49.498(2)(c)3.3. No individual may willfully and knowingly certify under subd. 2. a material and false statement in an assessment. 49.498(2)(c)4.4. No individual may willfully and knowingly cause another individual to certify under subd. 2. a material and false statement in an assessment. 49.498(2)(c)5.5. If the department determines by survey of a nursing facility or otherwise that an individual has knowingly and willfully certified a false assessment under subd. 2., the department may require that individuals who are independent of the nursing facility and are approved by the department conduct and certify assessments under this paragraph. 49.498(2)(c)6.a.a. Conduct an assessment under subd. 1. no later than 4 days after the admission of an individual admitted after September 30, 1990. 49.498(2)(c)6.b.b. Conduct all of the assessments under subd. 1. for a resident of the nursing facility by October 1, 1991, for a resident who resides in the facility on that date; promptly after a significant change in a resident’s physical or mental condition; and, for every resident, no less often than once every 12 months. 49.498(2)(c)6.c.c. Examine a resident no less frequently than once every 3 months and, as appropriate, revise the resident’s assessment under subd. 1. to assure the assessment’s continuing accuracy. 49.498(2)(c)7.7. The assessment conducted under subd. 1. shall be used in developing, reviewing and revising a nursing facility resident’s plan of care under par. (b). 49.498(2)(c)8.8. A nursing facility shall coordinate an assessment conducted under this paragraph with the conduct of preadmission screening under s. 49.45 (6c) (b) to the maximum extent practicable in order to avoid duplicative testing and effort. 49.498(2)(d)1.1. To the extent needed to fulfill the plans of care required under par. (b), a nursing facility shall provide or arrange for the provision of all of the following, which shall meet professional standards of quality: 49.498(2)(d)1.a.a. Nursing services and specialized rehabilitative services to attain or maintain the highest practicable physical, mental and psychosocial well-being of each resident. 49.498(2)(d)1.b.b. Medically related social services to attain or maintain the highest practicable physical, mental and psychosocial well-being of each resident. 49.498(2)(d)1.c.c. Pharmaceutical services, including procedures that assure the accurate acquiring, receiving, dispensing and administering of all drugs and biologicals, to meet the needs of each resident. 49.498(2)(d)1.d.d. Dietary services that assure that the meals meet the daily nutritional and special dietary needs of each resident. 49.498(2)(d)1.e.e. An ongoing program, directed by a qualified professional, of activities designed to meet the interests and the physical, mental and psychosocial well-being of each resident. 49.498(2)(d)1.f.f. Routine dental services to the extent covered under the approved state medicaid plan and emergency dental services to meet the needs of each resident. 49.498(2)(d)2.2. Services specified under subd. 1. a. to d. and f. shall be provided to a resident by qualified persons in accordance with the resident’s written plan of care under par. (b). 49.498(2)(d)3.a.a. Provide 24-hour per day licensed nursing services which are sufficient to meet the nursing needs of its residents; and 49.498(2)(d)3.b.b. Shall use the services of a registered professional nurse at least 8 consecutive hours per day, 7 days per week. 49.498(2)(d)4.4. Subject to subd. 5., the department may waive the requirement under subd. 3. a. or b. if all of the following apply: 49.498(2)(d)4.a.a. The nursing facility demonstrates to the satisfaction of the department that the nursing facility has been unable, despite diligent efforts including offering wages at the community prevailing rate for nursing facilities, to recruit appropriate personnel. 49.498(2)(d)4.b.b. The department determines that a waiver of the requirement will not endanger the health or safety of nursing facility residents. 49.498(2)(d)4.c.c. The department finds that a registered professional nurse or a physician is obligated to respond immediately to telephone calls from the nursing facility for any periods in which licensed nursing services are not available. 49.498(2)(d)5.5. A waiver under subd. 4. is subject to annual review by the department and to review by the secretary of the federal department of health and human services. The department may, in granting or reviewing a waiver, require the nursing facility to employ other qualified, licensed personnel. 49.498(2)(e)2.2. A nursing facility may not use the individual as a nurse aide unless the nursing facility has inquired of the department concerning information about the individual in the registry under s. 146.40 (4g). 49.498(2)(e)3.3. A nursing facility shall provide the regular performance review and regular in-service education that assures that individuals used as nurse aides are competent to perform services as nurse aides, including training for individuals to provide nursing and nursing-related services to nursing facility residents with cognitive impairments.