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. DHS 105.14(2)(i)1.1. When an ADDC seeks a change of ownership, the transferee shall submit a complete application for certification as required under par. (a) 2. at least 30 days prior to the change of ownership. DHS 105.14(2)(i)2.2. If a participant is given less than 30 days’ notice of the change of ownership, neither the transferor nor the transferee may enforce any advanced notice requirements for discharge as specified in any participant’s enrollment agreement. DHS 105.14(2)(i)3.3. The transferor shall notify the department within 30 days before a change of ownership of an ADCC and shall include the name and contact information of the transferee. DHS 105.14(2)(i)4.4. The transferor remains responsible for the operation of the ADCC until the department issues a certification to the transferee. DHS 105.14(2)(i)5.5. The transferor shall disclose to the transferee any waiver or variance granted by the department under sub. (1) (c), or outstanding deficiencies. DHS 105.14(2)(i)6.6. Any violation reported in a department inspection report shall be corrected prior to the change of ownership. Any correction must be verified by the department prior to the issuance of the certification to the transferee. DHS 105.14(2)(i)7.7. The department shall issue a certification only for the premises and persons named in the certification application. A certification may not be transferred or reassigned without following the change of ownership provisions in this paragraph. DHS 105.14(2)(j)1.1. An ADCC that intends to close shall notify the department, each participant or legal representative, and case manager, if any, in writing at least 30 days before closing and comply with the discharge requirements under sub. (5) (c). DHS 105.14(2)(j)2.2. The ADCC shall surrender the certification to the department when the ADCC closes. DHS 105.14(2)(j)3.3. The ADCC shall surrender its certification if it has not served any participants for 24 months. DHS 105.14(2)(k)1.1. If a participant dies while at or under the supervision of the ADCC, the ADCC shall report the following to the department no later than 3 days after any of the following occurs: DHS 105.14(2)(k)1.a.a. Death due to physical restraint, psychotropic medication, or suicide, if there is reasonable cause to believe that the death was related to physical restraint, psychotropic medication, or suicide. DHS 105.14(2)(k)1.b.b. Death due to accident or injury not attributable to physical restraint, psychotropic medication, or suicide. DHS 105.14(2)(k)2.2. An ADCC is not required to report a death to the department if the death is the result of natural causes, and none of the circumstances surrounding the death involve a condition under subd. 1. DHS 105.14(2)(L)(L) Other reporting requirements. An ADCC shall send a written report to the department within 3 working days after any of the following occurs: DHS 105.14(2)(L)1.1. Any time a participant’s whereabouts are unknown, except those instances when a participant who is competent chooses not to disclose his or her whereabouts or location to the ADCC. The ADCC shall also notify the local law enforcement authority immediately upon discovering that a participant is missing. DHS 105.14(2)(L)2.2. Any time law enforcement is called to the ADCC as a result of an incident that jeopardizes the health, safety or welfare of a participant or caregiver. The ADCC’s report to the department shall provide a description of the circumstances requiring the law enforcement intervention. DHS 105.14(2)(L)3.3. Any incident or accident resulting in serious injury requiring hospital admission or emergency room treatment of a participant. DHS 105.14(2)(L)4.4. A catastrophe causing structural damage to the ADCC that results in any change in services provided to the participants. DHS 105.14(2)(L)6.6. Anytime the ADCC must evacuate and temporarily relocate participants and caregivers from the ADCC for reasons other than a fire drill. DHS 105.14(2)(m)1.1. ‘Misconduct reporting.’ When an ADCC receives a report of an allegation of abuse or neglect of a participant, or misappropriation of property, the ADCC shall take immediate action to ensure the safety of each participant and security of their property. The ADCC shall do all of the following: DHS 105.14(2)(m)1.a.a. Thoroughly investigate any allegation of abuse or neglect of a participant, or misappropriation of property and document all allegations, investigations, and the results of investigations. DHS 105.14(2)(m)1.b.b. Report incidents to the department when the ADCC’s investigation concludes the alleged abuse, or neglect of a participant or misappropriation of property meets the definition of abuse or neglect of a participant, or of misappropriation of property under ch. DHS 13. The ADCC shall maintain documentation of any investigations. DHS 105.14(2)(m)1.c.c. Use the form or web-based application provided by the department to submit all reportable incidents to the department within 7 days from the date the ADCC knew or should have known about the abuse, neglect, or misappropriation of property. DHS 105.14(2)(m)1.d.d. Document its conclusions and rationales in writing if it concludes, after investigation, that the incident did not meet the definition of abuse, neglect, or misappropriation.
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administrativecode
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Department of Health Services (DHS)
Chs. DHS 101-109; Medical Assistance
administrativecode/DHS 105.14(2)(b)1.k.
administrativecode/DHS 105.14(2)(b)1.k.
section
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