Chapter DHS 131

DHS 131.33(3)(f) (f) Responses to medications, symptom management, treatments, and services.

DHS 131.33(3)(g) (g) Outcome measure data elements, as described in s. DHS 131.20 (5).

DHS 131.33(3)(h) (h) Physician certification and recertification of terminal illness.

DHS 131.33(3)(i) (i) A statement of whether or not the patient, if an adult, has prepared an advance directive; and a copy of the advance directive, if prepared.

DHS 131.33(3)(j) (j) Physician orders.

DHS 131.33(3)(k) (k) Patient and family identification information.

DHS 131.33(3)(L) (L) Referral information, medical history and pertinent hospital discharge summaries.

DHS 131.33(3)(m) (m) Transfer and discharge summaries.

DHS 131.33(4) (4) Authentication.

DHS 131.33(4)(a) (a) Entries. All entries shall be legible, permanently recorded, dated and authenticated by the person making the entry, and shall include that person’s name and title.

DHS 131.33(4)(b) (b) Written record. A written record shall be made for every service provided on the date the service is provided. This written record shall be incorporated into the clinical record no later than 7 calendar days after the date of service.

DHS 131.33(4)(c) (c) Medical symbols. Medical symbols and abbreviations may be used in the clinical records if approved by a written program policy which defines the symbols and abbreviations and controls their use.

DHS 131.33(4)(d) (d) Protection of information. Written record policies shall ensure that all record information is safeguarded against loss, destruction and unauthorized usage.

DHS 131.33(4)(e) (e) Retention and destruction.

DHS 131.33(4)(e)1. 1. An original clinical record and legible copy or copies of court orders or other documents, if any, authorizing another person to speak or act on behalf of the patient shall be retained for a period of at least 5 years following a patient’s discharge or death when there is no requirement in state law. All other records required by this chapter shall be retained for a period of at least 2 years.

DHS 131.33(4)(e)2. 2. A hospice shall arrange for the storage and safekeeping of records for the periods and under the conditions required by this paragraph in the event the hospice closes.

DHS 131.33(4)(e)3. 3. If the ownership of a hospice changes, the clinical records and indexes shall remain with the hospice.

DHS 131.33 History History: CR 10-034: cr. Register September 2010 No. 657, eff. 10-1-10.

DHS 131.34 DHS 131.34 Personnel qualifications.

DHS 131.34(1) (1) Personnel qualifications. All professionals who furnish services directly, under an individual contract, or under arrangements with a hospice, shall be legally authorized, licensed, certified or registered in accordance with applicable federal, state and local laws, and shall act only within the scope of his or her state license, or state certification, or registration. Personnel qualifications shall be kept current at all times.

DHS 131.34 History History: CR 10-034: cr. Register September 2010 No. 657, eff. 10-1-10.

subch. V of ch. DHS 131 Subchapter V — Physical Environment

DHS 131.35 DHS 131.35 Definitions. In this subchapter:

DHS 131.35(1) (1) “Existing construction” or “existing facility” means a building which is in place or is being constructed with plans approved by the department prior to August 1, 2020.

DHS 131.35(2) (2) “Freestanding hospice facility” means a residential facility serving 3 or more patients which is not located in a licensed hospital or nursing home.

DHS 131.35(3) (3) “Life Safety Code” means the National Fire Protection Association’s Standard 101.

DHS 131.35(4) (4) “New construction” means construction for the first time of any building or addition to an existing building, the plans for which are approved on or after August 1, 2020.

DHS 131.35(5) (5) “NFPA” means the National Fire Protection Association.

DHS 131.35 History History: CR 10-034: cr. Register September 2010 No. 657, eff. 10-1-10; CR 19-092: am. (1), (3), (4), r. and recr. (5) Register July 2020 No. 775, eff. 8-1-20; correction in (1), (5) made under s. 13.92 (4) (b) 14., Stats., Register July 2020 No. 775.

DHS 131.36 DHS 131.36 Scope. This subchapter applies to freestanding hospice facilities.

DHS 131.36 Note Note: Inpatient hospices located in nursing homes or hospitals must meet applicable administrative codes.

DHS 131.36 History History: CR 10-034: cr. Register September 2010 No. 657, eff. 10-1-10.

DHS 131.37 DHS 131.37 Physical plant.

DHS 131.37(1) (1) General requirements. The building of a freestanding hospice shall be constructed and maintained so that it is functional for the delivery of hospice services, appropriate to the needs of the community and protects the health and safety of the patients. The provisions of this section apply to all new, remodeled and existing construction unless otherwise noted. Wherever a requirement in this section is in conflict with the applicable Life Safety Code under s. DHS 131.38, the Life Safety Code shall take precedence.

DHS 131.37(5) (5) Patient bedrooms.

DHS 131.37(5)(a) (a) Design and location. Patient bedrooms shall be designed and equipped for the comfort and privacy of the patient and shall be equipped with or located near toilet and bathing facilities.

DHS 131.37(5)(b) (b) Capacity.

DHS 131.37(5)(b)1. 1. A patient bedroom may accommodate no more than 2 patients. Patients of the opposite sex may not be required to occupy the same sleeping room.

DHS 131.37(5)(b)2. 2. The minimum floor area per bed shall be 80 square feet in multiple patient rooms and 100 square feet in single patient rooms. The distance between patient beds in multipatient rooms shall be at least 3 feet.

DHS 131.37(5)(c) (c) Bed arrangements.

DHS 131.37(5)(c)2. 2. There shall be at least 3 feet between beds where the space is necessary for patient or staff access.

DHS 131.37(5)(c)3. 3. Visual privacy shall be provided for each patient in multibed patient rooms. In new or remodeled construction, cubicle curtains shall be provided.

DHS 131.37(5)(d) (d) Semiambulatory and nonambulatory patients. For rooms with semiambulatory or nonambulatory patients, mobility space at the end and one side of each bed may not be not less than 4 feet. Adequate accessible space for storage of a patient’s wheelchair or other adaptive or prosthetic equipment shall be provided and shall be readily accessible to the patient.

DHS 131.37(5)(e) (e) Equipment and supplies. Each patient shall be provided with all of the following:

DHS 131.37(5)(e)1. 1. A separate bed of proper size and height for the convenience of the patient. Beds shall be at least 36 inches wide and shall be maintained in good condition.

DHS 131.37(5)(e)2. 2. Drawer space available in the bedroom for personal clothing and possessions.

DHS 131.37(5)(e)3. 3. Closet or wardrobe space with clothes racks and shelves in the bedroom.

DHS 131.37(7) (7) Windows.

DHS 131.37(7)(a) (a) Minimum size. Every living and sleeping room shall have one or more outside-facing windows.

DHS 131.37(7)(b) (b) Openable bedroom window. At least one outside window in a bedroom shall be openable from the inside without the use of tools.

DHS 131.37(7)(c) (c) Window screens. All openable windows in habitable rooms shall have insect-proof screens.

DHS 131.37(8) (8) Electrical.

DHS 131.37(8)(a) (a) Every hospice facility shall be supplied with electrical service and shall have wiring, outlets and fixtures properly installed and maintained in good and safe working condition.

DHS 131.37(8)(b) (b) Extension cords shall not be used in lieu of permanent wiring.

DHS 131.37(8)(c) (c) Exposed wiring is prohibited.

DHS 131.37(8)(f) (f) There shall be a switch or equivalent device for turning on at least one light in each room or passageway. The switch or equivalent device shall be located so as to conveniently control the lighting in the area.

DHS 131.37(8)(g) (g) All electrical cords and appliances shall be maintained in a safe condition. Frayed wires and cracked or damaged switches, plugs and electric fixtures shall be repaired or replaced.

DHS 131.37(9) (9) Patient call system. A reliable call mechanism shall be provided in every location where patients may be left unattended, including patient rooms, toilet and bathing areas and designated high risk treatment areas from which individuals may need to summon assistance.

DHS 131.37(10) (10) Bedding and laundry. There shall be separate clean linen and dirty linen storage areas.

DHS 131.37(10)(b) (b) Each patient shall have available all of the following:

DHS 131.37(10)(b)1. 1. Sufficient blankets to keep warm.

DHS 131.37(10)(b)2. 2. A pillow.

DHS 131.37(10)(b)3. 3. Mattress and pillow covers as necessary to keep mattresses and pillows clean and dry.

DHS 131.37 Note Note: When plastic mattress covers are used, there shall be a mattress pad the same size as the mattress over the plastic mattress cover.

DHS 131.37(10)(c) (c) Clean sheets, pillowcases, towels and washcloths shall be available at least weekly and shall be changed as necessary to ensure that at all times they are clean and free from odors.

DHS 131.37(11) (11) Dayroom or lounge. At least one dayroom or lounge, centrally located, shall be provided for use of the patients.

DHS 131.37(12) (12) Size of dining room. Dining rooms shall be of sufficient size to seat all patients at no more than 2 shifts. Dining tables and chairs shall be provided. Television trays or portable card tables may not be used as the primary dining tables.

DHS 131.37(13) (13) Kitchen. The kitchen shall be located on the premises, or a satisfactory sanitary method of transportation of food shall be provided. If there is a kitchen on the premises, it shall meet food service needs and be arranged and equipped for proper refrigeration, heating, storage, preparation and serving of food. Adequate space shall be provided for proper refuse handling and washing of waste receptacles, and for storage of cleaning compounds.

DHS 131.37(14) (14) Multipurpose room. If a multipurpose room is used for dining, diversional and social activities of patients, there shall be sufficient space to accommodate all activities and minimize their interference with each other.

DHS 131.37(15) (15) Total area.

DHS 131.37(15)(a) (a) In existing facilities, the combined floor space of dining, recreation, and activity areas shall not be less than 15 square feet per bed. Solaria and lobby sitting space may be included, but shall not include required exit paths. A required exit path in these areas shall be at least 4 feet wide.

DHS 131.37(15)(b) (b) In new construction, the combined floor space of dining, recreation, and activity areas shall not be less than 25 square feet per bed. Solaria and lobby areas, exclusive of traffic areas, shall be categorized as living room space.

DHS 131.37(15)(c) (c) All required dining and living areas within the building shall be internally accessible to every patient of the hospice.

DHS 131.37(15)(d) (d) Each habitable room shall contain furnishings appropriate to the intended use of the room. Furnishings shall be safe for use by patients, and shall be comfortable, clean and maintained in good repair.

DHS 131.37(15)(e) (e) Adequate space and equipment shall be designated to meet the needs of the patients and family members for privacy and social activities.

DHS 131.37(16) (16) Heating.

DHS 131.37(16)(a) (a) The facility shall have a heating system capable of maintaining a temperature of 72º F. (20º C.) during periods of occupancy. Temperatures during sleeping hours may be reduced to 68º F. (18º C.). Higher or lower temperatures shall be available upon request.

DHS 131.37(16)(b) (b) The heating system shall be maintained in a safe and properly functioning condition.

DHS 131.37(16)(c) (c) The use of portable space heaters is prohibited.

DHS 131.37(17) (17) Bath and toilet facilities.

DHS 131.37(17)(a) (a) Each hospice shall have at least one separate bath and one separate toilet room or one combination bath and toilet room for the use of patients which is accessible from public, non-sleeping areas, except where private bath and toilet rooms are adjacent to each sleeping room.

DHS 131.37(17)(b) (b) Each floor in which patient sleeping, dining and living rooms are located shall have bath and toilet facilities or one combination bath and toilet room for use of patients which is accessible from public, non-sleeping areas, except where private bath and toilet rooms are adjacent to each bedroom.

DHS 131.37(17)(c) (c) All bath and toilet areas shall be well lighted.

DHS 131.37(17)(d) (d) Toilets, bathtubs and showers used by residents shall provide for individual privacy. If door locks are used for privacy they shall be operable from both sides in an emergency.

DHS 131.37(17)(e) (e) All toilet and bathing areas, facilities and fixtures shall be kept clean, in good repair and in good working order.

DHS 131.37(18) (18) Water supply.

DHS 131.37(18)(a) (a) Each sink, bathtub and shower shall be connected to hot and cold water, and adequate hot water shall be supplied to meet the needs of the patients.

DHS 131.37(18)(b) (b) Hot water from taps accessible to patients shall not exceed 115° F.

DHS 131.37(18)(c) (c) Where a public water supply is not available, the well or wells shall be approved by the Wisconsin department of natural resources. Water samples from an approved well shall be tested at least annually at the state laboratory of hygiene or another laboratory approved under 42 CFR 493 (CLIA).