DHS 107.113(5)(b)(b) Supervision of the recipient when supervision is the only service provided; 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)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)(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 HistoryHistory: 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 107.12DHS 107.12 Private duty nursing 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. DHS 107.12(1)(c)(c) Services may be provided only when prescribed by a provider acting within the scope of the provider’s practice and the prescription calls for a level of care which the nurse is licensed and competent to provide. DHS 107.12(1)(d)1.1. A written plan of care, including a functional assessment, medication and treatment orders, shall be established for every recipient admitted for care and shall be incorporated in the recipient’s medical record within 72 hours after acceptance in consultation with the recipient and the recipient’s provider acting within the scope of the provider’s practice and shall be signed by the provider within 20 working days following the recipient’s admission for care. The provider’s plan of care shall include, in addition to the medication and treatment orders: DHS 107.12(1)(d)1.b.b. Methods for delivering needed care, and an indication of which other professional disciplines, if any, are responsible for delivering the care; DHS 107.12(1)(d)1.c.c. Provision for care coordination by an RN when more than one nurse is necessary to staff the recipient’s case; and DHS 107.12(1)(d)1.d.d. A description of functional capability, mental status, dietary needs and allergies.