Section 10.73. Information and referral requirements for long-term care facilities.

 

(1)   Purpose. This section implements ss. 50.034 (5m) to (5p) and (8) , 50.035 (4m) to (4p) and (11) and 50.04 (2g) to (2i) , Stats., which establish requirements for adult family homes, residential care apartment complexes, community-based residential facilities and nursing homes to provide information to prospective residents and to refer certain prospective or newly admitted residents to a resource center and establish penalties for non-compliance.

(2)   Applicability. Except as otherwise specified, this section applies to a long-term care facility only to the extent that the secretary has certified under s. DHS 10.71 that one or more resource centers are available for referrals from the facility for one or more specified target groups.

(3)   Provision of information required. Subject to sub. (2) , the long-term care facility shall give to each prospective resident, the resident's guardian, or a representative designated by the resident written information about the services of a resource center, the family care benefit and the availability of screening to determine the prospective resident's eligibility for the family care benefit. The facility shall provide the information at the time it first provides, in response to a request from the person or his or her representative, any written information about the facility, its services or potential admission, or at the time that it accepts an application for admission from the person, whichever is first. The written information shall be provided to the facility by the department or by the resource center that is the subject of the information.

(4)   Required referral.

(a) Subject to sub. (2) , a long-term care facility shall refer a person seeking admission to the facility to the resource center serving the county in which the person resides or intends to reside, if the person has a disability or condition expected to last at least 90 days and is at least 65 years or age or has a developmental or physical disability. The facility shall make the referral when it first provides an assessment of the person's needs for nursing or residential services, or at the time that it accepts an application for admission from the person. The facility is not required to make the referral if any of the following applies:

1. The person is under the age of 17 years and 9 months.

2. A functional screen under s. DHS 10.33 has been completed for the person within the previous 6 months.

3. The person is seeking admission to the long-term care facility only for respite care.

4. The person is an enrollee of a care management organization.

5. The long-term care facility has been notified that the person was referred to the resource center by another entity within the previous 30 days.

(b) If the long-term care facility admits a person without referral because the person's disability or condition is not expected to last at least 90 days, the facility shall later refer the person to the resource center if the person's disability or condition is later expected to last at least 90 days. The facility shall refer the person within three business days of determining that the person's disability or condition is likely to last longer than was expected at the time of admission.

(c) A person seeking admission or about to be admitted to a long-term care facility on a private pay basis who is referred to a resource center need not provide financial information to a resource center or county agency, unless the person is expected to be eligible for medical assistance within 6 months or unless the person wishes to apply for the family care benefit.

(5)   Penalties for rcacs and cbrfs.

(a) Forfeiture . If the department finds that a residential care apartment complex or a community-based residential facility has not complied with the requirements of this section, it may directly impose a forfeiture of not more than $500 for each violation. If the department determines that a forfeiture should be assessed for a particular violation, the department shall send a notice of assessment to the facility. The notice shall specify the amount of the forfeiture assessed, the violation and the statute or rule alleged to have been violated, and shall inform the facility of the right to a hearing under par. (b) .

(b) Right to hearing. A residential care apartment complex or a community-based residential facility may contest an assessment of a forfeiture by sending, within 10 days after receipt of notice under par. (a) , a written request for a hearing under s. 227.44 , Stats., to the division of hearings and appeals in the department of administration. A hearing request shall be considered filed on the date of actual receipt by the division of hearings and appeals, or the date of the postmark, whichever is earlier. A request filed by facsimile is complete upon transmission. If the request is filed by facsimile transmission and such transmission is completed between 5 p.m. and midnight, one day shall be added to the prescribed period. The hearing shall be scheduled and conducted in accordance with the requirements of ss. 50.034 (8) (c) and 50.035 (11) (c) , Stats.

(c) Payment of forfeitures . All forfeitures shall be paid to the department within 10 days after receipt of notice of assessment or, if the forfeiture is contested under par. (b) , within 10 days after receipt of the final decision after exhaustion of administrative review, unless the final decision is appealed and the order is stayed by court order. The department shall remit all forfeitures paid to the state treasurer for deposit in the school fund.

(6)   Penalties for nursing homes. Failure to comply with the requirements of s. 50.04 (2g) and (2h) , Stats., and this section is a class "C" violation under s. 50.04 (4) (b) 3. , Stats.

History: Cr. Register, October, 2000, No. 538 , eff. 11-1-00; correction in (1) made under s. 13.92 (4) (b) 7. , Stats., Register November 2008 No. 635 .

Note

A hearing request should be addressed to the Division of Hearings and Appeals, P.O. Box 7875, Madison, WI 53707. Hearing requests may be delivered in person to that office at 5005 University Avenue, Room 201, Madison, WI. Microsoft Windows NT 6.1.7601 Service Pack 1