Chapter DHS 89
RESIDENTIAL CARE APARTMENT COMPLEXES
Subchapter I — General Provisions
DHS 89.11 Authority and purpose. DHS 89.14 Registration or certification requirement. DHS 89.15 Limitation on use of name “residential care apartment complex”. Subchapter II — General Requirements for Operation
DHS 89.22 Building requirements. DHS 89.24 Hours of service. DHS 89.25 Schedule of fees for services. DHS 89.26 Comprehensive assessment. DHS 89.27 Service agreement. DHS 89.28 Risk agreement. DHS 89.29 Admission and retention of tenants. DHS 89.295 Variance for demonstration projects in family care pilots. Subchapter III — Tenant Rights
DHS 89.32 Facility policies and procedures. DHS 89.33 Explanation of tenant rights. DHS 89.34 Rights of tenants. DHS 89.36 Coercion and retaliation prohibited. Subchapter IV — Registration
DHS 89.42 Information requirements, application procedure and form. DHS 89.44 Termination and revocation. Subchapter V — Certification
DHS 89.52 Standards for operation. DHS 89.53 Certification procedures. DHS 89.54 Reporting of changes. DHS 89.56 Intermediate sanctions and penalties. DHS 89.58 Coercion and retaliation prohibited. Subchapter VI — Approval of Partial Conversion of a Nursing Home or Community-Based Residential Facility
DHS 89.61 Submission of additional information. DHS 89.62 Application review and approval. Ch. DHS 89 NoteNote: This chapter was titled Assisted Living Facilities before December 1, 1998. Chapter HFS 89 was renumbered to chapter DHS 89 under s. 13.92 (4) (b) 1., Stats., and corrections made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635. DHS 89.11DHS 89.11 Authority and purpose. This chapter is promulgated under the authority of s. 50.034, Stats., to establish standards and procedures for the certification or registration of residential care apartment complexes in order to promote the health and safety of persons residing in and receiving services from those facilities. This chapter is intended to ensure that all residential care apartment complexes provide each tenant with an independent apartment in a setting that is home-like and residential in character; make available personal, supportive and nursing services that are appropriate to the needs, abilities and preferences of individual tenants; and operate in a manner that protects tenants’ rights, respects tenant privacy, enhances tenant self-reliance and supports tenant autonomy in decision-making including the right to accept risk. DHS 89.11 NoteNote: Before September 6, 1997, residential care apartment complexes were called “assisted living facilities.” The name change was made by 1997 Wisconsin Act 13. DHS 89.12(1)(1) This chapter applies to the department and to all residential care apartment complexes operating in Wisconsin. DHS 89.12(2)(2) This chapter does not apply to nursing homes, community-based residential facilities or hospitals or to congregate housing or housing for the elderly. DHS 89.13DHS 89.13 Definitions. In this chapter: DHS 89.13(1)(1) “Residential care apartment complex” or “facility” means a place where 5 or more adults reside that consists of independent apartments, each of which has an individual lockable entrance and exit, a kitchen, including a stove, and individual bathroom, sleeping and living areas, and that provides, to a person who resides in the place, not more than 28 hours per week of services that are supportive, personal and nursing services. “Residential care apartment complex” does not include a nursing home or a community-based residential facility, but may be physically part of a structure that is a nursing home or community-based residential facility. DHS 89.13(2)(2) “Residential care apartment complex services” means services provided by a residential care apartment complex, either directly or under contract, to meet needs identified in a tenant’s service agreement, to meet unscheduled care needs or to provide emergency services 24 hours a day. DHS 89.13(3)(3) “Bathroom” means a room with floor to ceiling walls and a door which contains a toilet, a sink and a bathtub or shower. DHS 89.13(5)(5) “Comprehensive assessment” means a systematic procedure for identifying an individual’s physical, health and social needs; preferences; and capacity for self-care. DHS 89.13(6)(6) “Congregate housing” means multi-unit rental housing which offers limited social support for tenants, including meals in a common dining room and space for group social and recreational activities. DHS 89.13 NoteNote: Congregate housing may become a residential care apartment complex if it chooses to offer supportive, personal and nursing services.
DHS 89.13(7)(7) “Contract” means all written agreements between the tenant and the residential care apartment complex, including the service agreement, the risk agreement and any rental or sales contract. DHS 89.13(8)(8) “Department” means the Wisconsin department of health services. DHS 89.13(9)(9) “Designated representative” means anyone identified by a tenant to represent the tenant in relation to the tenant’s residential care apartment complex. A designated representative may be a family member, friend, health care agent, guardian or other person named by the tenant. DHS 89.13(10)(10) “Emergency assistance” means aid provided in the event of a situation that creates an imminent risk of serious harm to the health or safety of the person if he or she is not helped immediately. DHS 89.13(11)(11) “Functionally distinct area” means a space that can be distinguished from other areas within the apartment by its actual or intended use. A functionally distinct area need not be a separate room. DHS 89.13(12)(12) “Health monitoring” means the assessment of physical, functional and cognitive status to detect changes that may indicate health problems and to facilitate appropriate intervention. Health monitoring includes assessment of nutritional status, confusion, unsteady gait, urinary incontinence, edema of extremities, fever, hypertension and other conditions. DHS 89.13(13)(13) “Hospice care” means medical or support services for management of a terminal illness furnished by a hospice as defined in s. 50.90 (1), Stats. DHS 89.13(14)(14) “Housing for the elderly” means multi-unit rental housing that is specially designed for and marketed to older people but does not offer supportive services, personal services and nursing services to its tenants. DHS 89.13 NoteNote: Housing for the elderly may become a residential care apartment complex if it chooses to offer supportive, personal and nursing services.
DHS 89.13(15)(15) “Incapable of making care decisions” means unable to understand one’s own needs for supportive, personal or nursing services; to choose what, if any, services one wants to receive to meet those needs; and to understand the outcome likely to result from that choice. The term refers to the ability to make a decision and not to the content or result of the decision. DHS 89.13(16)(16) “Independent apartment” means an individual living unit that has its own individual lockable entrance and exit, kitchen, bathroom, sleeping and living areas. DHS 89.13(17)(17) “Individual lockable entrance and exit” means a door that provides access to an independent apartment and is equipped with an individually keyed lock which is operable from both inside and outside the unit and which the tenant can open, close and lock to ensure privacy. DHS 89.13(17m)(17m) “Involuntary administration of psychotropic medication” means any of the following: DHS 89.13(17m)(a)(a) Placing psychotropic medication in an individual’s food or drink with knowledge that the individual protests receipt of the psychotropic medication. DHS 89.13(17m)(b)(b) Forcibly restraining an individual to enable administration of psychotropic medication. DHS 89.13(17m)(c)(c) Requiring an individual to take psychotropic medication as a condition of receiving privileges or benefits. DHS 89.13(18)(18) “Kitchen” means a visually and functionally distinct area within the living unit which is intended to be used exclusively for food preparation and which contains a stove, a refrigerator, a sink, counter space for food preparation and a place for storage of utensils and supplies. DHS 89.13(19)(19) “Living area” means a visually and functionally distinct area within the living unit which is intended for general use and which is not a bathroom, kitchen or sleeping area. DHS 89.13(21)(21) “Medication administration” means giving or assisting tenants in taking prescription and nonprescription medications in the correct dosage, at the proper time and in the specified manner. DHS 89.13(22)(22) “Medication management” means oversight by a nurse, pharmacist or other health care professional to minimize risks associated with use of medications. Medication management includes proper storage of medications; preparation of a medication organization or reminder system; assessment of the effectiveness of medications; monitoring for side effects, negative reactions and drug interactions; and delegation and supervision of medication administration. DHS 89.13(24)(24) “Nursing services” means nursing procedures, excluding personal services, which, according to the provisions of ch. 441, Stats., the nurse practice act, must be performed by a registered nurse or as a delegated act under the supervision of a registered nurse. DHS 89.13(25)(25) “Personal services” means direct assistance with activities of daily living, including dressing, eating, bathing, grooming, toileting, transferring and ambulation or mobility. DHS 89.13(25g)(25g) “Protest” means make more than one discernible negative response, other than mere silence, to the offer of, recommendation for, or other proffering of voluntary receipt of psychotropic medication. “Protest” does not mean a discernible negative response to a proposed method of administration of the psychotropic medication.
