Chapter DHS 132

DHS 132.695(2)(d)1. 1. A psychologist licensed under ch. 455, Stats.;

DHS 132.695(2)(d)2. 2. A physician;

DHS 132.695(2)(d)3. 3. A social worker with a graduate degree from a school of social work accredited or approved by the council on social work education or with a bachelor’s degree in social work from a college or university accredited or approved by the council on social work education.

DHS 132.695(2)(d)4. 4. A physical or occupational therapist who meets the requirements of s. DHS 105.27 or 105.28;

DHS 132.695(2)(d)5. 5. A speech pathologist or audiologist who meets the requirements of s. DHS 105.30 or 105.31;

DHS 132.695(2)(d)6. 6. A registered nurse;

DHS 132.695(2)(d)7. 7. A therapeutic recreation specialist who is a graduate of an accredited program or who has a bachelor’s degree in a specialty area such as art, dance, music, physical education or recreation therapy; or

DHS 132.695(2)(d)8. 8. A human services professional who has a bachelor’s degree in a human services field other than a field under subds. 1. to 7., such as rehabilitation counseling, special education or sociology.

DHS 132.695(3) (3) Active treatment programming. All residents who are developmentally disabled shall receive active treatment. Active treatment shall include the resident’s regular participation, in accordance with the IPP, in professionally developed and supervised activities, experiences and therapies.

DHS 132.695(4) (4) Resident care planning.

DHS 132.695(4)(b) (b) Development and content of the individual program plan.

DHS 132.695(4)(b)1. 1. Except in the case of a person admitted for short-term care, within 30 days following the date of admission, the interdisciplinary team, with the participation of the staff providing resident care, shall review the preadmission evaluation and physician’s plan of care and shall develop an IPP based on the new resident’s history and an assessment of the resident’s needs by all relevant disciplines, including any physician’s evaluations or orders.

DHS 132.695(4)(b)2. 2. The IPP shall include:

DHS 132.695(4)(b)2.a. a. Evaluation procedures for determining whether the methods or strategies are accomplishing the care objectives; and

DHS 132.695(4)(b)2.b. b. A written interpretation of the preadmission evaluation in terms of any specific supportive actions, if appropriate, to be undertaken by the resident’s family or legal guardian and by appropriate community resources.

DHS 132.695(4)(c) (c) Reassessment of individual program plan.

DHS 132.695(4)(c)1. 1. The care provided by staff from each of the disciplines involved in the resident’s treatment shall be reviewed by the professional responsible for monitoring delivery of the specific service.

DHS 132.695(4)(c)2. 2. Individual care plans shall be reassessed and updated at least quarterly by the interdisciplinary team, with more frequent updates if an individual’s needs warrant it, and at least every 30 days by the QIDP to review goals.

DHS 132.695(4)(c)3. 3. Reassessment results and other necessary information obtained through the specialists’ assessments shall be disseminated to other resident care staff as part of the IPP process.

DHS 132.695(4)(c)4. 4. Documentation of the reassessment results, treatment objectives, plans and procedures, and continuing treatment progress reports shall be recorded in the resident’s record.

DHS 132.695(4)(d) (d) Implementation. Progress notes shall reflect the treatment and services provided to meet the goals stated in the IPP.

DHS 132.695 Note Note: See ch. DHS 134 for rules governing residential care facilities that primarily serve developmentally disabled persons who require active treatment.

DHS 132.695 History History: Cr. Register, January, 1987, No. 373, eff. 2-1-87; am. (2) (a), (b), (3), (4) (a), (b), (c) 1., 2. intro. and a. and (d), renum. (2) (c) to (d) and am. (intro.) and 3., cr. (2) (c), Register, February, 1989, No. 398, eff. 3-1-89; correction in (2) (d) 4. made under s. 13.93 (2m) (b) 7., Stats., Register, August, 2000, No. 536; CR 06-053: cons., renum. and am. (3) (a) (intro.) and 1. (intro.) to be (3), r. (3) (a) 1. a. and b., 2., and (b), (4) (a), (b) 2. a. to c. and (c) 1., 2. and 3., renum. (4) (b) 2. d. and e. and (c) 1. a. to d. to be (4) (b) 2. a. and b. and (c) 1. to 4., Register August 2007 No. 620, eff. 9-1-07; corrections in (2) (d) 4. and 5. made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637; 2019 Wis. Act 1: am. (2) (d) (intro.), (4) (c) 2. Register May 2019 No. 761, eff. 6-1-19.

DHS 132.70 DHS 132.70 Special requirements when persons are admitted for short-term care.

DHS 132.70(1) (1) Scope. A facility may admit persons for short-term care. A facility that admits persons for short-term care may use the procedures included in this section rather than the procedures included in ss. DHS 132.52 and 132.60 (8). Short-term care is for either respite or recuperative purposes. The requirements in this section apply to all facilities that admit persons for short-term care when they admit, evaluate or provide care for these persons. Except as specified in this section, all requirements of this chapter, including s. DHS 132.51, apply to all facilities that admit persons for short-term care.

DHS 132.70(2) (2) Procedures for admission. Respite care. For a person admitted to a facility for respite care, the following admission and resident care planning procedures may be carried out in place of the requirements under ss. DHS 132.52 and 132.60 (8):

DHS 132.70(2)(a) (a) A registered nurse or physician shall complete a comprehensive resident assessment of the person prior to or on the day of admission. This comprehensive assessment shall include evaluation of the person’s medical, nursing, dietary, rehabilitative, pharmaceutical, dental, social and activity needs. The consulting or staff pharmacist shall participate in the comprehensive assessment. As part of the comprehensive assessment, when the registered nurse or physician has identified a need for a special service, staff from the discipline that provides the service shall, on referral from the registered nurse or physician, complete a history and assessment of the person’s prior health and care in that discipline. The comprehensive resident assessment shall include:

DHS 132.70(2)(a)1. 1. A summary of the major needs of the person and of the care to be provided;

DHS 132.70(2)(a)2. 2. The attending physician’s plans for discharge.

DHS 132.70(2)(b) (b) The registered nurse, with verbal agreement of the attending physician, shall develop a written plan of care for the person being admitted prior to or at the time of admission. The plan of care shall be based on the comprehensive resident assessment under par. (a), the physician’s orders, and any special assessments under par. (a).

DHS 132.70(2)(c) (c) The facility shall send a copy of the comprehensive resident assessment, the physician’s orders and the plan of care under par. (b) to the person’s attending physician. The attending physician shall sign the assessment and the plan of care within 48 hours after the person is admitted.

DHS 132.70(3) (3) Admission information.

DHS 132.70(3)(a) (a) This subsection takes the place of s. DHS 132.31 (1) (d) 1. for persons admitted for respite care or recuperative care.

DHS 132.70(3)(b) (b) No person may be admitted to a facility for respite care or recuperative care without signing or the person’s guardian or designated representative signing an acknowledgement of having received a statement before or on the day of admission that indicates the expected length of stay, with a note that the responsibility for care of the resident reverts to the resident or other responsible party following expiration of the designated length of stay.

DHS 132.70(4) (4) Medications.

DHS 132.70(4)(c) (c) Respite care residents and recuperative care residents may bring medications into the facility as permitted by written policy of the facility.

DHS 132.70(7) (7) Records.

DHS 132.70(7)(a) (a) Contents. The medical record for each respite care resident and each recuperative care resident shall include, in place of the items required under s. DHS 132.45 (5):

DHS 132.70(7)(a)1. 1. The resident care plan prepared under sub. (2) (b).

DHS 132.70(7)(a)2. 2. Admission nursing notes identifying pertinent problems to be addressed and areas of care to be maintained;

DHS 132.70(7)(a)3. 3. For recuperative care residents, nursing notes addressing pertinent problems identified in the resident care plan and, for respite care residents, nursing notes prepared by a registered nurse or licensed practical nurse to document the resident’s condition and the care provided;

DHS 132.70(7)(a)4. 4. Physicians’ orders;

DHS 132.70(7)(a)5. 5. A record of medications;

DHS 132.70(7)(a)6. 6. Any progress notes by physicians or health care specialists that document resident care and progress;

DHS 132.70(7)(a)7. 7. For respite care residents, a record of change in condition during the stay at the facility; and

DHS 132.70(7)(a)8. 8. For recuperative care residents, the physician’s discharge summary with identification of resident progress, and, for respite care residents, the registered nurse’s discharge summary with notes of resident progress during the stay.

DHS 132.70(7)(b) (b) Location and accessibility. The medical record for each short-term care resident shall be kept with the medical records of other residents and shall be readily accessible to authorized representatives of the department.

DHS 132.70 History History: Cr. Register, January, 1987, No. 373, eff. 2-1-87; am. (1), (2) (a) (intro.) and (b) (intro.), Register, February, 1989, No. 398, eff. 3-1-89; CR 06-053: r. (2) (a) 1. b., (b), (3) (b) 2. to 9., (4) (a) and (b), (5) and (6), renum. (2) (a) (intro.), 1. (intro.), 2. and 3. to be (2) (intro.), (a) (intro.), (b) and (c), am. (2) (a) (intro.) and (b) and (7) (a) 1., cons., renum., and am. (3) (b) (intro.) and 1. to be (3) (b), Register August 2007 No. 620, eff. 9-1-07; correction in (2) (c) made under s. 13.93 (2m) (b) 7., Stats., Register August 2007 No. 620.

subch. VII of ch. DHS 132 Subchapter VII — Physical Environment

DHS 132.71 DHS 132.71 Furniture, equipment and supplies.

DHS 132.71(1) (1) Furniture in resident care areas.

DHS 132.71(1)(b) (b) Bedding.

DHS 132.71(1)(b)1. 1. Each resident shall be provided at least one clean, comfortable pillow. Additional pillows shall be provided if requested by the resident or required by the resident’s condition.

DHS 132.71(1)(b)2. 2. Each bed shall have a mattress pad.

DHS 132.71(1)(b)3. 3. A moisture-proof mattress cover and pillow cover shall be provided to keep each mattress and pillow clean and dry.

DHS 132.71(1)(b)4. 4.

DHS 132.71(1)(b)4.a. a. A supply of sheets and pillow cases sufficient to keep beds clean, dry, and odor-free shall be stocked. At least 2 sheets and 2 pillow cases shall be furnished to each resident each week.

DHS 132.71(1)(b)4.b. b. Beds occupied by bedfast or incontinent residents shall be provided draw sheets.

DHS 132.71(1)(b)6. 6. Each bed shall have a clean, washable bedspread.

DHS 132.71(1)(c) (c) Other furnishings.

DHS 132.71(1)(c)2. 2.

DHS 132.71(1)(c)2.a. a. At least one chair shall be in each room for each bed. A folding chair shall not be used. If requested by the resident or guardian, a wheel-chair or geri-chair may be substituted.

DHS 132.71(1)(c)2.b. b. An additional chair with arms shall be available upon request.

DHS 132.71(1)(c)4. 4. Adequate compartment or drawer space shall be provided in each room for each resident to store personal clothing and effects and to store, as space permits, other personal possessions in a reasonably secure manner.

DHS 132.71(1)(c)5. 5. A sturdy and stable table that can be placed over the bed or armchair shall be provided to every resident who does not eat in the dining area.

DHS 132.71(1)(d) (d) Towels, washcloths, and soap.

DHS 132.71(1)(d)1. 1. Clean towels and washcloths shall be provided to each resident as needed. Towels shall not be used by more than one resident between launderings.

DHS 132.71(1)(d)2. 2. An individual towel rack shall be installed at each resident’s bedside or at the lavatory.

DHS 132.71(1)(d)3. 3. Single service towels and soap shall be provided at each lavatory for use by staff.

DHS 132.71(1)(e) (e) Window coverings. Every window shall be supplied with flame retardant shades, draw drapes or other covering material or devices which, when properly used and maintained, shall afford privacy and light control for the resident.

DHS 132.71(2) (2) Resident care equipment.

DHS 132.71(2)(a) (a) Personal need items. When a resident because of his or her condition needs a mouthwash cup, a wash basin, a soap dish, a bedpan, an emesis basin, or a standard urinal and cover, that item shall be provided to the resident. This equipment may not be interchanged between residents until it is effectively washed and sanitized.

DHS 132.71(2)(c) (c) First aid supplies. Each nursing unit shall be supplied with first aid supplies, including bandages, sterile gauze dressings, bandage scissors, tape, and a sling tourniquet.

DHS 132.71(2)(d) (d) Other equipment. Other equipment, such as wheelchairs with brakes, footstools, commodes, foot cradles, footboards, under-the-mattress bedboards, walkers, trapeze frames, transfer boards, parallel bars, reciprocal pulleys, suction machines, patient lifts, and Stryker or Foster frames, shall be used as needed for the care of the residents.

DHS 132.71(7) (7) Oxygen.

DHS 132.71(7)(a) (a) No oil or grease shall be used on oxygen equipment.

DHS 132.71(7)(b) (b) When placed at the resident’s bedside, oxygen tanks shall be securely fastened to a tip-proof carrier or base.

DHS 132.71(7)(c) (c) Oxygen regulators shall not be stored with solution left in the attached humidifier bottle.

DHS 132.71(7)(d) (d) When in use at the resident’s bedside, cannulas, hoses, and humidifier bottles shall be maintained and used in accordance with current standards of practice and manufacturers’ recommendations.

DHS 132.71(7)(e) (e) Disposable inhalation equipment shall be maintained and used in accordance with current standards of practice and manufacturers’ recommendations.

DHS 132.71(7)(f) (f) With other inhalation equipment such as intermittent positive pressure breathing equipment, the entire resident breathing circuit, including nebulizers and humidifiers, shall be maintained and used in accordance with current standards of practice and manufacturers’ recommendations.

DHS 132.71 History History: Cr. Register, July, 1982, No. 319, eff. 8-1-82; am. (1) (e), (2) (a) and (3), Register, January, 1987, No. 373, eff. 2-1-87; CR 06-053: r. (1) (a), (b) 5., (c) 1. and 3., (2) (b) and (3) to (6), Register August 2007 No. 620, eff. 9-1-07; 2015 Wis. Act 107: am. (7) (d) to (f) Register November 2015 No. 719, eff. 12-1-15.

DHS 132.72 DHS 132.72 Housekeeping services.

DHS 132.72(1) (1) Requirement. Facilities shall develop and implement written policies that ensure a safe and sanitary environment for personnel and residents at all times.

DHS 132.72(2) (2) Cleaning.

DHS 132.72(2)(e) (e) Combustibles in storage areas. Attics, cellars and other storage areas shall be kept safe and free from dangerous accumulations of combustible materials. Combustibles such as cleaning rags and compounds shall be kept in closed metal containers.

DHS 132.72(2)(f) (f) Grounds. The grounds shall be kept free from refuse, litter, and waste water. Areas around buildings, sidewalks, gardens, and patios shall be kept clear of dense undergrowth.

DHS 132.72(3) (3) Poisons. All poisonous compounds shall be clearly labeled as poisonous and, when not in use, shall be stored in a locked area separate from food, kitchenware, and medications.

DHS 132.72(4) (4) Garbage. Storage containers. All garbage and rubbish shall be stored in leakproof, nonabsorbent containers with close-fitting covers, and in areas separate from those used for the preparation and storage of food. Containers shall be cleaned regularly. Paperboard containers shall not be used.