Wisconsin Administrative Code › Department of Health Services › DHS 101-109 - Medical Assistance › Chapter DHS 105 - Provider Certification › Section DHS 105.14 - Adult day care centers

Current through June 24, 2024
(1) GENERAL PROVISIONS.
(a)
Introduction.
In
				accordance with s.
				49.45(2)
				(a) 11. and (47) (a) and (b), Stats., this
				section is promulgated to establish regulations and standards for the care,
				treatment or services, and health, safety, rights, well-being and welfare of
				participants in certified adult day care centers (ADCCs). This section is
				promulgated to ensure that each ADCC provides a supportive environment in a
				community-based group setting that is the least restrictive of each
				participant's freedom, and that care and services are provided in a manner that
				protects the rights and dignity of each participant.
(b)
Definitions.
1. "Abuse" has the meaning given in s.
				DHS
				13.03(1) (a).
2. "Accessible" means barriers are not
				present that prevent a person from entering, leaving, or functioning within an
				ADCC without physical help.
3.
				"Activities of daily living" or "ADL" means bathing, eating, oral hygiene,
				dressing, toileting, incontinence care, mobility and transferring from one
				surface to another such as from a bed to a chair.
4. "Adult" means an individual who is at
				least 18 years of age.
5. "Adult
				day care center" or "ADCC" means an entity that provides services for part of a
				day in a group setting to adults who need an enriched health, supportive or
				social experience, and who may need assistance with activities of daily living,
				supervision, or protection.
6.
				"Applicant" means the person seeking certification of an ADCC.
7. "Assessment" means gathering and analyzing
				information about a prospective or existing participant's needs and abilities
				as provided in sub. (7) (a).
8.
				"Caregiver" has the meaning given in s.
				50.065(1)
				(ag), Stats.
9. "Chemical restraint" means a psychotropic
				medication used for discipline or convenience, and not required to treat
				medical symptoms.
10. "Department"
				means the Wisconsin department of health services.
11. "Legal representative" means any of the
				following:
a. The health care agent under an
				activated power of attorney for health care under ch. 155, Stats.
b. A person appointed as a durable power of
				attorney under ch. 244, Stats.
c. A
				guardian, guardian of the estate, or guardian of the person, as defined in s.
				54.01(10), (11), or
				(12), Stats.
12. "Medication administration" means the
				direct injection, ingestion or other application of a prescription or
				over-the-counter drug or device to a participant, but does not include
				reminders to take the medication. Medication administration can be performed by
				any of the following:
a. A
				practitioner.
b. The practitioner's
				authorized agent.
c. An ADCC
				caregiver, or the participant, at the direction of the practitioner.
13. "Misappropriation of property"
				has the meaning given in s.
				DHS
				13.03(12).
14. "Neglect" has the meaning given in s.
				DHS
				13.03(14).
15. "Nursing care" means nursing procedures,
				other than personal or supportive care, that a registered nurse or a licensed
				practical nurse performs directly on or to a participant.
16. "Occupant" means any of the following:
a. A person who lives and sleeps in the ADCC,
				but who is not a participant.
b. A
				non-client resident, as defined in s.
				50.065(1)
				(cn), Stats.
17. "Operator" means an individual or
				business entity to whom a certification is granted and is legally responsible
				for the operation of the ADCC.
18.
				"Participant" means an adult who attends the ADCC during listed hours of
				operation and receives care, treatment, or services.
19. "Participant group" means a group of
				participants who need similar services because of a common disability,
				condition, or status. "Participant group" includes a group of individuals who
				have any of the following:
a. Functional
				impairments commonly associated with advanced age.
b. Irreversible dementia, such as Alzheimer's
				disease.
c. A developmental
				disability, as defined in s.
				51.01(5),
				Stats.
d. An emotional disturbance
				or a mental illness, as defined in s.
				51.01(13)
				(a), Stats.
e. A physical disability.
f. A traumatic brain injury.
20. "Physical restraint" means any
				manual method, article, device, or garment interfering with the free movement
				of the participant or the normal functioning of a portion of the participant's
				body or normal access to a portion of the participant's body, and which the
				participant is unable to remove easily, or confinement of a participant in a
				locked room.
21. "Program director"
				means an employee who is responsible for the management and day-to-day
				operation of the ADCC. A program director includes any of the following:
a. The operator.
b. An employee designated by the
				operator.
22.
				"Psychotropic medication" means a prescription drug, defined in s.
				450.01(20),
				Stats., that is used to treat or manage a psychiatric symptom or challenging
				behavior.
23. "Qualified Caregiver"
				means an employee who is at least 18 years of age and has successfully
				completed all of the applicable orientation and training under sub. (4) (a) and
				(b).
24.
a. "Seclusion" means physical or social
				separation of a participant from others by actions of caregivers.
b. "Seclusion" does not include separation to
				prevent the spread of communicable disease or voluntary cool-down periods in an
				unlocked room.
25.
				"Serious injury" means an injury from any incident or accident which results in
				any of the following:
a. A temporary or
				permanent increase in the level of assistance needed in one or more ADL
				categories, such as bathing, eating, oral hygiene, dressing, toileting,
				incontinence care, or mobility and transferring.
b. A fracture.
c. A pronounced decline in communication or
				cognitive abilities.
26.
				"Significant change" in a participant's physical or mental condition means any
				of the following:
a. A decline in a
				participant's medical condition that results in further impairment.
b. A decline in 2 or more ADLs.
c. A pronounced decline in communication or
				cognitive abilities.
d. A decline
				in behavior or mood which requires either a temporary or permanent increase in
				the level of assistance needed in one or more ADL categories, such as bathing,
				eating, oral hygiene, dressing, toileting, incontinence care, or mobility and
				transferring.
27.
				"Standard precautions" are a set of infection control practices used to prevent
				transmission of diseases that can be acquired by contact with blood, body
				fluids, non-intact skin (including rashes), and mucous membranes. These
				measures are used when providing care to all individuals, whether or not they
				appear infectious or symptomatic.
28.
a.
				"Supervision" means oversight of a participant's functioning.
b. "Supervision" includes keeping track of a
				participant's whereabouts and providing guidance and intervention when needed
				by a participant.
28m.
				"Transferee" means the recipient of a property or business in a change of
				ownership process who will submit application for a new
				certification.
29. "Transferor"
				means the current operator in a change of ownership process who will
				voluntarily relinquish the current certification.
31. "Utensils" means dishes, silverware and
				pots and pans used for storing, preparing, serving, or consuming
				food.
32. "Variance" means an
				alternate means of meeting a requirement in this section, as approved by the
				department under par. (c).
33.
				"Volunteer" means any person who provides services for participants without
				compensation.
34. "Waiver" means an
				exemption from a requirement in this section, as approved by the department
				under par. (c).
(c)
Variances and waivers.
1.
				The department may grant approval of a waiver or variance if the department
				determines that the proposed waiver or variance will not jeopardize the health,
				safety, welfare or rights of any participant.
2. A written request for a waiver or variance
				shall be sent to the department and include justification that the waiver or
				variance will not adversely affect the health, safety or welfare of any
				participant for the requested action.
3. A written request for a variance shall
				include a description of an alternative means planned to meet the intent of the
				requirement.
4. The department may
				terminate approval of a waiver or variance if any of the following occurs:
a. The department determines the waiver or
				variance has adversely affected the health, safety, well-being or welfare of a
				participant.
b. The ADCC fails to
				comply with any of the conditions of the waiver or variance as
				granted.
c. A change in
				circumstances from the time the waiver or variance approval was initially
				granted.
d. The ADCC failed to
				disclose a fact that is material to the approval.