DHS 107.112(3)(b)1. 1. Review and interpretation of the physician’s orders;

DHS 107.112(3)(b)2. 2. Frequency and anticipated duration of service;

DHS 107.112(3)(b)3. 3. Evaluation of the recipient’s needs and preferences; and

DHS 107.112(3)(b)4. 4. Assessment of the recipient’s social and physical environment, including family involvement, living conditions, the recipient’s level of functioning and any pertinent cultural factors such as language.

DHS 107.112(3)(c) (c) Review of the plan of care, evaluation of the recipient’s condition and supervisory review of the personal care worker shall be made by a registered nurse at least every 60 days. The review shall include a visit to the recipient’s home, review of the personal care worker’s daily written record and discussion with the physician of any necessary changes in the plan of care.

DHS 107.112(3)(d) (d) Reimbursement for registered nurse supervisory visits is limited to one visit per month.

DHS 107.112(3)(e) (e) No more than one-third of the time spent by a personal care worker may be in performing housekeeping activities.

DHS 107.112(4) (4) Non-covered services. The following services are not covered services:

DHS 107.112(4)(a) (a) Personal care services provided in a hospital or a nursing home or in a community-based residential facility, as defined in s. 50.01 (1), Stats., with more than 20 beds;

DHS 107.112(4)(b) (b) Homemaking services and cleaning of areas not used during personal care service activities, unless directly related to the care of the person and essential to the recipient’s health;

DHS 107.112(4)(c) (c) Personal care services not documented in the plan of care;

DHS 107.112(4)(d) (d) Personal care services provided by a responsible relative under s. 49.90, Stats.;

DHS 107.112(4)(e) (e) Personal care services provided in excess of 50 hours per calendar year without prior authorization;

DHS 107.112(4)(f) (f) Services other than those listed in subs. (1) (b) and (2) (b);

DHS 107.112(4)(g) (g) Skilled nursing services, including:

DHS 107.112(4)(g)1. 1. Insertion and sterile irrigation of catheters;

DHS 107.112(4)(g)2. 2. Giving of injections;

DHS 107.112(4)(g)3. 3. Application of dressings involving prescription medication and use of aseptic techniques; and

DHS 107.112(4)(g)4. 4. Administration of medicine that is not usually self-administered; and

DHS 107.112(4)(h) (h) Therapy services.

DHS 107.112 History History: Cr. Register, April, 1988, No. 388, eff. 7-1-88; renum. (2) to be (2) (a), cr. (2) (b), am. (3) (e), Register, December, 1988, No. 396, eff. 1-1-89; r. and recr. (2) (b), r. (3) (f), am. (4) (f), Register, February, 1993, No. 446, eff. 3-1-93; emerg. am. (2) (a), (4) (e), eff. 1-1-94; correction in (3) (a) made under s. 13.92 (4) (b) 7., Stats., Register December 2008 No. 636; CR 20-039: am. (2) (a), (4) (e) Register October 2021 No. 790, eff. 11-1-21.

DHS 107.113 DHS 107.113 Respiratory care for ventilator-assisted recipients.

DHS 107.113(1) (1) Covered services.

DHS 107.113(1)(a) (a) Services, medical supplies and equipment necessary to provide life support for a recipient who has been hospitalized for at least 30 consecutive days for his or her respiratory condition and who is dependent on a ventilator for at least 6 hours per day shall be covered services when these services are provided to the recipient in the recipient’s home.

DHS 107.113(1)(b) (b) A recipient receiving these services is one for whom respiratory care can safely be provided in any setting in which normal life activities take place, excluding all of the following settings:

DHS 107.113(1)(b)1. 1. A hospital.

DHS 107.113(1)(b)2. 2. A nursing facility.

DHS 107.113(1)(b)3. 3. An intermediate care facility for individuals with intellectual disabilities.

DHS 107.113(1)(b)4. 4. Any setting in which payment is or could be made under medical assistance for inpatient services that include room and board.