Requirements for skilled nursing facilities – Wis. Stat. Ann. § 49.498

Requirements for Skilled Nursing Facilities

This law sets forth a number of administrative requirements for skilled nursing facilities.  First, the law sets forth requirements related to the provision of services and patient care, requiring a certain quality of care for each resident.  Nursing facilities must create a "quality assessment and assurance committee" that will meet at least quarterly to identify and correct quality issues.  The law also sets forth, in detail, the services that the facilities are required to provide.

Nursing facilities must create a written plan of care for every resident that contains the resident's medical needs and plans for meeting these needs. The resident's physician and registered professional nurse must, "to the extent practicable," prepare the plan with the help of the resident or their family and legal representation and review and revise the plan following a periodic assessment of the resident's capacity as conducted by the nursing facility.

The law then sets forth the resident's rights, including but not limited to right to be free from physical/mental abuse, the right to privacy, the right to confidentiality of personal and clinical records, etc.

Nursing facilities must keep clinical records for all of their residents that contain the care plans, assessments, and preadmission screening results.  Residents of nursing homes must have the right to choose their physician, participate, unless incompetent, in the creation and revision of their care plans, and to be "fully informed in advance" about their treatment or changes in their treatment.

Nursing facilities may only transfer or discharge a resident if:

• The resident's welfare necessitates transfer or discharge and the circumstances necessitating the transfer or discharge are documented in the resident's record.
• The resident's health has improved so that they no longer require nursing facility services and such improvement is documented in their medical record.
• The resident is endangering the safety or health of persons within the nursing facility.
• The resident has not paid for their care within the facility.
• The facility closes.

Nursing facilities must document the circumstances regarding discharge or transfer if the transfer or discharge is necessary for the patient's welfare, due to their improved condition, or is necessary to protect the safety or health of others.

The law then lists sets forth the resident's rights with respect to access and visitation and the equal access to quality care regardless of payment.  The law sets forth certain specific requirements for admissions policies at these facilities, requirements regulating the protection of resident's funds, administration requirements, licensing requirements, requirements for infection control, and requirements for compliance with applicable laws and regulations.

The law states that the department of health services set forth rules governing nursing facilities, related to mechanism for hearing appeals on transfers/discharges, performing assessments of residents, and establishing criteria for denial of payment and for closure of a facility.  The law sets forth definitions for classes of violations from class 1 to class 3, and the penalty amounts for each of these violations.  The law sets forth the requirements for seeking judicial review of agency determinations under this section.