop and preparation area, including island-type areas. In addition, if a kitchen is used for dining purposes, one per 75 square feet of floor area. Separate outlets shall be provided for refrigerators.

DHS 83.46(4)(d)2.c. c. Laundry room, minimum of one.

DHS 83.46(4)(d)2.d. d. Toilet rooms, one, which may be part of the wall fixture if 72 inches or less from the floor.

DHS 83.46(4)(d)2.e. e. Other habitable rooms, minimum of 2.

DHS 83.46(4)(e) (e) Outlets. Electrical outlets shall be located to limit the use of extension cords. Extension cords shall not be used in lieu of permanent wiring.

DHS 83.46(4)(f) (f) Switches. Switches or equivalent devices for turning on at least one light in each room or passageway shall be located to conveniently control the lighting in the area.

DHS 83.46(4)(g) (g) Temporary and exposed wiring. All temporary wiring and exposed wiring, whether in use or abandoned, shall be removed.

DHS 83.46 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; correction in (3) made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637; correction in (3) made under s. 13.92 (4) (b) 7., Stats., Register July 2011 No. 667.

subch. IX of ch. DHS 83 Subchapter IX — Safety

DHS 83.47 DHS 83.47 Fire safety requirements.

DHS 83.47(1) (1) Evacuation capabilities.