DHS 129.03(22)(22) “Hospice medication aide” means a nurse aide who is able to administer medications in a hospice after passing a department-approved medication course. DHS 129.03(24)(24) “Licensed health care professional” means a physician, physician’s assistant, nurse practitioner, physical, speech or occupational therapist, an occupational therapy assistant, a registered nurse, a licensed practical nurse or any other health or health service professional subject to the jurisdiction of the Wisconsin department of safety and professional services. DHS 129.03(26)(26) “Mechanical support” means any article, device or garment that is used only to achieve the proper position or balance of the client. DHS 129.03(30)(a)(a) “Nurse aide” means a person, regardless of the person’s title, who provides routine client-related services under the supervision of a registered nurse or licensed practical nurse. “Nurse aide” includes any of the following: DHS 129.03(30)(a)2.2. Any person providing nursing or nursing-related services to clients, regardless of the title under which the person is employed, except individuals in sub. (31). DHS 129.03(30)(a)4.4. Any person employed to provide nursing or nursing-related services, or employed within the last 24 months as a nurse aide by a health care provider. DHS 129.03(30)(c)(c) “Nurse aide” does not mean a person whose duties primarily involve skills that are different from those taught in training and competency evaluation programs approved under ss. DHS 129.07 and 129.08. A volunteer is not a “nurse aide”. DHS 129.03(30m)(30m) “Nurse aide training program” means an instructional program for a nurse aide that is approved by the department as mandated by s. DHS 146.40 (3) or (3g), Stats. DHS 129.03(33)(33) “Nursing home medication aide” means a nurse aide who is able to administer medications in a nursing home or a facility for the developmentally disabled after passing a department-approved medication course. DHS 129.03(34)(34) “Onsite review” means an evaluation of a training program conducted at the physical location of the training program to verify the program is in compliance with the terms of the approval issued. DHS 129.03(35)(35) “Plan of correction” means the training program’s plan to correct all areas identified as deficient during an onsite review. DHS 129.03(36)(36) “Preliminary approval” means the initial 3 month approval issued by the department following the completed review and verification of all aspects of the application. DHS 129.03(37)(37) “Primary instructor” means a registered nurse licensed to practice in Wisconsin who has a minimum of 2 years of nursing experience working as a registered nurse, at least one year of which must be in the provision of long-term care facility services, and who has completed a course in adult education or supervising nurse aides. DHS 129.03(38)(38) “PRN medications” means medications administered as necessary based on the resident’s or patient’s condition. DHS 129.03(39)(39) “Program” means the facility, agency or other entity or individual who operates an approved training program. DHS 129.03(40)(40) “Program trainer” means an individual from a health related field who provides specialized training about that field to nurse aides under the general supervision of the primary instructor. DHS 129.03(42)(42) “Qualified medication consultant” means one of the following: DHS 129.03(42)(c)(c) A masters-prepared registered nurse, teaching medication administration to RN or LPN students. DHS 129.03(43)(43) “Registered nurse (RN)” means an individual who is licensed as a registered nurse under s. 441.06, Stats., or who has a temporary permit under s. 441.08, Stats., to practice as a registered nurse. DHS 129.03(44)(44) “Registry” means the department’s record of all persons who are eligible to be employed by a health care provider, and who have either: DHS 129.03(44)(a)(a) Successfully completed a training and competency evaluation program. DHS 129.03(45)(45) “Restorative services” means the therapeutic practice, education and training to restore, promote, and maintain the client’s fullest possible level of functioning. DHS 129.03(46)(46) “Restraint” means any garment, device, or medication used primarily to modify client behavior by interfering with the free movement of the client or normal functioning of a portion of the body, and which the client is unable to remove easily, or confinement in a locked room, but does not include mechanical support. DHS 129.03(47)(47) “Revocation” means withdrawal of a nurse aide training program’s or competency evaluation program’s approval for failing to comply with applicable state requirements specified in s. 146.40, Stats. DHS 129.03(49)(49) “Statement of deficiencies” means the official document on which the Department records citations. DHS 129.03(50)(50) “Student nurse” means an individual who is enrolled in a school for professional nurses or a school for licensed practical nurses that meets standards established by the Board of Nursing under s. 441.01 (4), Stats., and ch. N 1, or who has successfully completed the course work of a basic nursing course in any school that is approved by the Board of Nursing under s. 441.06 (1) (a), Stats., but has not successfully completed the examination under s. 441.06 (1) (e) or 441.10 (1) (e), Stats. DHS 129.03(51)(51) “Substantial change” means a change to the facility, agency, organization or person that administers the training; program designee; program site; the curriculum; the classroom; the clinical site; primary instructor; and program trainer. DHS 129.03(52)(52) “Suspension” means a temporary withdrawal of the department’s approval for a facility, agency or other organization to provide a training or competency evaluation program if the entity providing the program is not in compliance with an approval previously issued by the department. DHS 129.03(53)(53) “Training program” means a program approved under this chapter to train nurse aides, feeding assistants or medication aides. DHS 129.03(54)(54) “Variance” means the department’s approval of an alternate requirement requested by a health care provider in place of a requirement of this chapter. DHS 129.03(55)(55) “Waiver” means the department’s approval of an exemption requested by a health care provider from a requirement of this chapter. DHS 129.03(56)(56) “Waiver of prohibition” means an authorization for a program to be taught in but not by the entity’s staff that has had its approval denied or withdrawn pursuant to Public Law 105-15, Section 1819 (f) (2) and Section 1919 (f) (2) of the Social Security Act, and 42 U.S.C. 1395i3 (f) (2) and 42 U.S.C. 1396r (f) (2). DHS 129.03 HistoryHistory: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08; corrections in (1), (4), (21), (23), (27), (28) and (29) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635; correction in (24) made under s. 13.92 (4) (b) 6., Stats., Register February 2012 No. 674; correction in (50) made under s. 13.92 (4) (b) 7., Stats., Register July 2015 No. 715; correction in (25) and (50) made under s. 13.92 (4) (b) 7., Stats., Register November 2015 No. 719; CR 16-088: cr. (30m) Register September 2017 No. 741, eff. 10-1-17; 2019 Wis. Act 1: am. (19) (c) Register May 2019 No. 761, eff. 6-1-19; CR 20-068: am. (18) Register December 2021 No. 792, eff. 1-1-22; CR 21-087: r. and recr. (30m), r. (31) Register June 2022 No. 798, eff. 7-1-22. DHS 129.04(1)(1) Requirements for waivers or variances. The department may grant a request for a waiver of or a variance from a requirement of this chapter if the department finds that the waiver or variance will not adversely affect the health, safety or welfare of any client; and that either: DHS 129.04(1)(a)(a) The requirement that the health care provider or program seeks relief from would result in unreasonable hardship or is infeasible as applied to the training program or competency evaluation program. DHS 129.04(1)(b)(b) If the request is for a variance, the proposed alternative to a rule, including new concepts, methods, procedures, practice, techniques, equipment, personnel qualifications, pilot project or other alternative is in the interest of client care and management or more effective training or testing programs or management. DHS 129.04(2)(a)(a) Requests. A request for a waiver or variance may be made at any time, shall be made in writing to the department and shall state all of the following: DHS 129.04(2)(a)4.4. If the request is for a variance, the proposed alternative to the rule, including new concepts, methods, procedures, practice, techniques, equipment, personnel qualifications, pilot project or other alternative or alternatives the program proposes and a description of how the proposed alternative or alternatives serves the interests of training and competency evaluation in a manner that is as protective as the requirement from which the variance is sought; and DHS 129.04(2)(a)6.6. The department may require additional information from the health care provider or program prior to acting on the request. DHS 129.04 NoteNote: A request for a waiver or variance should be addressed to the Division of Quality Assurance, P.O. Box 2969, Madison, WI 53701-2969 or faxed to 608-264-6340.
DHS 129.04(2)(b)1.1. The department shall grant or deny in writing each request for a waiver or variance. The notice of denial shall contain reasons for the denial. DHS 129.04(2)(b)2.2. The terms of a waiver or variance shall be modified upon agreement between the department and the health care provider or program. DHS 129.04(2)(b)3.3. The department may impose additional conditions on a waiver or variance it considers necessary to protect the health, safety or welfare of clients. DHS 129.04(2)(c)(c) Revocation. The department may revoke a waiver or variance, with written notice to the program, subject to the hearing requirements in par. (d), for any of the following reasons: DHS 129.04(2)(c)1.1. The department determines the waiver or variance is adversely affecting the effectiveness of the health care provider or program. DHS 129.04(2)(c)2.2. The health care provider or program failed to comply with the waiver or variance as granted or with a condition of the waiver or variance. DHS 129.04(2)(c)3.3. The health care provider or program notifies the department in writing that the program wishes to relinquish the waiver or variance and be subject to the rule previously waived or varied. DHS 129.04(2)(d)(d) Hearings. A health care provider or program may contest the denial of a requested waiver or variance by requesting a hearing under ch. 227, Stats., and s. DHS 129.10. DHS 129.04(3)(3) Nurse aide training or competency evaluation program waiver of prohibition. Pursuant to amendments made to Public Law 105-15, Section 1819 (f) (2) and Section 1919 (f) (2) of the Social Security Act, and 42 U.S.C. 1395i3 (f) (2) and 42 U.S.C. 1396r (f) (2), the department may authorize a waiver of the 2-year prohibition for approval of training programs or the competency evaluation program offered in but not by a facility under the following circumstances: DHS 129.04(3)(a)(a) No other department-approved program is offered within a reasonable distance of the facility. A reasonable distance means any of the following: DHS 129.04(3)(a)1.1. There is no department-approved program within 45 miles or 60 minutes away, one-way, from the facility requesting a waiver. DHS 129.04(3)(a)2.2. The only program within 45 miles or 60 minutes away, one-way, from the facility is out-of-state and would require the person to first qualify on another state’s registry and then apply to be added to the registry as an out-of-state transfer applicant. DHS 129.04(3)(a)3.3. There is a documented lack of qualified instructors to fulfill the program requirements at other sites within the 45 miles or 60 minutes, away, one-way radius. DHS 129.04(3)(b)(b) The facility shall have an adequate environment for operating the program. An adequate environment means the citations leading to the prohibition were non-resident and non-nursing care related. DHS 129.04(3)(c)(c) If the citations leading to the prohibition were resident or nursing care related: DHS 129.04(3)(c)1.1. The citations were corrected at revisit and there were no cites at or since the previous standard survey that were resident or nursing care related; or DHS 129.04(3)(c)2.2. The program termination resulted from a new citation at a standard survey revisit and the facility had no other citations at or since the previous standard survey that were resident or nursing care related; or DHS 129.04(3)(c)3.3. The facility had an immediate jeopardy situation in a resident or nursing care related area that was corrected at the time of survey and had no other citations at or since the previous standard survey that were resident or nursing care related; or DHS 129.04(3)(c)4.4. The facility had a history of resident or nursing care related citations, but has demonstrated efforts beyond normal means to attain and maintain substantial compliance. History means since the most recent training program approval. DHS 129.04(3)(d)(d) The facility’s physical environment is adequate in that the physical or structural requirements are in substantial compliance or there is a waiver request pending. DHS 129.04(3)(e)(e) The program provided in the facility shall be by another entity unrelated to the facility that has agreed to provide the training. Competency testing shall also be done by an entity unrelated to the facility or the training program.
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