reglab/statecodes huggingface dataset:
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 118 - Trauma Care › Subchapter I - General Provisions › Section DHS 118.01 - Authority and purpose

Current through June 24, 2024
This chapter is promulgated under the authority of s.
					 256.25(2),
					 Stats., to develop and implement a statewide trauma care system. The purpose of
					 the statewide trauma care system is to reduce death and disability resulting
					 from traumatic injury by decreasing the incidence of trauma, providing optimal
					 care of trauma victims and their families, and collecting and analyzing
					 trauma-related data.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 118 - Trauma Care › Subchapter I - General Provisions › Section DHS 118.02 - Applicability

Current through June 24, 2024
This chapter applies to all of the following:
(1) The department.
(2) All persons who are any of the following:
(a) An emergency medical services
				  practitioner.
(d) A medical
				  director.
(e) An emergency medical
				  responder.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 118 - Trauma Care › Subchapter II - Statewide Organization for Trauma Care › Section DHS 118.05 - Statewide trauma advisory council

Current through June 24, 2024
The statewide trauma advisory council shall be responsible
					 for all of the following:
(1) Advising
				  the department on issues related to the development, implementation and
				  evaluation of the statewide trauma care system.
(2) Reviewing and approving the department's
				  proposed format and content of RTAC trauma plans.
(3) Reviewing and recommending components of
				  the department's trauma data submission manual under s.
				  DHS
				  118.09(2) (a) and the use of trauma
				  registry data under s.
				  DHS
				  118.09(4) (a).
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 118 - Trauma Care › Subchapter II - Statewide Organization for Trauma Care › Section DHS 118.07 - EMS services

Current through June 24, 2024
(1) RESPONSIBILITY TO AFFILIATE WITH ONE
				  RTAC.
(a) All ambulance service providers and
				  emergency medical responder services shall select one regional trauma advisory
				  council for primary membership by July 30, 2005.
(b) Notwithstanding par. (a), an emergency
				  medical services practitioner, emergency medical responder, or ambulance
				  service provider may participate in any regional trauma advisory
				  council.
(c) An ambulance service
				  provider or emergency medical responder service shall notify the department if
				  the service changes membership in an RTAC.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 118 - Trauma Care › Subchapter II - Statewide Organization for Trauma Care › Section DHS 118.08 - Hospitals

Current through June 24, 2024
(1) HOSPITAL RESPONSIBILITY TO AFFILIATE WITH
				  AN RTAC.
(a)
1. All hospitals shall select one regional
				  trauma advisory council for primary membership by July 30, 2005.
2. Pursuant to s.
				  DHS
				  118.04(2) (c) 3., the hospital shall
				  submit its selection under subd. 1. to the department for approval.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 118 - Trauma Care › Subchapter III - Trauma Care Improvement › Section DHS 118.09 - Trauma registry

Current through June 24, 2024
(1) PURPOSE. The purpose of the trauma
				  registry is to collect and analyze trauma system data to evaluate the delivery
				  of adult and pediatric trauma care, develop injury prevention strategies for
				  all ages, and provide resources for research and education.
(2) DEPARTMENT COORDINATION OF DATA COLLECTED
				  BY TRAUMA CARE FACILITIES, AMBULANCE SERVICE PROVIDERS AND EMERGENCY MEDICAL
				  RESPONDER SERVICES. The department shall do all of the following:
(a) Develop and publish a data submission
				  manual that specifies all of the following:
1. Data elements and definitions.
2. Definitions of what constitutes a
				  reportable trauma case.
3. Method
				  of submitting data to the department.
4. Timetables for data submission.
5. Electronic record format.
6. Protections for individual record
				  confidentiality.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 118 - Trauma Care › Subchapter III - Trauma Care Improvement › Section DHS 118.10 - Performance improvement

Current through June 24, 2024
(1) PURPOSE. Each
				  RTAC shall use the trauma registry data collected under s.
				  DHS
				  118.09 to improve trauma care, reduce death and
				  disability and correct local and regional injury problems.
Note:
The RTAC should include in its
					 performance improvement activities for all patient ages a surgeon involved in
					 trauma care, an emergency department physician, an EMS representative, an EMS
					 medical director, a person who coordinates the trauma program or the
					 performance improvement process in a trauma facility, and other trauma care and
					 prevention professionals the RTAC determines appropriate.
(2) DATA CONFIDENTIALITY. Each RTAC shall
				  observe the confidentiality provisions of the Health Insurance Portability and
				  Accountability Act under.
(3)
				  PROCESS. The performance improvement process shall include all of the following
				  for both pediatrics and adults:
(a) Data
				  collection and analysis.
(b) Adult
				  and pediatric-specific quality indicators for evaluating the trauma system and
				  its components.
(c) A system for
				  case referral.
(d) A process for
				  indicator review and audit.
(e) A
				  mechanism for loop-closure.
(f) A
				  mechanism for feedback to executive council.
(g) An evaluation of system
				  performance.
(h) A procedure for
				  ensuring that all parties having access to information associated with
				  individuals and entities with respect to a trauma care system problem or issue
				  keep the information confidential throughout the performance improvement
				  process.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter I - General Provisions › Section DHS 120.01 - Authority and purpose

Current through June 24, 2024
This chapter is promulgated under the authority of s.
					 153.75, Stats., to
					 implement ch. 153, Stats. Its purpose is to provide to health care providers,
					 insurers, consumers, governmental agencies and others information concerning
					 health care providers and uncompensated health care services, and provide
					 information to assist in peer review for the purpose of quality
					 assurance.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter I - General Provisions › Section DHS 120.02 - Applicability

Current through June 24, 2024
This chapter applies to the department, the board on health
					 care information, the independent review board, qualified vendors, health care
					 plans, health care providers licensed in this state and persons requesting data
					 from the department.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter I - General Provisions › Section DHS 120.03 - Definitions

Current through June 24, 2024
Unless otherwise indicated, in this chapter:
(1) "Affirmation statement" means a
				  department document that when signed by a health care provider or an authorized
				  representative of a health care provider submitting data to the department
				  affirms, to the best of the signer's knowledge, all of the following:
(a) Any necessary corrections to data
				  submitted to the department have been made.
(b) The data submitted are complete and
				  accurate.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter II - Administration › Section DHS 120.04 - Assessments to fund the ch 153, Stats., operations of the department and the board

Current through June 24, 2024
(1) DEFINITIONS. In this section:
(a) "Net expenditure" means the excess of
				  revenues over expenses.
(b) "State
				  fiscal year" means the 12-month period beginning July 1 and ending the
				  following June 30.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter II - Administration › Section DHS 120.05 - Communications addressed to the department

Current through June 24, 2024
(1) FORMAT.
				  Individual health care professionals or the chief executive officer of the
				  facility or the designee of the individual health care professional or the
				  chief executive officer of the facility shall sign all written information or
				  communications submitted by or on behalf of a health care provider to the
				  department.
(2) TIMING. All written
				  communications, including documents, reports and information required to be
				  submitted to the department shall be submitted by 1st class registered mail, by
				  delivery in person or in an electronic format specified by the department. The
				  date of submission is the date the written communication is postmarked, the
				  date delivery in person is made, or the date on the electronic
				  communication.
Send all communications, except the actual payment of
						assessments under s.
						DHS
						120.04(4), to the following address:
						Bureau of Health Information and Policy, P. O. Box 2659, Madison, WI
						53701-2659, or deliver them to Room 372, 1 West Wilson Street, Madison,
						Wisconsin.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter II - Administration › Section DHS 120.06 - Selection of a contractor

Current through June 24, 2024
(1) DEFINITIONS. In
				  this section:
(a) "Contractor" means a person
				  under contract to the department to collect, process, analyze or store data for
				  any of the purposes of this chapter.
(b) "Major purchaser, payer or provider of
				  health care services" means any of the following:
1. A person, a trust, a multiple employer
				  trust, a multiple employer welfare association, an employee benefit plan
				  administrator or a labor organization that purchases health benefits, which
				  provides health care benefits or services for more than 500 of its full-time
				  equivalent employees, or members in the case of a labor organization, either
				  through an insurer or by means of a self-funded program of benefits.
2. An insurer that writes accident and health
				  insurance and is among the 20 leading insurers for either group or individual
				  accident and health insurance, as specified in the market shares table of the
				  most recent annual Wisconsin insurance report of the state commissioner of
				  insurance. "Major purchaser, payer or provider of health care services" does
				  not include an insurer that writes only disability income insurance.
3. A trust, a multiple employer trust, a
				  multiple employer welfare association or an employee benefit plan
				  administrator, including an insurer, that administers health benefits for more
				  than 29,000 individuals.
4. A
				  person that provides health care services and has 100 or more full-time
				  equivalent employees.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter II - Administration › Section DHS 120.07 - Training

Current through June 24, 2024
(1) GENERAL. The department shall conduct
				  throughout the state a series of training sessions for data submitters to
				  explain its policies and procedures and to provide assistance in implementing
				  the requirements of ch. 153, Stats., and this chapter.
(2) DATA SUBMISSION TRAINING ASSOCIATED WITH
				  SS.
				  DHS 120.12(5),
				  (5M) AND (6), 120.13 AND 120.14(1).
(a) The department shall sponsor data
				  submission training each time the department establishes a major change in the
				  data submission process.
(b) Each
				  data submitting entity shall authorize appropriate staff to attend the
				  department's data submission training.
(c) If a data submitting entity replaces its
				  department-trained data submission designee, the data submitting entity shall
				  either transfer the knowledge required to submit data to another designee or
				  make arrangements with the department for the replacement designee to obtain
				  department training.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter II - Administration › Section DHS 120.08 - Reporting status changes required

Current through June 24, 2024
A facility shall report to the department any of the
					 following within 45 days after the event occurs:
(1) The opening of a new facility.
(2) The closing of the facility.
(3) The merger of 2 or more
				  facilities.
(4) A change in the
				  name of the facility.
(5) A change
				  of the facility's address.
(6) A
				  change in the identity of the chief executive officer or chief administrative
				  officer of the facility.
(7) A
				  change in the beginning and ending dates of the facility's fiscal
				  year.
Health care providers who are required to send their
						information directly to the department should use the following address: Bureau
						of Health Information and Policy, P. O. Box 2659, Madison, Wisconsin
						53701-2659, or deliver the communications to Room 372, 1 W. Wilson Street,
						Madison, Wisconsin.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter II - Administration › Section DHS 120.09 - Notice of hospital rate increases or charges in excess of rates

Current through June 24, 2024
(1) DEFINITIONS. In
				  this section:
(a) "Annualized percentage"
				  means an estimate of the percentage increase in a hospital's gross revenue due
				  to a price increase in charges for patient services for the 12-month period
				  beginning with the effective date of the price increase.
(b) "Change in the consumer price index"
				  means the percentage difference between the consumer price index, as defined in
				  s.
				  16.004(8)
				  (e) 1, Stats., for the 12-month period ending
				  on December 31 of the preceding year and the consumer price index for the
				  12-month period ending on December 31 of the year prior to the preceding
				  year.
(c) "Charge element" means
				  any service, supply or combination of services or supplies that is specified in
				  the categories for payment under the charge revenue code of the uniform patient
				  billing form.
(d) "Class 1 notice"
				  means, in accordance with s.
				  985.07(1),
				  Stats., the publication of a notice at least once in a newspaper likely to give
				  notice to interested persons in the area where the hospital is
				  located.
(e) "Room and board" means
				  the charges associated with all services provided to the patient in a private
				  or semi-private room.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter II - Administration › Section DHS 120.10 - Liabilities; penalties

Current through June 24, 2024
(1) DEFINITION. In this section, "type of
				  data" means inpatient, emergency department, ambulatory, fiscal, annual and
				  other health care provider data required to be submitted to the department
				  under this chapter.
(2) CIVIL
				  LIABILITY. In accordance with s.
				  153.76, Stats.,
				  and except as provided in sub. (3), whoever violates the patient
				  confidentiality provisions defined in ss.
				  153.50
				  and
				  153.75(1)
				  (a), Stats., shall be liable to the patient
				  for actual damages and costs, plus exemplary damages of up to $1,000 for a
				  negligent violation and up to $5,000 for an intentional violation.
(3) IMMUNITY FROM LIABILITY.
(a) In accordance with s.
				  153.77,
				  Stats., and except as provided in par. (b), a health care provider that submits
				  information to the department under this chapter is immune from civil liability
				  for all of the following:
1. Any act or
				  omission of an employee, official or agent of the health care provider that
				  results in the release of a prohibited data element while submitting data to
				  the department.
2. Any act or
				  omission of the department that results in the release of data.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter III - Data Collection and Submission › Section DHS 120.12 - Data to be submitted by hospitals

Current through June 24, 2024
(1) UNCOMPENSATED
				  HEALTH CARE PLAN.
(a)
Data to be
				  collected.
Hospitals shall provide all of the following data:
1. A set of definitions describing terms used
				  by the hospital throughout the uncompensated health care plan.
2. The procedures the hospital uses to
				  determine a patient's ability to pay for health care services received and to
				  verify financial information from the patient.
3. The hospital's means of informing the
				  public about charity care available at that hospital and a description of the
				  procedure for obtaining the care.
4. The amount of any state loan funds,
				  excluding fund proceeds from the Wisconsin health and educational facilities
				  authority, outstanding with a continuing obligation during the previous
				  year.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter III - Data Collection and Submission › Section DHS 120.13 - Data to be submitted by freestanding ambulatory surgery centers

Current through June 24, 2024
(1) DATA TO BE
				  COLLECTED.
(a)
Types of procedures
				  reported.
Freestanding ambulatory surgery centers shall report to the
				  department information relating to any ambulatory patient surgical procedure
				  within any of the following general types:
1.
				  Operations on the integumentary system.
2. Operations on the musculoskeletal
				  system.
3. Operations on the
				  respiratory system.
4. Operations
				  on the cardiovascular system.
5.
				  Operations on the hemic and lymphatic systems.
6. Operations on the mediastinum and
				  diaphragm.
7. Operations on the
				  digestive system.
8. Operations on
				  the urinary system.
9. Operations
				  on the male genital system.
10.
				  Intersex surgery.
11. Laparoscopy
				  and hysteroscopy.
12. Operations on
				  the female genital system.
13.
				  Maternity care and delivery.
14.
				  Operations on the endocrine system.
15. Operations on the nervous
				  system.
16. Operations on the eye
				  and ocular adnexa.
17. Operations
				  on the auditory system.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter III - Data Collection and Submission › Section DHS 120.14 - Data to be submitted by physician class of provider

Current through June 24, 2024
(1) CLAIMS DATA.
(a)
Data to be collected.
Physicians shall submit all of the following data elements:
1. Patient's birth date.
2. Patient's gender.
3. Patient zip code.
4. Patient condition related to
				  employment.
5. Patient condition
				  related to auto accident.
6.
				  Patient condition related to other accident.
7. Date of current illness, injury or
				  pregnancy.
8. The first date of
				  illness, if patient has had same or similar illness.
9. Primary payer category code.
10. Secondary payer category code.
11. Medical record or chart number.
12. Name of referring physician.
13. Identification number of referring
				  physician.
14. Patient control
				  number.
15. Whether tests were sent
				  to an outside lab.
16. Outside lab
				  charges.
17. Diagnosis or nature of
				  illness or injury.
18. Medical
				  assistance resubmission code.
19.
				  Prior authorization number.
20.
				  Dates of service.
21. Place of
				  service.
22. Type of
				  service.
23. Codes for procedures,
				  services or supplies.
24.
				  Modifiers.
25. Charges.
26. Days or units.
27. Encrypted case identifier.
28. Provider employer identification
				  number.
29. Patient account
				  number.
30. Whether the provider
				  accepts assignment.
31. Total
				  charge.
32. Name of facility where
				  services were rendered.
33. Address
				  of facility where services were rendered.
34. Physician's and supplier's billing
				  name.
35. Physician's and
				  supplier's billing address.
36.
				  Billing physician's identification number.
37. Performing physician's identification
				  number.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter III - Data Collection and Submission › Section DHS 120.15 - Data to be submitted by other classes of health care providers

Current through June 24, 2024
(1) APPLICABILITY.
				  This section applies to all of the following classes of health care providers:
(a) Dentists licensed under ch. 447,
				  Stats.
(b) Chiropractors licensed
				  under ch. 446, Stats.
(c)
				  Podiatrists licensed under ch. 448, Stats.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter III - Data Collection and Submission › Section DHS 120.16 - Data to be submitted by health care plans

Current through June 24, 2024
(1) APPLICABILITY.
				  This section applies to health care plans that either voluntarily submit health
				  care plan data directly to the department or submit it to the department
				  through the data collection of other state agencies.
(2) DATA TO BE COLLECTED. The department
				  shall collect all of the following types of data from each participating health
				  care plan or through a designated state agency:
(a)
Financial data.
Information regarding the financial status of the health care plan secured
				  under the authority of the commissioner of insurance.
(b)
Market conduct.
Information regarding the conduct of the health care plan in the marketplace
				  secured under the authority of the commissioner of insurance.
(c)
Quality indicators.
Measures of quality of care provided by the health care plan from the office of
				  the commissioner of insurance.
Note: Quality indicators include Health Plan Employer Data
					 and Information (HEDIS) measures and Consumer Assessment of Health Plans
					 (CAHPS) patient satisfaction measures.
(d)
Grievances and complaints
				  data.
Measures of grievances and complaints filed by enrollees of the
				  health care plan from the office of the commissioner of insurance and the
				  department of employee trust funds.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter IV - Standard Reports › Section DHS 120.20 - General provisions

Current through June 24, 2024
(1) STANDARD REPORTS. The department shall
				  prepare the paper reports listed in this subsection and shall make these paper
				  reports available to the public at a charge that meets the department's cost of
				  printing, copying and mailing a report to the requester. The department shall
				  make electronic copies of the reports available from the department's website
				  at no charge.
(a) Hospital rate increase
				  report.
(b) Patient-level data
				  utilization, charge and quality report.
(c) Guide to Wisconsin hospitals
				  report.
(d) Uncompensated health
				  care services report.
(e) Consumer
				  guide.
(f) Hospital quality
				  indicators.
Note: The Department's web address is:
http://www.dhs.wisconsin.gov
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter IV - Standard Reports › Section DHS 120.21 - Guide to Wisconsin hospitals

Current through June 24, 2024
(1) DATA SOURCES.
				  The guide to Wisconsin hospitals shall be based on data derived from all of the
				  following sources:
(a) The annual hospital
				  fiscal year survey.
(b) The annual
				  survey of hospitals.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter IV - Standard Reports › Section DHS 120.22 - Utilization, charge and quality reports

Current through June 24, 2024
(1) DATA SOURCES.
				  The utilization, charge and quality reports shall be based on four broad types
				  of data:
(a) Facility-level data derived from
				  all of the following sources:
1. The annual
				  hospital fiscal year survey.
2. The
				  annual survey of hospitals.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter IV - Standard Reports › Section DHS 120.23 - Consumer guide

Current through June 24, 2024
(1) DATA SOURCES. The consumer guide shall
				  draw on the following data sources:
(a)
				  Bureau of health information databases, including those related to inpatient
				  stays, ambulatory visits, physician encounters, facility financial and services
				  information and health care provider workforce data.
Note: The bureau of health information was renamed the the
					 bureau of health information and policy.
(b) Databases of other department agencies,
				  including those of the division of health care financing and the bureau of
				  quality assurance.
Note: The bureau of quality assurance was renamed the the
					 division of quality assurance.
(c) Databases of other state agencies,
				  including the office of the commissioner of insurance for information related
				  to health plan finances, market conduct, complaints and grievances, and quality
				  indicators.
(d) Other private
				  sector information available through various websites.
(e) Federal databases, including those of the
				  health care financing administration.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter IV - Standard Reports › Section DHS 120.24 - Hospital rate increase report

Current through June 24, 2024
(1) DATA SOURCES.
				  The hospital rate increase report shall be based on notarized copies of notices
				  placed in newspapers and submitted to the department by hospitals.
(2) CONTENTS.
(a) The hospital rate increase report shall
				  contain all of the following information:
1.
				  For each hospital that publishes a notice as specified under s.
				  DHS
				  120.09(2), the report shall list all
				  of the following:
a. The name of the hospital
				  and the city in which the hospital is located.
b. The date the increase will be
				  effective.
c. The resulting
				  annualized percentage increase.
d.
				  The geographic area of analysis in which the hospital is located.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter IV - Standard Reports › Section DHS 120.25 - Uncompensated health care services report

Current through June 24, 2024
(1) DATA SOURCES.
				  The uncompensated health care services report shall be based on data derived
				  from all of the following sources:
(a) Annual
				  hospital plans for the provision of uncompensated health care submitted to the
				  department by hospitals.
(b) Fiscal
				  surveys of hospitals conducted by the department.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter IV - Standard Reports › Section DHS 120.26 - Hospital quality indicators report

Current through June 24, 2024
(1) DATA SOURCE.
				  The hospital quality indicators report shall be based on hospital inpatient
				  data collected by the department under s.
				  DHS
				  120.12(5). The inpatient discharge
				  data are reformatted by the department to be consistent with nationally
				  recognized quality indicators.
Note: An example of nationally recognized quality
					 indicators are the health care utilization project (HCUP) quality
					 indicators.
(2) CONTENTS.
				  The hospital quality indicators report shall present variations in the delivery
				  of inpatient care at individual hospitals without identifying the individual
				  hospitals. The purpose of the report is to promote improvements in the overall
				  quality of hospital care by providing an analysis of the variations in care
				  delivery across the state. Where appropriate, national comparisons serve as
				  improvement benchmarks. Each report shall include all the following
				  information:
(a) A description of the report's
				  data and the limitations in interpreting the data.
(b) A description of nationally recognized
				  quality indicators.
(c) A
				  discussion of how to interpret the analysis of the variations in care delivery
				  across the state.
(d) A graphical
				  presentation of the performance of hospitals relative to the quality indicators
				  selected for presentation in the report.
(e) A discussion of how a hospital may obtain
				  from the department hospital-specific information resulting from application of
				  the nationally recognized quality indicators.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter V - Data Dissemination › Section DHS 120.29 - Public use files

Current through June 24, 2024
(1) Public use data files based on
				  information submitted by health care providers other than hospitals or
				  ambulatory surgery centers may not permit the identification of specific
				  patients, employers or health care providers. The department shall protect
				  identification of patients, employers and health care providers by all
				  necessary means, including all of the following:
(a) The deletion of patient
				  identifiers.
(b) The use of
				  calculated variables and aggregated variables.
(c) The specification of counties as to
				  residence rather than zip codes.
(d) The use of 5-year categories for age
				  rather than exact age.
(e) Not
				  releasing information concerning a patient's race or ethnicity, or dates of
				  admission, discharge, procedures or visits.
(f) Masking sensitive diagnoses and
				  procedures by use of larger diagnostic and procedure categories.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter V - Data Dissemination › Section DHS 120.30 - Patient data elements considered patient-identifiable

Current through June 24, 2024
(1) NONRELEASE OF
				  PATIENT-IDENTIFIABLE DATA. The department may not release or provide access to
				  patient-identifiable data, except as provided in s.
				  153.50(4),
				  Stats. The department shall protect the identity of a patient by all necessary
				  means, including the use of calculated, masked or aggregated
				  variables.
(2) PROCEDURES GOVERNING
				  RELEASE OF PATIENT-IDENTIFIABLE DATA.
(a)
				  Persons authorized and desiring to access patient-identifiable data under s.
				  153.50(4),
				  Stats., shall submit to the department a request for the release of the data in
				  writing and shall include all of the following:
1. The requester's name and
				  address.
2. The reason for the
				  request.
3. For a person who is
				  authorized under s.
				  153.50(4),
				  Stats., to receive or have access to patient-identifiable data, evidence, in
				  writing, that indicates the authorization.
4. For an entity that is authorized under s.
				  153.50(4),
				  Stats., to receive or have access to patient-identifiable data, evidence, in
				  writing, of all of the following:
a. The
				  federal or state statutory requirement to obtain the patient-identifiable
				  data.
b. Any federal or state
				  statutory requirement to uphold the patient confidentiality provisions of this
				  chapter or patient confidentiality provisions that are more restrictive than
				  those of this chapter; or, if the latter evidence is inapplicable, an
				  agreement, in writing, to uphold the patient confidentiality provisions of this
				  chapter.
c. An entity specified
				  under s.
				  153.50(4),
				  Stats., having access to data elements considered patient-identifiable may not
				  rerelease these data elements.
Note: Requests should be sent to the following address:
					 Bureau of Health Information and Policy, P. O. Box 26599, Madison, Wisconsin
					 53701-2659, or deliver the communications to Room 372, 1 W. Wilson Street,
					 Madison, Wisconsin.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 120 - Health care information › Subchapter V - Data Dissemination › Section DHS 120.31 - Data dissemination

Current through June 24, 2024
(1) DEFINITIONS. In this section:
(a) "Calculated variable" means a data
				  element that is computed or derived from an original data item or derived using
				  another data source.
(b) "Release
				  raw patient data" means to show, lend or give the raw patient data, or any
				  subset thereof, to another person.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 122 - Long-Term Care Facility Bed Additions And Capital Expenditures Review › Section DHS 122.01 - Authority and purpose

Current through June 24, 2024
This chapter is promulgated under the authority of s.
				  150.03, Stats.
				  It provides definitions, criteria and procedures to implement subchs. I and II
				  of ch. 150, Stats., concerning containment of health care costs through the
				  biennial establishment of a limit on the number of nursing home beds permitted
				  in the state, interim adjustments to that limit and approval by the department
				  of projects proposing to add to the supply of nursing home beds and of other
				  projects proposing capital expenditures for nursing homes in excess of
				  $600,000.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 122 - Long-Term Care Facility Bed Additions And Capital Expenditures Review › Section DHS 122.02 - Applicability

Current through June 24, 2024
(1) This chapter applies to all activities
				described in s.
				150.21, Stats.,
				undertaken by or on behalf of any nursing home including any facility for the
				developmentally disabled (FDD).
(2)
				The following activities are subject to review and approval under this chapter
				as the construction or total replacement of a nursing home within the meaning
				of s.
				150.21(1),
				Stats., or an increase in the bed capacity of a nursing home within the meaning
				of s.
				150.21(2),
				Stats.:
(a) The conversion of a skilled
				nursing facility under 42 CFR 442 Subpt. D or an intermediate care facility
				under 42 CFR 442 Subpt. F to an intermediate care facility for individuals with
				intellectual disabilities under 42 CFR 442, Subpt. G, for purposes of medical
				assistance certification;
(b) The
				conversion of an intermediate care facility for individuals with intellectual
				disabilities under 42 CFR 442 Subpt. G to a skilled nursing facility under 42
				CFR 442 Subpt. D or an intermediate care facility under 42 CFR 442 Subpt. F,
				for purposes of medical assistance certification;
(c) A conversion described in par. (a) or (b)
				of part of a facility; and
(d) Any
				other activity which would increase the statewide number of beds in FDDs or
				beds in nursing homes exclusive of FDDs.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 122 - Long-Term Care Facility Bed Additions And Capital Expenditures Review › Section DHS 122.03 - Definitions

Current through June 24, 2024
In this chapter:
(1)
				"Affected party" means:
(a) The
				applicant;
(b) Other persons
				providing similar services in the applicant's planning area;
(c) Members of the public to be served by the
				project;
(d) Local planning
				agencies, including area agencies on aging and zoning authorities;
(e) Other applicants undergoing concurrent
				review;
(f) Local units of
				government, including county boards of supervisors and city councils, and the
				administrative agencies serving those units of government; and
(g) Third-party payers.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 122 - Long-Term Care Facility Bed Additions And Capital Expenditures Review › Section DHS 122.04 - Statewide bed limit

Current through June 24, 2024
(1) DEPARTMENT RECOMMENDATION.
(a)
Nursing homes exclusive of
				FDDs.
The department shall biennially update and submit to the
				legislature statewide recommended bed limits for nursing homes exclusive of
				FDDs, taking into account programs the purpose of which is to reduce
				institutionalization of persons in long-term care facility settings. In
				developing the recommendation for a new statewide bed limit, the department
				shall add the following numbers for nursing homes exclusive of FDDs:
1. The number of beds licensed under subch. I
				of ch. 50, Stats., exclusive of beds in FDDs;
2. The number of new beds approved under s.
				150.29,
				Stats.; and
3. An allotment for new
				beds which shall be derived by dividing medical assistance reimbursement funds
				available for new beds as proposed in the following biennial budget by an
				estimated medical assistance allowable skilled care per diem rate. The
				resulting patient days shall be divided by the most recent available 3-year
				average percentage ratio of medical assistance residents to total residents.
				The patient days shall then be divided by the number of days in the year. This
				figure is the new allotment. Separate allotments shall be developed for nursing
				homes exclusive of FDDs. The new bed allotment shall be the maximum number of
				new nursing home beds exclusive of FDDs which may be approved during the
				biennium for which the new bed limit is approved by the legislature.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 122 - Long-Term Care Facility Bed Additions And Capital Expenditures Review › Section DHS 122.05 - Bed allocation methodology

Current through June 24, 2024
(1) NURSING HOME
				BEDS EXCLUSIVE OF FDD BEDS.
(a)
Distribution of the statewide allotment of new beds.
In
				distributing among planning areas new nursing home beds exclusive of FDD beds
				from the allotment under s.
				DHS 122.04(1)
				(a) 3, the department shall proceed as
				follows:
1. Calculate for each planning area
				the population growth for the age cohorts under 65, 65 to 74, 75 to 84 and over
				84 years of age for a 3-year period beginning in the calendar year for which
				the most current data on utilization of nursing homes are available;
2. Divide each planning area's population
				growth for each age cohort by the state growth in population for each cohort
				for those years to obtain the percentage that a planning area's growth
				represents of the total state growth by cohort;
3. Ascertain the statewide nursing home
				utilization percentage for each of the age cohorts in subd. 1. and multiply
				these by the new bed allotment for nursing homes exclusive of FDDs calculated
				pursuant to s.
				DHS 122.04(1) (a)
				3 to get the statewide allotment for each age
				cohort;
4. Multiply the statewide
				allotment for each age cohort by each planning area's percentage of state
				growth for its respective cohort calculated under subd. 2.;
5. Add the 4 age cohort allotments for each
				planning area to determine the unadjusted new bed allotment for each planning
				area for nursing homes exclusive of FDDs;
6. Adjust downward the allotment for each
				planning area that has more beds per 1,000 residents age 65 and over than there
				are beds per 1,000 residents age 65 and over statewide by multiplying the
				unadjusted allotment for the planning area by the ratio of the number of
				existing and approved beds per 1,000 residents age 65 and over statewide to the
				number of existing and approved beds per 1,000 residents age 65 and over in the
				planning area as calculated from county level data, and subtracting the result
				from the unadjusted allotment. The result shall be the maximum new bed
				allotment for that planning area; and
7. Increase the unadjusted allotment for the
				remaining planning areas proportionately so that the total new bed allotments
				for all planning areas equal the total statewide new bed allotment calculated
				pursuant to s.
				DHS 122.04(1) (a)
				3. The result shall be the maximum new bed
				allotments for these planning areas.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 122 - Long-Term Care Facility Bed Additions And Capital Expenditures Review › Section DHS 122.06 - Request for applications

Current through June 24, 2024
(1) BEDS.
(a)
New beds.
1. After amendment of the statewide bed limit
				by the legislature, the department shall accept applications to fill the
				allotments for new beds, if any, for each planning area. Allotments shall be
				determined in the manner described in s.
				DHS
				122.05. Application shall be made according to the
				following schedule:
a. In January for all
				counties located in health planning area #2;
b. In April for all counties located in
				health planning area #1;
c. In July
				for all counties located in health planning areas #3, 4, and 7; and
d. In October for all counties located in
				health planning areas #5 and 6.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 122 - Long-Term Care Facility Bed Additions And Capital Expenditures Review › Section DHS 122.08 - Hearing process

Current through June 24, 2024
(1) RIGHT TO A HEARING. An applicant whose
				application is rejected may request a public hearing to review the department's
				initial finding.
(2) REQUEST FOR A
				HEARING.
(a) An applicant desiring a public
				hearing shall file a written request for a public hearing, no later than 10
				days after the issuance of the initial finding, to both the department's
				division of health care financing and the department of administration's
				division of hearings and appeals.
Note:
The Division of Health Care Financing has
				  been renamed the Division of Health Care Access and Accountability. The mailing
				  address of the Department's Division of Health Care Access and Accountability
				  is P.O. Box 309, Madison, Wisconsin 53701 and the mailing address of the
				  Division of Hearings and Appeals P.O. Box 7875, Madison, Wisconsin
				  53707.
(b) The applicant
				requesting the hearing shall identify the criteria at issue no later than 20
				days after the issuance of the finding.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 122 - Long-Term Care Facility Bed Additions And Capital Expenditures Review › Section DHS 122.09 - Enforcement

Current through June 24, 2024
(1) REPORTING REQUIREMENTS.
(a) Each holder of an approval shall submit
				to the department, on forms provided by the department, regular progress
				reports which describe the current status of the project. These reports shall
				include or shall have attached:
1. An
				up-to-date copy of the proposed building plans;
2. An up-to-date copy of the estimate of
				construction costs or copies of bids for construction costs, or both;
3. An up-to-date statement of the total
				project costs;
4. Up-to-date copies
				of current financing commitment documents, by source of funds; and
5. A narrative description of the current
				status of the project, specifying any material changes in project scope, cost,
				proposed per diem rates or design anticipated by the approval holder.
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 122 - Long-Term Care Facility Bed Additions And Capital Expenditures Review › Appendix A

Current through June 24, 2024
Designated Health Planning Areas in Wisconsin [
				  DHS
				  122.03(15) ]
Health Planning Area #1
Columbia, Dane, Dodge, Grant, Green, Iowa, Jefferson,
				  Lafayette, Richland, Rock, Sauk counties
Health Planning Area #2
Kenosha, Milwaukee, Ozaukee, Racine, Walworth, Washington,
				  Waukesha counties
Health Planning Area #3
Calumet, Fond du Lac, Green Lake, Marquette, Outagamie,
				  Waupaca, Waushara, Winnebago counties
Health Planning Area #4
Brown, Door, Kewaunee, Manitowoc, Marinette, Menominee,
				  Oconto, Shawano, Sheboygan counties
Health Planning Area #5
Barron, Buffalo, Chippewa, Clark, Crawford, Dunn, Eau Claire,
				  Jackson, La Crosse, Monroe, Pepin, Pierce, Polk, Rusk, St. Croix, Trempealeau,
				  Vernon counties
Health Planning Area #6
Adams, Florence, Forest, Juneau, Langlade, Lincoln, Marathon,
				  Oneida, Portage, Taylor, Vilas, Wood counties
Health Planning Area #7
Ashland, Bayfield, Burnett, Douglas, Iron, Price, Sawyer,
				  Washburn counties
Wisconsin Administrative Code › Department of Health Services › DHS 110-199 - Health › Chapter DHS 124 - Hospitals › Subchapter I - General › Section DHS 124.01 - Authority, purpose and applicability

Current through June 24, 2024
This chapter establishes standards for the construction,
					 maintenance and operation of hospitals. The chapter is promulgated under the
					 authority of s.
					 50.36(1),
					 Stats., to ensure that hospital patients receive safe and adequate care and
					 treatment and that the health and safety of patients and hospital employees are
					 protected. The provisions of this chapter apply to all facilities meeting the
					 definition of hospital in s.
					 50.33(2),
					 Stats., that are not specifically exempt under s.
					 50.39,
					 Stats., except for those provisions that apply only to particular types of
					 hospitals.
Among facilities that are specifically exempt under s.
						50.39,
						Stats., from being treated as hospitals for purposes of regulation under ss.
						50.32
						to
						50.39
						and this chapter are physicians' clinics and offices, nursing homes, the
						Milwaukee County Mental Health Center and correctional institutions operated by
						the Wisconsin department of corrections.