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. DHS 105.14(2)(m)2.2. ‘Elder abuse and adults-at-risk reporting.’ The ADCC shall follow the elder abuse reporting requirements under s. 46.90, Stats., and the adult at risk requirements under s. 55.043, Stats., whichever is applicable. DHS 105.14(2)(m)3.3. ‘Injuries of unknown source.’ When an ADCC receives a report of a participant’s injury with an unknown cause, it shall thoroughly investigate, document, and report an injury of unknown source in a manner consistent with the requirements of subd. 1. or 2. when both of the following conditions are met: DHS 105.14(2)(m)3.a.a. The source of the injury was not observed by any person or the source of the injury could not be explained by the participant. DHS 105.14(2)(m)3.b.b. The injury appears suspicious because of the extent of the injury or the location of the injury on the participant. DHS 105.14(2)(m)3.c.c. The ADCC shall maintain documentation for each investigation of an injury referenced under subd. 3. DHS 105.14(2)(m)4.4. ‘Other duties.’ Filing reports under subd. 1. or 2. does not relieve the operator of any obligation to report an incident to any other authority, including law enforcement or the coroner, or both. DHS 105.14(2)(n)1.1. The ADCC shall immediately notify the participant’s legal representative and the participant’s residential provider and document the notification when there is an incident or injury to the participant or a significant change in the participant’s physical or mental condition. DHS 105.14(2)(n)2.2. The ADCC shall immediately notify the participant’s legal representative and document the notification when there is an allegation of abuse or neglect of the participant. DHS 105.14(2)(n)3.3. The ADCC shall notify the participant’s legal representative within 72 hours when there is an allegation of misappropriation of the participant’s property and document the notification. DHS 105.14(2)(n)4.4. The ADCC shall give the participant or the participant’s legal representative a 30-day written notice of any change in services available or in charges for services that will be in effect for more than 30 days. DHS 105.14(2)(o)(o) Documentation requirement. All written reports required under sub. (2) (k) to (n), shall include, at a minimum, all of the following: DHS 105.14(2)(o)3.3. The action taken by the provider to ensure the health, safety, welfare and well-being of each participant following the reportable occurrence. DHS 105.14(2)(p)1.1. The ADCC shall retain all records required under this section for 2 years, unless otherwise specified in this section. DHS 105.14(2)(p)2.2. Participant records shall be retained for 7 years following the date of a participant’s final discharge. DHS 105.14(2)(p)3.3. Employee records shall be retained for 3 years following a caregiver’s separation from employment at the ADCC. DHS 105.14(3)(a)1.1. ‘Qualifications.’ An operator shall be at least 21 years old and meet the caregiver background requirements under s. 50.065, Stats., and ch. DHS 12. DHS 105.14(3)(a)2.b.b. Comply with the requirements set by the Federal 1991 Americans with Disabilities Act, and by the occupation, safety and health administration. DHS 105.14(3)(a)2.d.d. Develop and implement written policies and procedures to investigate allegations of abuse, neglect, and misappropriation of property and injuries of unknown source as described in sub. (2) (m). DHS 105.14(3)(a)2.e.e. Report any change in participant group in writing to the department at least 30 days in advance of the anticipated change. The ADCC shall not implement the change until the operator receives written approval from the department. DHS 105.14(3)(a)2.f.f. Report any change in the ADCC’s capacity in writing to the department. The operator shall not implement the change in capacity until the operator receives written approval from the department. DHS 105.14(3)(a)2.g.g. Provide to each participant, the participant’s legal representative, or third party payer, a 30 day written notice of any change in the ADCC’s capacity or client group. DHS 105.14(3)(a)2.h.h. Post the ADCC certification, any statement of deficiency, notice of revocation and any other notice of enforcement action in a public area that is visually and physically accessible. A statement of deficiency shall remain posted for 90 days following receipt. Notices of revocation or suspension of certification shall remain posted until a final determination is made. DHS 105.14(3)(a)2.i.i. Prohibit the existence or continuation of any condition which creates or may create a substantial risk to the health, safety, well-being or welfare of any participant. DHS 105.14(3)(a)2.j.j. Ensure that the presence of other occupants does not adversely affect the health, safety, well-being or welfare of a participant. DHS 105.14(3)(b)1.1. ‘Qualifications.’ The program director of an ADCC shall be at least 21 years of age and have the capacity to respond to the needs of each participant and manage the day to day operations of the ADCC. The program director shall have at least one of the following qualifications: DHS 105.14(3)(b)1.a.a. An associate degree or higher from an accredited college in a health care related field. DHS 105.14(3)(b)1.b.b. At least 2 years’ experience working in a health care related field which served a population similar to the participant group at the ADCC. DHS 105.14(3)(b)2.a.a. Supervise the daily operation of the ADCC, including participant care and services, personnel, finances, and physical plant. DHS 105.14(3)(b)2.b.b. Provide the supervision necessary to ensure that each participant receive proper care and treatment, that their health and safety are protected and promoted, and that their rights are respected. DHS 105.14(3)(b)3.3. ‘Exemptions.’ The qualified program director of record at the ADCC, at the time this rule becomes effective, shall be exempt from the qualification requirements as specified in subd. 1. DHS 105.14(3)(b)4.4. ‘Program director absence.’ A qualified caregiver who is at least 18 years old shall be designated as in charge whenever the program director is absent from the ADCC. DHS 105.14(3)(c)(c) Caregiver. Each caregiver shall be at least 16 years old and have the skills, education, experience and ability to fulfill the caregiver’s job requirements. DHS 105.14(3)(d)1.1. ‘Caregiver background checks.’ The ADCC shall obtain a background check pursuant to s. 50.065, Stats., and ch. DHS 12, for any person who is, or is expected to be, an employee or contractor of the ADCC, who is or is expected to be under the control of the ADCC, and who has, or is expected to have, regular, direct contact with participants. DHS 105.14(3)(d)2.a.a. The ADCC shall obtain documentation from a physician, physician assistant, clinical nurse practitioner, or a licensed registered nurse indicating all employees have been screened for clinically apparent communicable diseases including tuberculosis. Screening for tuberculosis shall be conducted in accordance with current standards of practice. The screening and documentation shall be completed within 90 days before the start of employment or before assumption of duties in which the caregiver will have direct contact with any participant. The ADCC shall keep screening documentation confidential, except the department shall have access to the screening documentation for verification purposes. DHS 105.14(3)(d)2.b.b. Employees shall be re-screened for clinically apparent communicable diseases as described in this subdivision based on the likelihood of exposure to communicable diseases, including tuberculosis. DHS 105.14(3)(d)2.c.c. A person who has a communicable disease shall not be permitted to work or be present in the ADCC if the disease would present a risk to the health or safety of any participant. DHS 105.14(3)(e)1.1. A separate record for each employee shall be maintained and kept current. Employee records shall include, at minimum, all of the following information: DHS 105.14(3)(e)2.2. Employee records shall be available upon request at the ADCC for review by the department. DHS 105.14(4)(a)(a) Orientation. Before performing any job duties, all employees shall receive appropriate orientation to their job responsibilities and to the ADCC and its policies, including emergency and evacuation procedures, participant rights, and prevention and reporting any allegation of participant abuse, neglect, and misappropriation of participant property. DHS 105.14(4)(b)1.1. Within 90 days of employment, the ADCC shall provide, obtain or otherwise ensure each caregiver receives training in all the following areas: DHS 105.14(4)(b)1.a.a. Meeting the physical, social and mental health needs of each participant group served by an ADCC. Specific training shall include, as applicable, activities, safety risks, managing and responding to challenging behaviors, environmental considerations, disease processes, communication skills, and nutritional needs. DHS 105.14(4)(b)2.2. The ADCC shall provide, obtain, or otherwise ensure each caregiver receives and successfully completes specific task training prior to assuming these job duties, including all of the following: DHS 105.14(4)(b)2.a.a. Personal care training for all caregivers who provide assistance with activities of daily living. Training shall be appropriate to the care and services provided. Specific training topics may include toileting and incontinence care, mobility and transferring, eating, bathing, and dressing. DHS 105.14(4)(b)2.b.b. Standard precaution training for all caregivers who may be exposed to blood, body fluids or other moist body substances, including mucous membranes, non-intact skin, secretions, and excretions except sweat, whether or not they contain visible blood. DHS 105.14(4)(b)2.c.c. Medication administration and management training for all caregivers who manage, administer, or assist participants with prescribed or over-the-counter medications. DHS 105.14(4)(c)(c) Caregiver supervision. Until a caregiver has completed all required training, the caregiver shall be directly supervised by the program director or by a qualified caregiver. DHS 105.14(4)(d)(d) Continuing education. The program director and every caregiver shall receive at least 10 hours per calendar year of continuing education beginning with the first full calendar year of employment. Continuing education shall be relevant to the job responsibilities and shall include, at a minimum, all of the following: DHS 105.14(4)(e)1.1. The ADCC shall maintain documentation of orientation and all the applicable training under sub. (4) (a), (b), and (d). Documentation shall include the name of the employee, the name of the instructor, the dates of training, a description of the course content, and the length of the training.
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Department of Health Services (DHS)
Chs. DHS 101-109; Medical Assistance
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