DHS 107.113(4)(b) (b) Respiratory care provided to a recipient residing in a community-based residential facility (CBRF) as defined in s. 50.01 (1g), Stats., shall be in accordance with the requirements of ch. DHS 83.

DHS 107.113(4)(c) (c) Durable medical equipment and disposable medical supplies shall be provided in accordance with conditions set out in s. DHS 107.24.

DHS 107.113(4)(d) (d) Respiratory care services provided by a licensed practical nurse shall be provided under the supervision of a registered nurse and in accordance with standards of practice set out in s. N 6.04.

DHS 107.113(4)(e) (e) Case coordination services provided by the designated case coordinator shall be documented in the clinical record, including the extent and scope of specific care coordination provided.

DHS 107.113(4)(f) (f) In the event that a recipient receiving respiratory care services is discharged from the care of one respiratory care provider and admitted to the care of another respiratory care provider continues to receive services under this section, the admitting provider shall coordinate services with the discharging provider to ensure continuity of care. The admitting provider shall establish the recipient’s plan of care as provided under sub. (2) and request prior authorization under sub. (3).

DHS 107.113(4)(g) (g) Travel, recordkeeping and RN supervision of a licensed practical nurse are not separately reimbursable services.

DHS 107.113(5) (5) Non-covered services. The following services are not covered services:

DHS 107.113(5)(a) (a) Parenting;

DHS 107.113(5)(b) (b) Supervision of the recipient when supervision is the only service provided;

DHS 107.113(5)(c) (c) Services provided without prior authorization;

DHS 107.113(5)(d) (d)

DHS 107.113(5)(d)1. 1. Except as provided in subd. 2., services provided by an individual nurse under this section that, when combined with services provided to all recipients and other patients under the nurse’s care, exceed either of the following limitations:

DHS 107.113(5)(d)1.a. a. A total of 12 hours in a calendar day.

DHS 107.113(5)(d)1.b. b. A total of 60 hours in a calendar week.

DHS 107.113(5)(d)2. 2. Services may exceed the limitations in subd. 1. when both of the following conditions are met:

DHS 107.113(5)(d)2.a. a. The services are approved by the department on a case-by-case basis for circumstances that could not reasonably have been predicted.

DHS 107.113(5)(d)2.b. b. Failure to provide skilled nursing services likely would result in serious impairment of the recipient’s health.

DHS 107.113(5)(e) (e) Services provided in a setting other than the recipient’s place of residence; and

DHS 107.113(5)(f) (f) Services that are not medically appropriate.

DHS 107.113(5)(g) (g)

DHS 107.113(5)(g)1. 1. Except as provided in subd. 2., services provided during any 24-hour period during which the nurse who performs the services has less than 8 continuous and uninterrupted hours off duty.

DHS 107.113(5)(g)2. 2. Services may exceed the limitations in subd. 1. when both of the following conditions are met:

DHS 107.113(5)(g)2.a. a. The services are approved by the department on a case-by-case basis for circumstances that could not reasonably have been predicted.

DHS 107.113(5)(g)2.b. b. Failure to provide skilled nursing services likely would result in serious impairment of the recipient’s health.

DHS 107.113 History History: Cr. Register, February, 1993, No. 446, eff. 3-1-93; correction in (4) (c) made under s. 13.93 (2m) (b) 7., Stats., Register, April, 1999, No. 520; CR 05-052: r. and recr. (5) (d), cr. (5) (g) Register June 2007 No. 618, eff. 7-1-07; corrections in (1) (intro.), (3) and (4) (b) made under s. 13.92 (4) (b) 7., Stats., Register December 2008 No. 636; CR 23-046: r. and recr. (1), am. (2) (intro.), (a), (3) (a), (4) (f) Register April 2024 No. 820, eff. 5-1-24; correction in (1) (b) 2. made under s. 35.17, Stats., correction in numbering of (1) (d) 4. a. to c. made under s. 13.92 (4) (b) 7., Stats., and (3) (a) renumbered (3) under s. 13.92 (4) (b) 1., Stats., Register April 2024 No. 820.

DHS 107.12 DHS 107.12 Private duty nursing services.

DHS 107.12(1) (1) Covered services.

DHS 107.12(1)(a) (a) Private duty nursing is skilled nursing care available for recipients with medical conditions requiring more continuous skilled care than can be provided on a part-time, intermittent basis. Only a recipient who requires 8 or more hours of skilled nursing care and is authorized to receive these services in the home setting may make use of the approved hours outside of that setting during those hours when normal life activities take him or her outside of that setting. Private duty nursing may be provided according to the requirements under ss. DHS 105.16 and 105.19 when the written plan of care specifies the medical necessity for this type of service.

DHS 107.12(1)(b) (b) Private duty nursing services provided by a certified registered nurse in independent practice are those services prescribed by a provider acting within the scope of the provider’s practice which comprise the practice of professional nursing as described under s. 441.001 (4), Stats., and s. N 6.03. Private duty nursing services provided by a certified licensed practical nurse are those services which comprise the practice of practical nursing under s. 441.001 (3), Stats., and s. N 6.04. An LPN may provide private duty nursing services delegated by a registered nurse as delegated nursing acts under the requirements of ch. N 6 and guidelines established by the state board of nursing.