DHS 105.19(5)(f) (f) To be taught, and have the family or other persons living with the recipient taught, the treatment required, so that the recipient can, to the extent possible, help himself or herself, and the family or other party designated by the recipient can understand and help the recipient;

DHS 105.19(5)(g) (g) To have one’s property treated with respect; and

DHS 105.19(5)(h) (h) To complain about care that was provided or not provided, and to seek resolution of the complaint without fear of recrimination.

DHS 105.19(6) (6) Universal precautions. A nurse shall have the necessary orientation, education and training in epidemiology, modes of transmission and prevention of HIV and other blood-borne or body fluid-borne infections and shall follow universal blood and body-fluid precautions for each recipient for whom services are provided. The nurse shall employ protective measures recommended by the federal centers for disease control (CDC), including those pertaining to medical equipment and supplies, to minimize the risk of infection from HIV and other blood-borne pathogens.

DHS 105.19 Note Note: A copy of the CDC recommended universal precautions may be obtained from the Division of Quality Assurance, P.O. Box 2969, Madison, Wisconsin 53701.

DHS 105.19(7) (7) Medical record. The nurse shall maintain a medical record for each recipient. The record shall document the nature and scope of all services provided and shall be systematically organized and readily accessible to authorized department personnel. The medical record shall document the recipient’s condition, problems, progress and all services rendered, and shall include:

DHS 105.19(7)(a) (a) Recipient identification information;

DHS 105.19(7)(b) (b) Appropriate hospital information, including discharge information, diagnosis, current patient status and post-discharge plan of care;

DHS 105.19(7)(c) (c) Recipient admission evaluation and assessment;

DHS 105.19(7)(d) (d) All medical orders, including the written plan of care and all interim physician’s orders;

DHS 105.19(7)(e) (e) A consolidated list of medications, including start and stop dates, dosage, route of administration and frequency. This list shall be reviewed and updated for each nursing visit, if necessary;

DHS 105.19(7)(f) (f) Progress notes posted as frequently as necessary to clearly and accurately document the recipient’s status and services provided. In this paragraph, “progress note” means a written notation, dated and signed by a member of the health team providing covered services, that summarizes facts about care furnished and the recipient’s response during a given period of time;

DHS 105.19(7)(g) (g) Clinical notes written the day service is provided and incorporated into the clinical record within 7 days after the visit or recipient contact. In this paragraph, “clinical note” means a notation of a contact with a recipient that is written and dated by a member of the home health team providing covered services, and that describes signs and symptoms, treatment and drugs administered and the patient’s reaction, and any changes in physical or emotional condition;

DHS 105.19(7)(h) (h) Written summaries of the recipient’s care provided by the nurse to the physician at least every 62 days; and

DHS 105.19(7)(i) (i) Written authorizations from the recipient or the recipient’s guardian when it is necessary for the nurse to procure medical supplies or equipment needed by the recipient.

DHS 105.19(7m) (7m) Electronic visit verification. The nurse is required to capture and retain EVV records.

DHS 105.19(8) (8) Back-up and emergency procedures.

DHS 105.19(8)(a) (a) A recipient’s nurse shall designate an alternate nurse to provide services to the recipient in the event the nurse is temporarily unable to provide services. The recipient shall be informed of the identity of the alternate nurse before the alternate nurse provides services.

DHS 105.19(8)(b) (b) The nurse shall document a plan for recipient-specific emergency procedures in the event a life-threatening situation or fire occurs or there are severe weather warnings. This plan shall be made available to the recipient and all caregivers prior to initiation of these procedures.

DHS 105.19(8)(c) (c) The nurse shall take appropriate action and immediately notify the recipient’s physician, guardian, if any, and any other responsible person designated in writing by the patient or guardian of any significant accident, injury or adverse change in the recipient’s condition.

DHS 105.19(9) (9) Discharge of the recipient. A recipient shall be discharged from services provided by the nurse upon the recipient’s request, upon the decision of the recipient’s physician, or if the nurse documents that continuing to provide services to the recipient presents a direct threat to the nurse’s health or safety and further documents the refusal of the attending physician to authorize discharge of the recipient with full knowledge and understanding of the threat to the nurse. The nurse shall recommend discharge to the physician and recipient if the recipient does not require services or requires services beyond the nurse’s capability. The nurse provider shall issue a notification of discharge to the recipient or guardian, if possible at least 2 calendar weeks prior to cessation of skilled nursing services, and shall, in all circumstances, provide assistance in arranging for the continuity of all medically necessary care prior to discharge.

DHS 105.19(10) (10) Department review.

DHS 105.19(10)(a) (a) Record review. The department may periodically review the records described in this section and s. DHS 106.02 (9), subject only to restrictions of law. All records shall be made immediately available upon the request of an authorized department representative.

DHS 105.19(10)(b) (b) In-home visits. As part of the review under par. (a), the department may contact recipients who have received or are receiving MA services from a nurse provider. The nurse provider shall provide any identifying information requested by the department. The department may select the recipients for visits and may visit a recipient with the approval of the recipient or recipient’s guardian. The recipient to be visited shall be given the opportunity to have any person present whom he or she chooses during the visit by personnel of the department or other governmental investigating agency.

DHS 105.19(10)(c) (c) Investigation complaints. The department may investigate any complaint received by it concerning the provision of MA services by a nurse provider. Following the investigation, the department may issue a preliminary final report to the nurse provider in question, except when doing so would jeopardize any other investigation by the department or other state or federal agency.

DHS 105.19 History History: Cr. Register, February, 1986, No. 362, eff. 3-1-86; r. and recr. Register, January, 1991, No. 421, eff. 2-1-91; emerg. r. and recr., eff. 7-1-92; r. and recr. Register, February, 1993, No. 446, eff., 3-1-93; corrections in (1) (a) (intro.), (b) and (10) (a) made under s. 13.92 (4) (b) 7., Stats., Register December 2008 No. 636; CR 20-039: am. (1) (b) Register October 2021 No. 790, eff. 11-1-21; EmR2306: emerg. cr. (7m), eff. 5-1-23; CR 23-045: cr. (7m) Register January 2024 No. 817, eff. 2-1-24.

DHS 105.20 DHS 105.20 Nurse practitioners.

DHS 105.20(1) (1) Qualifications. For MA certification, a nurse practitioner shall be licensed as a registered nurse pursuant to s. 441.06, Stats., and fulfill one of the following requirements:

DHS 105.20(1)(a) (a) If practicing as a pediatric nurse practitioner, be currently certified by the American nurses’ association or by the national board of pediatric nurse practitioners and associates;