Chapter DHS 129

DHS 129.14(3) (3) The primary instructor may supplement the course by including other individuals for lecture or demonstration whose qualifications or experience add benefit to the training program.

DHS 129.14(4) (4) A paid feeding assistant is not permitted to lead the training of another paid feeding assistant student.

DHS 129.14 History History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.15 DHS 129.15 Feeding assistant training program approval process.

DHS 129.15(1) (1) A nursing home wishing to operate a feeding assistant training program shall apply for approval from the department on a form provided by the department with the nursing home’s proposed selected resident population, curriculum, and proposed feeding assistant instructor information.

DHS 129.15(2) (2) The department shall review the application and supporting materials to determine whether to approve or deny the feeding assistant training program. The department will issue a written notice regarding the decision of whether to approve or deny the application within 45 calendar days of receiving a complete application.

DHS 129.15(3) (3) Upon approval, the department shall issue, to the feeding assistant program, the standardized training curriculum the program selects, a Wisconsin Caregiver Program video cassette, standardized competency evaluation materials, feeding assistant training program, certificate template, and a feeding assistant roster.

DHS 129.15 Note Note: Link to the WI Caregiver program video and guide at https://www.dhs.wisconsin.gov/publications/p6/p63161.pdf and https://vimeo.com/546007413.

DHS 129.15 History History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.16 DHS 129.16 Feeding assistant employment requirements.

DHS 129.16(1) (1) A nursing home may not employ or use any person as a feeding assistant unless the person is at least 16 years of age and has:

DHS 129.16(1)(a) (a) Successfully passed a caregiver background check, that includes no employment or licensure-prohibitive offenses in s. 146.40 (4r), Stats., or s. 48.685, Stats.

DHS 129.16(1)(b) (b) Successfully completed a feeding assistant training and competency evaluation program and been determined competent to provide feeding and hydration services to residents.

DHS 129.16(2) (2) Nursing homes shall ensure feeding assistants only serve residents who have no complicated feeding problems with eating and hydration.

DHS 129.16(3) (3) Residents with complicated feeding problems, as defined in s. DHS 129.03 (10) shall be fed and hydrated by either a licensed health care professional or a nurse aide.

DHS 129.16(4) (4) The facility shall base their resident selection for feeding assistants based on the charge nurse’s assessment and each resident’s latest assessment and plan of care.

DHS 129.16(5) (5) Feeding assistants who are 16 or 17 years of age shall work under the direct supervision of an RN or LPN.

DHS 129.16(6) (6) Feeding assistants 18 years and older shall work under the general supervision of an RN, or an LPN. The feeding assistant is not permitted to perform other nursing or nursing-related duties including, but not limited to, measuring or recording intake or output, transferring, or toileting, etc.

DHS 129.16(7) (7) A nursing home may not employ or use any individual who has successfully completed a feeding assistant training and competency evaluation program as a feeding assistant unless that nursing home has a department-approved feeding assistant training program.

DHS 129.16 History History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.17 DHS 129.17 Feeding assistant training program requirements. Approved feeding assistant training programs shall submit all of the following information to the department:

DHS 129.17(1) (1) The program designee shall submit for approval a substantial change in the program to the department in writing. A program may not implement the proposed change in the program without the department’s written approval. In this subdivision, “substantial change” means a change in the program designee, primary instructor under s. DHS 129.14 (2) and the curriculum under s. DHS 129.12.

DHS 129.17(2) (2) The program designee shall submit an annual report to the department on a form provided by the department, and shall indicate the number of feeding assistants who were trained and tested during the year, including the number of individuals who dropped out or who failed the program.

DHS 129.17 History History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.18 DHS 129.18 Feeding assistant training program record retention requirements.

DHS 129.18(1) (1) Feeding assistant training programs shall maintain all of the following records for at least 3 years:

DHS 129.18(1)(a) (a) All student skill checklists, written examinations, certificates and other relevant training records.

DHS 129.18(1)(b) (b) Documentation of the training conducted and identification of the instructor who conducted the training.

DHS 129.18(1)(c) (c) Records of all individuals who have successfully completed the feeding assistant training and competency testing program.

DHS 129.18(2) (2) Training programs shall maintain the security of the test materials and certificate templates, to ensure disclosure or forgery does not occur.

DHS 129.18(3) (3) Nursing homes employing feeding assistants shall maintain all of the following personnel and other records for at least 3 years after feeding assistant has competed training:

DHS 129.18(3)(a) (a) A feeding assistant roster, recording all individuals employed by the facility as feeding assistants who successfully completed the feeding assistant training and competency evaluation, including a written or oral exam and a skill demonstration.

DHS 129.18(3)(b) (b) A copy of each feeding assistant’s training certificate, kept in the person’s personnel file.

DHS 129.18(3)(c) (c) The selected resident’s medical record, documenting that no complicated feeding condition exists.

DHS 129.18(3)(d) (d) The feeding assistant’s annual in-service session(s), relating to feeding assistant duties.

DHS 129.18(3)(e) (e) Annual evaluation documentation, determining a feeding assistant’s continued competence in feeding residents.

DHS 129.18 History History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.19 DHS 129.19 Feeding assistant training program prohibitions.

DHS 129.19(1) (1) The department will review substandard quality of care citations made under 42 CFR 483 that result in a prohibition of a nurse aide training or competency evaluation program for a nursing home, in order to determine the appropriate action for a feeding assistant training program. Program decisions will be made on a case-by-case basis.

DHS 129.19(2) (2) Any nursing home citation that directly relates to a feeding assistant training program may result in termination by the department of the feeding assistant training program.

DHS 129.19(3) (3) Feeding assistant training programs may request a waiver of the feeding assistant training prohibition by submitting a request in writing to the department. The department shall issue a written decision, either approving or denying the request, within 45 calendar days of receiving a complete waiver request.

DHS 129.19 History History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.20 DHS 129.20 Feeding assistant training program appeals.

DHS 129.20(1) (1) For any of the following department actions, a feeding assistant training program may request a hearing by filing an appeal with the department of administration’s division of hearings and appeals.

DHS 129.20(1)(a) (a) A denial of an application to operate a feeding assistant training program.

DHS 129.20(1)(b) (b) A denial of an approval of a feeding assistant instructor.

DHS 129.20(1)(c) (c) A termination or suspension of an approved feeding assistant training program.

DHS 129.20(1)(d) (d) An imposed plan of correction.

DHS 129.20(1)(e) (e) A denial of a request for a waiver or the revocation of a waiver.

DHS 129.20(2) (2) A request for a hearing shall be in writing and shall be filed with the department of administration’s division of hearings and appeals no later than 30 days after the date of the denial, suspension or revocation. An appeal is considered filed when received by the division of hearings and appeals.

DHS 129.20 Note Note: The address of the Department of Administration’s Division of Hearings and Appeals is P.O. Box 7875, Madison, Wisconsin 53707. Appeals may be delivered in person to that office at 5005 University Avenue, Room 201, Madison, Wisconsin.

DHS 129.20 History History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

subch. IV of ch. DHS 129 Subchapter IV — Medication Aides

DHS 129.21 DHS 129.21 Medication aide training program application and approval process.

DHS 129.21(1) (1) Approval process.

DHS 129.21(1)(a) (a) All medication aide training programs based in nursing homes shall be approved by the department.

DHS 129.21(1)(b) (b) Nursing homes and other entities wishing to operate a nursing home medication aide program shall submit a proposal for developing a medication aide course. The proposal shall include documentation of client needs, staff resources to provide the training and a description of the physical location of the training site. The proposal will be approved or denied by the department, and the department shall issue a decision within 30 calendar days of a completed proposal submittal.

DHS 129.21(1)(c) (c) After a medication aide program proposal is approved, medication aide course curriculum, course outline, instructor qualifications and other materials shall be submitted to and approved by the department before the training program can be implemented. The department will issue a decision on a completed course submittal within 90 calendar days.

DHS 129.21(1)(d) (d) The department will limit the number of approved programs to a maximum of 10, subject to determined needs as submitted in program development proposals. If the department determines there is a geographical or consumer-based need, the department may approve additional programs.

DHS 129.21(2) (2) Post approval review and monitoring.

DHS 129.21(2)(a) (a) The department shall conduct a post-approval review of a program every 2 years after the date on which the department formally approved the program. The department may conduct an on-site review of the program at any time to verify the program remains in compliance with the requirements of this chapter.

DHS 129.21(2)(b) (b) The program designee shall submit a report at least every 2 years to the department on a form provided by the department and shall provide any additional information requested by the department during its review of the program. The program designee shall allow reasonable means for the department to examine records and gather requested information.

DHS 129.21(2)(c) (c) The program designee shall report a substantial change in the program to the department in writing within 10 days of the change. A program may not operate without the department’s approval of any replacement or substantial change. Notwithstanding s. DHS 129.03 (51), in this subdivision, “substantial change” means any change in the instructor under s. DHS 129.22, or curriculum under s. DHS 129.24 (1).

DHS 129.21(2)(d) (d) All approved courses are subject to inspection. If at any time the department determines that a program has failed to comply with a requirement of this chapter, the department may, after providing written notice, impose a plan of correction on the program, suspend or revoke approval of the program.

DHS 129.21(2)(e) (e) The department may revoke approval of an instructor if the department determines the instructor failed to comply with any requirement of this subchapter.

DHS 129.21 Note Note: Current course proposal and course curriculum content requirements can be obtained from the Division of Quality Assurance, P.O. Box 2969, Madison, WI 53701-2969.

DHS 129.21 History History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.22 DHS 129.22 Standards for instructors of medication aide training programs. A medication aide program instructor shall be one of the following:

DHS 129.22(1) (1) A registered nurse, licensed in Wisconsin, with teaching experience in the principles of adult learning and training techniques and one or more years of experience in one of the following positions within the last 5 years immediately before the person will be a program instructor:

DHS 129.22(1)(a) (a) An instructor in a school of nursing.

DHS 129.22(1)(b) (b) A director of nursing in a nursing home or a hospital.

DHS 129.22(1)(c) (c) An in-service director in a nursing home.

DHS 129.22(1)(d) (d) A supervisory nurse in a nursing home.

DHS 129.22(2) (2) An approved primary instructor for nurse aide training under s. DHS 129.06.

DHS 129.22(3) (3) A pharmacist who is licensed in Wisconsin, with teaching experience in the principles of adult learning and training techniques, and who has at least one year of experience as a consultant to a nursing home.

DHS 129.22 History History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.23 DHS 129.23 Nursing home medication aide student qualifications.

DHS 129.23(1) (1) Student requirements. The student shall be at least 18 years of age, have a high school diploma or a high school equivalency diploma, and shall be listed on the registry as eligible to work in federally-certified health care settings.

DHS 129.23(2) (2) Work requirements. The student shall have at least 2,000 hours of experience as a nurse aide in direct patient care within the last 3 years and have worked a minimum of 40 hours as a nurse aide within the last 90 days, with the residents to whom the student will be administering medications during the clinical experience portion of the course.

DHS 129.23(3) (3) Written recommendation. The student shall have 4 written recommendations, 2 from licensed charge nurses, one from the director of nursing of the nursing home where the student will be working during the clinical experience, and one from the administrator of the nursing home where the student will be working during the clinical experience.

DHS 129.23 History History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.24 DHS 129.24 Standards for nursing home medication aide training programs.

DHS 129.24(1) (1) Curriculum.

DHS 129.24(1)(a) (a) Minimum requirements. A training program shall include at least the following 6 areas, specified in pars. (b) to (h):

DHS 129.24(1)(b) (b) Introduction.

DHS 129.24(1)(b)1. 1. To the course.

DHS 129.24(1)(b)2. 2. To the role of medication aides.

DHS 129.24(1)(c) (c) Legal and ethical considerations.

DHS 129.24(1)(c)1. 1. Federal and state nursing home standards, regulations, statutes, and administrative rules.