DHS 105.14(1)(b)23.23. “Qualified Caregiver” means an employee who is at least 18 years of age and has successfully completed all of the applicable orientation and training under sub. (4) (a) and (b). DHS 105.14(1)(b)24.a.a. “Seclusion” means physical or social separation of a participant from others by actions of caregivers. DHS 105.14(1)(b)24.b.b. “Seclusion” does not include separation to prevent the spread of communicable disease or voluntary cool-down periods in an unlocked room. DHS 105.14(1)(b)25.25. “Serious injury” means an injury from any incident or accident which results in any of the following: DHS 105.14(1)(b)25.a.a. A temporary or permanent increase in the level of assistance needed in one or more ADL categories, such as bathing, eating, oral hygiene, dressing, toileting, incontinence care, or mobility and transferring. DHS 105.14(1)(b)26.26. “Significant change” in a participant’s physical or mental condition means any of the following: DHS 105.14(1)(b)26.a.a. A decline in a participant’s medical condition that results in further impairment. DHS 105.14(1)(b)26.d.d. A decline in behavior or mood which requires either a temporary or permanent increase in the level of assistance needed in one or more ADL categories, such as bathing, eating, oral hygiene, dressing, toileting, incontinence care, or mobility and transferring. DHS 105.14(1)(b)27.27. “Standard precautions” are a set of infection control practices used to prevent transmission of diseases that can be acquired by contact with blood, body fluids, non-intact skin (including rashes), and mucous membranes. These measures are used when providing care to all individuals, whether or not they appear infectious or symptomatic. DHS 105.14(1)(b)28.b.b. “Supervision” includes keeping track of a participant’s whereabouts and providing guidance and intervention when needed by a participant. DHS 105.14(1)(b)28m.28m. “Transferee” means the recipient of a property or business in a change of ownership process who will submit application for a new certification. DHS 105.14(1)(b)29.29. “Transferor” means the current operator in a change of ownership process who will voluntarily relinquish the current certification. DHS 105.14(1)(b)31.31. “Utensils” means dishes, silverware and pots and pans used for storing, preparing, serving, or consuming food. DHS 105.14(1)(b)32.32. “Variance” means an alternate means of meeting a requirement in this section, as approved by the department under par. (c). DHS 105.14(1)(b)33.33. “Volunteer” means any person who provides services for participants without compensation. DHS 105.14(1)(b)34.34. “Waiver” means an exemption from a requirement in this section, as approved by the department under par. (c). DHS 105.14(1)(c)1.1. The department may grant approval of 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 participant. DHS 105.14(1)(c)2.2. 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 participant for the requested action. DHS 105.14(1)(c)3.3. A written request for a variance shall include a description of an alternative means planned to meet the intent of the requirement. DHS 105.14(1)(c)4.4. The department may terminate approval of a waiver or variance if any of the following occurs: DHS 105.14(1)(c)4.a.a. The department determines the waiver or variance has adversely affected the health, safety, well-being or welfare of a participant. DHS 105.14(1)(c)4.b.b. The ADCC fails to comply with any of the conditions of the waiver or variance as granted. DHS 105.14(1)(c)4.c.c. A change in circumstances from the time the waiver or variance approval was initially granted. DHS 105.14(2)(a)1.1. No person may receive reimbursement under s. 49.45 (7) (b), Stats., for the provision of services to a participant in an ADCC unless the ADCC is certified by the department. A person who assumes ownership interest in a certified ADCC, regardless of whether the transfer includes title to the real estate, or changes the location of the ADCC shall complete an application as required under this subsection. DHS 105.14(2)(a)2.2. An application for certification shall be on a form or web-based application provided by the department and shall include all of the following: DHS 105.14(2)(a)2.b.b. A floor plan specifying dimensions of the ADCC, including exits and planned room usage. DHS 105.14(2)(a)2.f.f. Evidence that the applicant has 60 days of projected operating funds in reserve. DHS 105.14(2)(a)2.g.g. Proof of transportation liability insurance if the ADCC provides transportation. DHS 105.14(2)(a)3.3. An ADCC may not be located on a parcel of land zoned for industrial or manufacturing use. DHS 105.14(2)(b)1.1. The program description included as part of an application under par. (a) 2. shall include all of the following: DHS 105.14(2)(b)1.a.a. The name of the operator, the program director, and the caregiver position in charge when the operator or program director is away from the ADCC. DHS 105.14(2)(b)1.c.c. A definition of the program goals and a description of the services provided or made available to participants at the ADCC. DHS 105.14(2)(b)1.e.e. A description of any limits the program establishes for providing service to a participant with specific care needs. DHS 105.14(2)(b)1.f.f. A fee schedule which includes the daily charges and additional fees for specific services, goods, or supplies that are not included in the daily charge, and the method for notifying a participant or a legal representative of fee changes. DHS 105.14(2)(b)1.g.g. A procedure for informing the participant’s legal representative, family, or caregiver of any major change in the participant’s general functioning or medical condition. DHS 105.14(2)(b)1.h.h. A procedure for documenting any incident occurring at the site which would affect the health, safety or welfare of a participant. DHS 105.14(2)(b)1.i.i. The participant group to be served and, if serving more than one participant group, an explanation acceptable to the department of how each participant group is compatible with one another. DHS 105.14(2)(b)1.j.j. A grievance procedure for investigating and resolving complaints made by a participant, legal representative, family member, caregiver, or other interested persons about the services provided by the ADCC which includes informing such persons of appropriate local, county and/or state agency contacts and informing such persons that pursuant to s. DHS 13.05 (4) (a) and s. 146.40 (4r) (a), Stats., any individual may report to the department that he or she believes that any person employed by or under contract with the ADCC has neglected or abused a participant or misappropriated the participant’s property. DHS 105.14(2)(b)1.k.k. The criteria for voluntary and involuntary discharge of a participant from the program as defined in sub. (5) (c). DHS 105.14(2)(b)2.2. Before finalizing an agreement to provide care, the ADCC shall provide its program description to each person seeking services or to the person’s legal representative, or both. DHS 105.14(2)(b)3.3. The program description shall be provided to each caregiver and any other person upon request. DHS 105.14(2)(c)(c) Fit and qualified determination. An applicant may not be certified unless the department determines the applicant is fit and qualified to operate an ADCC. To determine whether a person is fit and qualified, the department shall consider all of the following: DHS 105.14(2)(c)2.2. The applicant’s history of compliance with Wisconsin or any other state or federal licensing or certification requirements, including any license revocation or denial. DHS 105.14(2)(c)3.3. The applicant’s arrest and criminal records, including any of the following: DHS 105.14(2)(c)3.a.a. Crimes or acts involving abuse, neglect or mistreatment of a person or misappropriation of property of a person. DHS 105.14(2)(c)3.c.c. Crimes or acts related to the manufacture, distribution, use, or dispensing of a controlled substance. DHS 105.14(2)(c)3.d.d. Fraud or substantial or repeated violations of applicable laws and rules in the operation of any health care center or in the care of dependent persons. DHS 105.14(2)(c)3.e.e. A conviction or pending criminal charge which substantially relates to the care of adults or minors, to the funds or property of adults or minors, or to the operation of a residential or health care center. DHS 105.14(2)(c)4.4. The financial history and the financial viability of the applicant or the applicant’s organization, including any outstanding debts, fees, or fines due to the department or other government agencies. DHS 105.14(2)(d)1.1. Within 70 days of receipt of a complete application, the department shall review the application and either approve or deny certification of the ADCC. DHS 105.14(2)(d)2.2. A certification issued by the department shall be only for the premises and operator named in the application. A certification may not be transferred or assigned to another operator without following the change of ownership provisions in par. (i). DHS 105.14(2)(d)3.3. A certification is valid until suspended or revoked by the department. DHS 105.14(2)(d)4.4. The department shall deny a certification to any applicant who does not substantially comply with any provision of this chapter or ch. 49, Stats., who is not deemed fit and qualified as specified in par. (c), or who has failed to pay any fee or any outstanding amounts due to the department. DHS 105.14(2)(d)5.5. The department shall provide the reasons for denial and the process for appeal of the denial in writing to the applicant. DHS 105.14(2)(e)(e) Monitoring after certification. The department shall conduct periodic inspections of the ADCC during the period of certification and may, without notice to the operator, visit an ADCC at any time to determine if the ADCC is compliant with this section. The operator shall be able to verify compliance with this section and shall provide the department access to the ADCC, its staff, each participant, and records. DHS 105.14(2)(f)(f) Biennial reporting and fees. Every 24 months, on a date determined by the department, the operator shall submit a biennial report on the form provided by the department, and shall submit payment of the certification continuation fees. DHS 105.14(2)(g)1.1. ‘Notice of violation.’ The department shall issue a written notice of violation when it finds that an ADCC is in violation of this section or with any federal, state, or local laws and codes that govern the operation of the ADCC. The notice shall explain the grounds for the notice of violation, the sanction to be imposed, if any, and, if certification is suspended or revoked, and the process for an appeal. DHS 105.14(2)(g)2.2. ‘Plan of correction.’ An ADCC may submit a written plan of correction to the department within 10 days after the date of receipt of the notice of violation. DHS 105.14(2)(g)3.3. ‘Suspension.’ The department may summarily suspend the ADCC’s certification following procedures in ch. 227, Stats., when the department finds that participant health, safety or welfare requires emergency action. DHS 105.14(2)(g)4.4. ‘Revocation.’ The department may revoke the ADCC’s certification whenever the department finds that the ADCC has failed to maintain substantial compliance with one or more of the requirements set forth in this section. DHS 105.14(2)(h)1.1. Any person whose application for certification is denied under par. (d) or suspended or revoked under par. (g) 3. or 4. may request a hearing on that decision in accordance with s. 227.42, Stats. DHS 105.14(2)(h)2.2. A request for hearing shall be made in writing to the department of administration’s division of hearings and appeals. The request for a hearing must be received by the division of hearings and appeals within 10 days of the department’s written notice of certification denial under par. (d) 5., suspension under par. (g) 3., or revocation under par. (g) 4.
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administrativecode
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Department of Health Services (DHS)
Chs. DHS 101-109; Medical Assistance
administrativecode/DHS 105.14(1)(c)4.b.
administrativecode/DHS 105.14(1)(c)4.b.
section
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