Chapter DHS 131

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).

DHS 131.37(18)(d) (d) The hospice shall make provision for obtaining emergency fuel and water supplies.

DHS 131.37(20) (20) Facility maintenance.

DHS 131.37(20)(a) (a) The building shall be maintained in good repair and free of hazards such as cracks in floors, walls or ceilings, warped or loose boards, warped, broken, loose or cracked floor covering such as tile or linoleum, loose handrails or railings, and loose or broken window panes.

DHS 131.37(20)(b) (b) All electrical, mechanical, water supply, fire protection and sewage disposal systems shall be maintained in a safe and functioning condition.

DHS 131.37(20)(c) (c) All plumbing fixtures shall be in good repair, properly functioning and satisfactorily provided with protection to prevent contamination from entering the water supply piping.

DHS 131.37(20)(d) (d) Rooms shall be kept clean, well ventilated and tidy.

DHS 131.37(20)(e) (e) All furniture and furnishings shall be kept clean and maintained in good repair.

DHS 131.37(20)(f) (f) Storage areas shall be maintained in a safe, dry and orderly condition. Attics and basements shall be free of accumulation of garbage, refuse, soiled laundry, discarded furniture, old newspapers, boxes, discarded equipment and similar items.

DHS 131.37(20)(g) (g) Abrasive strips or nonskid surfaces to reduce or prevent slipping shall be used where slippery surfaces present a hazard.

DHS 131.37(20)(h) (h) The grounds, yards, and sidewalks shall be maintained in a neat, orderly and safe condition.

DHS 131.37(21) (21) Floors and stairs. Floors and stairs shall be maintained in a nonhazardous condition.

DHS 131.37(22) (22) Exits. Sidewalks, doorways, stairways, fire escapes and driveways used for exiting shall be kept free of ice, snow and obstructions.

DHS 131.37(23) (23) Door locks. The employee in charge of the facility on each work shift shall have a key or other means of opening all locks or closing devices on all doors in the facility.

DHS 131.37(24) (24) Emergency plan.

DHS 131.37(24)(a) (a) Each hospice shall have a written plan posted in a conspicuous place which specifies procedures for the orderly evacuation of patients in case of an emergency. The plan shall include an evacuation diagram. The evacuation diagram shall in addition be posted in a conspicuous place in the facility.

DHS 131.37(24)(b) (b) The licensee, administrator and all staff who work in the hospice facility shall be trained in all aspects of the emergency plan.

DHS 131.37(24)(c) (c) The procedures for exiting or taking shelter in the event of a fire, tornado, flooding or other disaster to be followed for patient safety shall be clearly communicated by the staff to the patients within 72 hours after admission and practiced at least quarterly by staff.

DHS 131.37 History History: CR 10-034: cr. Register September 2010 No. 657, eff. 10-1-10; correction in (1) made under s. 13.92 (4) (b) 7., Stats., Register September 2010 No. 657; corrections in (4) (a) and (b), (19) (a) to (c) made under s. 13.92 (4) (b) 7., Stats., Register January 2012 No. 673; CR 19-092: r. (2) to (4), am. (5) (a), r. and recr. (5) (a), am. (5) (b) 1., r. (5) (c) 1., am. (5) (d), (e) 3., r. (6), am. (7) (a), (c), r. and recr. (8) (b), (c), r. (8) (d), (e), am. (16) (c), (17) (a) 3., r. (17) (b), am. (18) (b), r. (19), (25) Register July 2020 No. 775, eff. 8-1-20; change in numbering in (17) made under s. 13.92 (4) (b) 1., Stats., Register July 2020.

DHS 131.38 DHS 131.38 Fire protection.

DHS 131.38(1) (1) Basic responsibility. The hospice shall provide fire protection adequate to ensure the safety of patients, staff and others on the hospice’s premises. Necessary safeguards such as extinguishers, sprinkling and detection devices, fire and smoke barriers and ventilation control barriers shall be installed to ensure rapid and effective fire and smoke control.

DHS 131.38(2) (2) Life safety code. Facilities shall meet the applicable provisions of the 2012 edition of the Life Safety Code (LSC).

DHS 131.38 Note Note: Copies of the 2012 Life Safety Code and related codes are on file in the Department’s Division of Quality Assurance and the Legislative Reference Bureau, and may be obtained from the National Fire Protection Association, 1 Batterymarch Park, Quincy, MA 02169.

DHS 131.38(3) (3) Fire safety evaluation system. An existing facility that does not meet all requirements of the applicable Life Safety Code may be considered in compliance with it if the facility achieves a passing score on the Fire Safety Evaluation System (FSES) developed by the U.S. department of commerce, national bureau of standards, to establish safety equivalencies under the Life Safety Code.