Wisconsin Code § 146.40

Instructional programs for nurse aides; reporting client abuse
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(1) In this section:
(ad) “Client” means a person who receives services from an
entity.
(ag) “Credential” has the meaning given in s. 440.01 (2) (a).
(as) “Entity” has the meaning given in s. 50.065 (1) (c).
(aw) “Feeding assistant” means an individual who has completed a state-approved training and testing program, as specified
by the department by rule, or training, as described in sub. (2m),
that satisfies the state-approved training requirement, to perform
one nursing-related duty, as defined by the department by rule.
(b) “Home health agency” has the meaning specified in s.
50.49 (1) (a).
(bo) “Hospice” means a hospice that is licensed under subch.
VI of ch. 50.
(br) “Hospital” has the meaning specified in s. 50.33 (2).
(bt) “Intermediate care facility for persons with an intellectual
disability” has the meaning given for “intermediate care facility
for the mentally retarded” under 42 USC 1396d (d).
(c) “Licensed practical nurse” means a licensed practical
nurse who is licensed or has a temporary permit under s. 441.10
or who holds a multistate license, as defined in s. 441.51 (2) (h),
issued in a party state, as defined in s. 441.51 (2) (k).
(d) “Nurse aide” means an individual who performs routine
patient care duties delegated by a registered nurse or licensed
practical nurse who supervises the individual, for the direct
health care of a patient or resident. “Nurse aide” does not mean a
feeding assistant, an individual who is licensed, permitted, certified, or registered under ch. 441, 448, 449, 450, 451, 455, 459, or
460, or an individual whose duties primarily involve skills that
are different than those taught in instructional programs for nurse
aides approved under sub. (3) or (3g) or evaluated by competency
evaluation programs for nurse aides approved under sub. (3m).
(e) “Nursing home” has the meaning specified in s. 50.01 (3).
(f) “Registered nurse” means a registered nurse who has a license under s. 441.06 or a temporary permit under s. 441.08 or
who holds a multistate license, as defined in s. 441.51 (2) (h), issued in a party state, as defined in s. 441.51 (2) (k).
(g) “Student nurse” means an individual who is currently enrolled in a school for professional nurses or a school for licensed
practical nurses that meets standards established under s. 441.01
(4), or who has successfully completed the course work of a basic
nursing course of the school but has not successfully completed
the examination under s. 441.06 (1) (e) or 441.10 (1) (f).
(2) A hospital, nursing home, intermediate care facility for
persons with an intellectual disability, home health agency, or
hospice may not employ or contract for the services of an individual as a nurse aide, regardless of the title under which the individual is employed or contracted for, unless one of the following is
true:
(a) The individual has successfully completed instruction in
an instructional program for nurse aides that is approved under
sub. (3) or (3g), or has been issued a waiver from completing instruction in an instructional program under sub. (2g) (b), and has
successfully completed a competency evaluation program that is
approved under sub. (3m). In order to be eligible under this paragraph, an individual who successfully completes instruction in an
instructional program for nurse aides that is approved under sub.
(3g) and who previously completed a competency evaluation program in another state must successfully complete a competency
evaluation program that is approved under sub. (3m), regardless
of whether the competency evaluation program that the individual completed in another state is the same as or substantially similar to a competency evaluation program that is approved under
sub. (3m).
(ac) The individual has been added to the registry under sub.
(4g) as provided under sub. (2g) (a).
(am) The individual has completed relevant education, training, instruction, or other experience in connection with any military service, as defined in s. 111.32 (12g), if the individual or the
hospital, nursing home, intermediate care facility, home health
agency, or hospice demonstrates to the satisfaction of the department that the education, training, instruction, or other experience
is substantially equivalent to an instructional program that is approved under sub. (3), and the individual has successfully completed a competency evaluation program that is approved under
sub. (3m).
(c) For hospitals, nursing homes, home health agencies or
hospices, whether or not certified providers of medical assistance, and intermediate care facilities persons with an intellectual
disability that are certified providers of medical assistance, the
individual is enrolled in an instructional program for nurse aides
that is approved under sub. (3) or (3g) and is employed or under
contract as a nurse’s assistant, home health aide or hospice aide
fewer than 120 calendar days by the hospital, nursing home,
home health agency, hospice or intermediate care facility for persons with an intellectual disability. All of the following applies to
an individual specified under this paragraph:
1. He or she may perform only services for which he or she
has received training and has been found proficient by an instructor under the instructional program.
2. The hospital, nursing home, home health agency, hospice,
or intermediate care facility for persons with an intellectual disability may not include the individual in meeting or complying
with a requirement for nursing care staff and functions, including
a minimum nursing staff requirement.
(d) For hospitals, nursing homes, home health agencies, or
hospices, whether or not certified providers of medical assistance, and intermediate care facilities for persons with an intellectual disability that are certified providers of medical assistance, the individual has successfully completed an instructional
program and a competency evaluation program for nurse aides
that is certified in another state that meets criteria for acceptance
in this state as specified by the department by rule.
(e) For hospitals, home health agencies, or hospices, whether
or not certified providers of medical assistance, nursing homes
that are not certified providers of medical assistance and intermediate care facilities for persons with an intellectual disability that
are certified providers of medical assistance, the individual is a
student nurse who has successfully completed a basic nursing
course from a school that is on the accredited list of schools specified under s. 441.01 (4) or who successfully completes a competency evaluation program for nurse aides that is approved by the
department under sub. (3m).
(em) For nursing homes that are certified providers of medical assistance, the individual is a student nurse who successfully
completes a competency evaluation program for nurse aides that
is approved by the department under sub. (3m).

(g) 1. For hospitals, nursing homes, home health agencies, or
hospices, whether or not certified providers of medical assistance, and intermediate care facilities for persons with an intellectual disability that are certified providers of medical assistance, the individual, if he or she has performed no nursing-related service for monetary compensation for 24 consecutive
months after having satisfied the requirement under par. (a),
again successfully completes a competency evaluation program
for nurse aides that is approved by the department under sub.
(3m).
2. For hospitals, nursing homes, home health agencies, or
hospices, whether or not certified providers of medical assistance, and intermediate care facilities for persons with an intellectual disability that are certified providers of medical assistance, the individual, if he or she has performed no nursing-related service for monetary compensation for 24 consecutive
months after having satisfied the requirement under par. (ac),
successfully completes a competency evaluation program for
nurse aides that is approved by the department under sub. (3m).
(2d) (a) Notwithstanding sub. (2), subject to par. (b), a hospital, nursing home, intermediate care facility for persons with an
intellectual disability, home health agency, or hospice may employ or contract for the services of an individual as a nurse aide, if
the individual is enrolled in an instructional program for nurse
aides that is approved under sub. (3) or (3g), is employed parttime as a nurse’s assistant, home health aide, or hospice aide
fewer than 120 days, and has a preceptor. The requirements of
sub. (2) (c) 1. and 2. apply to individuals under this subsection.
An individual employed or contracted as a nurse aide under this
subsection shall pass a Wisconsin-approved nurse aide competency evaluation examination within 120 calendar days of the
start of the individual’s part-time employment as a nurse aide or
may not continue to be employed or contracted as a nurse aide under this subsection.
(b) The department shall, as soon as possible after March 24,
2024, request any necessary federal approval required to implement this subsection and, if approval is granted or if no federal
approval is required, the department shall implement this subsection. If federal approval is necessary but not granted, the department may not implement this subsection.
(2g) (a) An individual who has previously been employed in
another state as a nurse aide for 2,088 hours or more within the
prior 2-year period and who has successfully completed a competency evaluation program in that other state that is the same as or
substantially similar to one approved under sub. (3m) may apply
to the department to be eligible to be employed or contracted as a
nurse aide under sub. (2) (ac). The department shall verify that
the individual was employed in that state as a nurse aide for 2,088
hours in the 2-year period prior to the date of application. If the
individual is so eligible, the department shall add the individual
to the registry under sub. (4g).
(b) An individual who has previously been employed in another state as a nurse aide for 2,088 hours or more within the
prior 2-year period but who has not successfully completed a
competency evaluation program that is the same as or substantially similar to one approved under sub. (3m) may apply to the
department to be eligible for a waiver from completing instruction in an instructional program for nurse aides under subs. (3)
and (3g). The department shall verify that the individual was employed in that state as a nurse aide for 2,088 hours in the 2-year
period prior to the date of application. If the individual is so eligible, the department shall issue the individual a waiver so that
the individual may complete a competency evaluation program
under sub. (3m) without completing instruction in an instructional program for nurse aides under sub. (3) or (3g).
(2m) A nursing home or intermediate care facility for persons with an intellectual disability, whether or not the nursing
home or intermediate care facility is a certified provider of medical assistance, may not employ or contract for the services of an
individual as a feeding assistant, regardless of the title under
which the individual is employed or contracted for, unless the individual has successfully completed a state-approved training and
testing program, as specified by the department by rule. Any relevant education, training, instruction, or other experience that an
individual has obtained in connection with any military service,
as defined in s. 111.32 (12g), counts toward satisfying the requirement to complete the state-approved training program under
this subsection, if the individual or the nursing home or intermediate care facility demonstrates to the satisfaction of the department that the education, training, instruction, or other experience
obtained by the individual is substantially equivalent to the stateapproved training program.
(3) Except as provided in sub. (4d), the department shall approve instructional programs for nurse aides that apply for, and
satisfy standards for, approval that are promulgated by rule by the
department. The department may not require an instructional
program to exceed the federally required minimum total training
hours or minimum hours of supervised practical training under
42 CFR 483.152 (a). The department shall review the curriculum
of each approved instructional program at least once every 24
months following the date of approval to determine whether the
program continues to satisfy the standards for approval. Under
this subsection, the department may, after providing notice, suspend or revoke the approval of an instructional program or impose a plan of correction on the program if the program fails to
satisfy the standards for approval or operates under conditions
that are other than those contained in the application approved by
the department.
(3g) Except as provided in sub. (4d), the department shall approve instructional programs for nurse aides that apply for approval; that satisfy standards for approval that are promulgated by
rule by the department; and that allow an individual who has successfully completed an instructional program for nurse aides in
another state to receive instruction in this state that, when combined with the instructional program in the other state, will result
in the individual having received substantially the same instruction as an individual who successfully completes an instructional
program approved under sub. (3). Only an individual so described may complete an instructional program for nurse aides
that is approved under this subsection. The department shall review the curriculum of each approved instructional program at
least once every 24 months following the date of approval to determine whether the program continues to satisfy the requirements of this subsection. Under this subsection, the department
may, after providing notice, suspend or revoke the approval of an
instructional program or impose a plan of correction on the program if the program fails to satisfy the requirements of this subsection or operates under conditions that are other than those contained in the application approved by the department.
(3m) The department shall review competency evaluation
programs for nurse aides and, except as provided in sub. (4d),
may approve those competency evaluation programs that satisfy
standards for approval that are specified in rules promulgated by
the department. The department may approve a competency
evaluation program to be taken by an individual who completes
an instructional program for nurse aides that is approved under
sub. (3g) only if the competency evaluation program is the same
as one to be taken by an individual who completes an instructional program for nurse aides that is approved under sub. (3).
Under this subsection, the department may, after providing notice, suspend or revoke approval of a competency evaluation program or impose a plan of correction on the program if the compe-

tency evaluation program fails to satisfy the standards for approval or operates under conditions that are other than those contained in the application approved by the department.
(4) A competency evaluation program approved under sub.
(3m) shall notify the department to include an individual on the
registry under sub. (4g) (a) 1. after the individual has successfully
completed the competency examination.
(4d) (a) Except as provided in par. (am), the department shall
require each applicant to provide the department with his or her
social security number, if the applicant is an individual, or the applicant’s federal employer identification number, if the applicant
is not an individual, as a condition of issuing an approval under
sub. (3), (3g), or (3m).
(am) If an individual specified under par. (a) does not have a
social security number, the individual, as a condition of obtaining
approval, shall submit a statement made or subscribed under oath
or affirmation to the department that the applicant does not have
a social security number. The form of the statement shall be prescribed by the department of children and families. An approval
issued in reliance upon a false statement submitted under this
paragraph is invalid.
(b) The department may not disclose any information received under par. (a) to any person except to the department of
revenue for the sole purpose of requesting certifications under s.
73.0301 and to the department of workforce development for the
sole purpose of requesting certifications under s. 108.227.
(c) Except as provided in par. (am), the department shall deny
an application for the issuance of an approval specified in par. (a)
if the applicant does not provide the information specified in par.
(a).
(d) The department shall deny an application for the issuance
of an approval specified in par. (a) or shall revoke an approval if
the department of revenue certifies under s. 73.0301 that the applicant for or holder of approval is liable for delinquent taxes or if
the department of workforce development certifies under s.
108.227 that the applicant for or holder of approval is liable for
delinquent unemployment insurance contributions.
(e) An action taken under par. (c) or (d) is subject to review
only as provided under s. 73.0301 (2) (b) and (5) or s. 108.227 (5)
and (6), whichever is applicable.
(4g) (a) The department shall establish and maintain a registry that contains all of the following:
1. A listing of all individuals who are added to the registry as
required under sub. (2g) and all individuals about whom the department is notified under sub. (4).
2. A listing of all individuals about whom the department is
notified under sub. (4r) (a) or (am), for whom the department
makes findings under sub. (4r) (b) and to whom any of the following applies:
a. The individual waives a hearing or fails to notify the department under sub. (4r) (c).
b. A hearing officer finds reasonable cause to believe that the
individual performed an action alleged under sub. (4r) (a) or
(am).
3. Findings of the department under sub. (4r) (b) or of the
hearing officer under sub. (4r) (d) concerning the misappropriation of property or the neglect or abuse of a client by an individual listed under subd. 2.
4. A brief statement, if any, of an individual about whom the
department is notified under sub. (4) and who disputes the department’s findings under sub. (4r) (b) or the hearing officer’s
findings under sub. (4r) (d).
(b) The department shall provide, upon receipt of a specific,
written request, information requested that is contained in the
registry under par. (a).
(c) Section 46.90 does not apply to this subsection.
(4m) An instructional program under sub. (3) or (3g) for
which the department has suspended or revoked approval or imposed a plan of correction or a competency evaluation program
under sub. (3m) for which the department has suspended or revoked approval or imposed a plan of correction may contest the
department’s action by sending, within 10 days after receipt of
notice of the contested action, a written request for hearing under
s. 227.44 to the division of hearings and appeals created under s.
15.103 (1). The administrator of the division may designate a
hearing examiner to preside over the case and recommend a decision to the administrator under s. 227.46. The decision of the administrator of the division shall be the final administrative decision. The division shall commence the hearing within 30 days after receipt of the request for hearing and shall issue a final decision within 15 days after the close of the hearing. Proceedings
before the division are governed by ch. 227. In any petition for judicial review of a decision by the division, the party, other than
the petitioner, who was in the proceeding before the division shall
be the named respondent. This subsection does not apply to a revocation of approval under sub. (4d) (d).
(4r) (a) Any individual may report to the department that he
or she believes that any person employed by or under contract
with an entity has neglected or abused a client or misappropriated
the client’s property.
(am) 1. An entity shall report to the department any allegation of misappropriation of the property of a client or of neglect
or abuse of a client by any individual employed by or under contract with the entity if the individual is under the control of the
entity.
3. An entity that intentionally fails to report an allegation of
misappropriation of the property of a client or of neglect or abuse
of a client may be required to forfeit not more than $1,000 and
may be subject to other sanctions specified by the department by
rule.
(b) Except as provided in pars. (em) and (er), the department
shall review and investigate any report received under par. (a) or
(am) and, if the allegation is substantiated, make specific, documented findings concerning the misappropriation of property or
the neglect or abuse. The department shall, in writing, notify the
individual specified in the report that the individual’s name and
the department’s findings about the individual shall be listed in
the registry under sub. (4g) (a) 2. and 3. unless the individual contests the listings in a hearing before the division of hearings and
appeals created under s. 15.103 (1) . The written notification
shall describe the investigation conducted by the department,
enumerate the findings alleging misappropriation of property or
neglect or abuse of a client and explain the consequence to the individual specified in the report of waiving a hearing to contest the
findings. The individual specified in the report shall have 30 calendar days after receipt of the notification to indicate to the department in writing whether he or she intends to contest the listing or to waive the hearing.
(c) If an individual under par. (b) notifies the department that
he or she waives a hearing to contest the listings in the registry
under par. (b), or fails to notify the department within 30 calendar
days after receipt of a notice under par. (b), the department shall
enter the name of the individual under sub. (4g) (a) 2. and the department’s findings about the individual under sub. (4g) (a) 3.
(d) If the person specified in the report received under par. (a)
or (am) timely notifies the division of hearings and appeals created under s. 15.103 (1) that he or she contests the listings in the
registry under par. (b), the division of hearings and appeals shall

hold a hearing under the requirements of ch. 227. If after presentation of evidence a hearing officer finds that there is no reasonable cause to believe that the person specified in the report received under par. (a) or (am) performed an action alleged under
par. (a) or (am), the hearing officer shall dismiss the proceeding.
If after presentation of evidence a hearing officer finds that there
is reasonable cause to believe that the person specified in the report received under par. (a) or (am) performed an action alleged
under par. (a) or (am), the hearing officer shall so find and shall
cause the name of the person specified in the report received under par. (a) or (am) to be entered under sub. (4g) (a) 2. and the
hearing officer’s findings about the person specified in the report
received under par. (a) or (am) to be entered under sub. (4g) (a) 3.
(e) The individual may provide the department with a brief
statement disputing the department’s findings under par. (b) or
the hearing officer’s findings under par. (d) and, if so provided,
the department shall enter the statement under sub. (4g) (a) 4.
(em) If the department receives a report under par. (a) or (am)
and determines that an individual who is the subject of the report
holds a credential that is related to the individual’s employment
at, or contract with, the entity, the department shall refer the report to the department of safety and professional services.
(er) The department may contract with private field investigators to conduct investigations of reports received by the department under par. (a) or (am).
(f) Section 46.90 does not apply to this subsection.
(5) (a) The department shall promulgate rules specifying
standards for approval in this state of instructional programs and
competency evaluation programs for nurse aides. The standards
shall include specialized training in providing care to individuals
with special needs.
(b) The department shall promulgate rules specifying criteria
for acceptance by this state of an instructional program and a
competency evaluation program that is certified in another state,
including whether the other state grants nurse aide privileges to
persons who have completed instruction in an instructional program that is approved under sub. (3) and whether one of the following is true:
1. If the other state certifies instructional programs and competency evaluation programs for nurse aides, the state’s requirements are substantially similar, as determined by the department,
to certification requirements in this state.
2. If the other state certifies nurse aides, that state’s requirements are such that one of the following applies:
a. The instructional programs required for attendance by persons receiving certificates are substantially similar, as determined
by the department, to instructional programs approved under sub.
(3).
b. The competency evaluation programs required for successful completion by persons receiving certificates are substantially similar, as determined by the department, to competency
evaluation programs approved under sub. (3m).
(6) Any person who violates sub. (2) shall forfeit not more
than $1,000.
(7) This section does not apply to a hospice that receives no
federal or state moneys for any purpose.

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