DHS 83.37(3)(a)1. 1. Transfer of medications from the original container to another container shall be done by a practitioner, registered nurse, or pharmacist. Transfer of medication to another container may be delegated to other personnel by a practitioner, registered nurse or pharmacist.

DHS 83.37(3)(a)2. 2. If a medication is administered by CBRF employees and the medication is transferred from the original container by a registered nurse, or practitioner or other personnel who were delegated the task, the CBRF shall have a legible label on the new container that includes, at a minimum, the resident’s name, medication name, dose and instructions for use. The CBRF shall maintain the original pharmacy container until the transferred medication is gone.

DHS 83.37(3)(b) (b) Unit dose packaging. For use during unplanned or non-routine events or activities, employees who have completed medication administration training as required in s. DHS 83.20 (2) (d) may transfer unit doses of medications into packages for the resident.

DHS 83.37(3)(c) (c) Administered by facility. The CBRF shall keep medicine cabinets locked and the key available only to personnel identified by the CBRF.

DHS 83.37(3)(d) (d) Refrigeration. Medications stored in a common refrigerator shall be properly labeled and stored in a locked box.

DHS 83.37(3)(e) (e) Proximity to chemicals. The CBRF may not store prescription and over-the-counter medications or dietary supplements next to chemicals or other contaminants.

DHS 83.37(3)(f) (f) Internal and external application. The CBRF shall physically separate medications for internal consumption from medications for external application.

DHS 83.37(3)(g) (g) Controlled substances. The CBRF shall provide separately locked and securely fastened boxes or drawers or permanently fixed compartments within the locked medications area for storage of schedule II drugs subject to 21 USC 812 (c), and Wisconsin’s uniform controlled substances act, ch. 961, Stats.

DHS 83.37(4) (4) Exemptions. Any CBRF that exclusively serves residents in the custody of a government correctional agency or who is alcohol or drug dependent is exempt from the requirements in sub. (2) (a) 2. These facilities may store medications in a central, secure area and employees may observe and record the self administration of medication as described in the resident’s individual service plan.

DHS 83.37 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; CR 10-091: am. (1) (h) 1. Register December 2010 No. 660, eff. 1-1-11.

DHS 83.38 DHS 83.38 Program services.

DHS 83.38(1) (1) Services. As appropriate, the CBRF shall teach residents the necessary skills to achieve and maintain the resident’s highest level of functioning. In addition to the assessed needs as determined under s. DHS 83.35 (1), the CBRF shall provide or arrange services adequate to meet the needs of the residents in all of the following areas:

DHS 83.38(1)(a) (a) Personal care. Personal care services shall be designed and provided to allow a resident to increase or maintain independence.

DHS 83.38(1)(b) (b) Supervision. The CBRF shall provide supervision appropriate to the resident’s needs.

DHS 83.38(1)(c) (c) Leisure time activities. The CBRF shall provide a daily activity program to meet the interests and capabilities of the residents. Employees shall encourage and promote resident participation in the activity program. The CBRF shall develop and post the activity schedule in an area available to residents.

DHS 83.38(1)(d) (d) Community activities. The CBRF shall provide information and assistance to facilitate participation in personal and community activities. The CBRF shall develop, update and make available to all residents, monthly schedules and notices of community activities, including costs.

DHS 83.38(1)(e) (e) Family and social contacts. The CBRF shall encourage and assist residents in maintaining family and social contacts.

DHS 83.38(1)(f) (f) Communication skills. The CBRF shall provide services to meet the resident’s communication needs.

DHS 83.38(1)(g) (g) Health monitoring.

DHS 83.38(1)(g)1. 1. The CBRF shall monitor the health of residents and make arrangements for physical health, oral health or mental health services unless otherwise arranged for by the resident. Each resident shall have an annual physical health examination completed by a physician or an advanced practice nurse as defined in s. N 8.02 (1), unless seen by a physician or an advanced practice nurse as defined in s. N 8.02 (1) more frequently.

DHS 83.38(1)(g)2. 2. When indicated, a CBRF shall observe residents’ food and fluid intake and acceptance of diet. The CBRF shall report significant deviations from normal food and fluid intake patterns to the resident’s physician or dietician.

DHS 83.38(1)(g)3. 3. The CBRF shall document communication with the resident’s physician and other health care providers, and shall record any changes in the resident’s health or mental health status in the resident’s record.

DHS 83.38(1)(h) (h) Medication administration. The CBRF shall provide medication administration appropriate to the resident’s needs.

DHS 83.38(1)(i) (i) Behavior management. The CBRF shall provide services to manage resident’s behaviors that may be harmful to themselves or others.

DHS 83.38(1)(j) (j) Information and referral. The CBRF shall provide information and referral to appropriate community services.

DHS 83.38(1)(k) (k) Transportation. The CBRF shall provide or arrange for transportation when needed for medical appointments, work, educational or training programs, religious services and for a reasonable number of community activities of interest. CBRFs that transport residents shall develop and implement written policies addressing the safe and secure transportation of residents.

DHS 83.38(2) (2) Terminally ill resident services.

DHS 83.38(2)(a) (a) A CBRF may provide more than 3 hours of nursing care per week to a resident who has a terminal illness and who requires the care under the following conditions:

DHS 83.38(2)(a)1. 1. The resident’s primary care provider is a licensed hospice or licensed home health agency.