DHS 83.38(2)(b) (b) When a resident who requires less than 3 hours of nursing care or the resident’s legal representative waives the services of a hospice program or home health agency, the CBRF shall develop and implement the written plan of care required under par. (c), which the resident’s primary physician shall review and approve.

DHS 83.38(2)(c) (c) The primary care provider and the CBRF shall develop a written, coordinated plan of care before the initiation of palliative or supportive care.

DHS 83.38 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09; CR 10-091: am. (1) (g) 1. Register December 2010 No. 660, eff. 1-1-11.

DHS 83.39 DHS 83.39 Infection control program.

DHS 83.39(1) (1) The licensee shall establish and follow an infection control program based on current standards of practice to prevent the development and transmission of communicable disease and infection.

DHS 83.39(2) (2) The infection control program shall include written policies and training for employees.

DHS 83.39(3) (3) Employees shall follow hand washing procedures according to centers for disease control and prevention standards.

DHS 83.39(4) (4) Other occupants shall comply with infection control requirements as stated in s. DHS 83.17 (2).

DHS 83.39(5) (5) The CBRF shall ensure that pets are vaccinated against diseases, including rabies, if appropriate.

DHS 83.39 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

DHS 83.40 DHS 83.40 Oxygen storage. Oxygen storage shall be in an area that is well ventilated and safe from environmental hazards, tampering, or the chance of accidental damage to the valve stem. If oxygen cylinders are in use, oxygen cylinders shall be secured in an upright position. If stored upright, cylinders must be secured. If stored horizontally, cylinders shall be on a level surface where they will remain stationary.

DHS 83.40 History History: CR 07-095: cr. Register January 2009 No. 637, eff. 4-1-09.

DHS 83.41 DHS 83.41 Food service.

DHS 83.41(1) (1) General requirements.

DHS 83.41(1)(a) (a) Food supply.

DHS 83.41(1)(a)1. 1. The CBRF shall maintain a food supply that is adequate to meet the needs of the residents.

DHS 83.41(1)(a)2. 2. Food shall be obtained from acceptable sources.

DHS 83.41(1)(b) (b) Equipment. The CBRF shall store equipment and utensils in a clean manner and shall maintain all utensils and equipment in good repair.

DHS 83.41(1)(c) (c) Dishwashing.

DHS 83.41(1)(c)1. 1. Whether washed by hand or mechanical means, all equipment and utensils shall be cleaned using separate steps for pre-washing, washing, rinsing and sanitizing. Residential dishwashers may be used in kitchens serving 20 or fewer residents. Kitchens serving 21 or more residents shall have a commercial type dishwasher for washing and sanitizing equipment and utensils in accordance with standard practices described in the Wisconsin food code.

DHS 83.41(1)(c)2. 2. A 3-compartment sink for washing, rinsing and sanitizing utensils, with drain boards at each end is required for all large facilities with a central kitchen. Washing, rinsing and sanitizing procedures shall be in accordance with standard practices described in the Wisconsin food code. In addition, a single compartment sink or overhead spray wash located adjacent to the soiled drain board is required for pre-washing.

DHS 83.41(2) (2) Nutrition.

DHS 83.41(2)(a) (a) Diets.

DHS 83.41(2)(a)1. 1. The CBRF shall provide each resident with palatable food that meets the recommended dietary allowance based on current dietary guidelines for Americans and any special dietary needs of each resident.

DHS 83.41(2)(a)2. 2. The CBRF shall provide a therapeutic diet as ordered by a resident’s physician.

DHS 83.41 Note Note: To obtain information on the Dietary Guidelines for Americans, see www.usda.gov/cnpp.

DHS 83.41(2)(b) (b) Meals.

DHS 83.41(2)(b)1. 1. The CBRF shall provide meals that are routinely served family or restaurant style, unless contraindicated in a resident’s individual service plan or for short-term medical needs.

DHS 83.41(2)(b)2. 2. The CBRF shall provide at least 3 meals a day, unless otherwise arranged according to the program statement or the resident’s individual service plan. A nutritious snack shall be offered in the evening or more often as consistent with the resident’s dietary needs.