Wisconsin CBRF and assisted living rules: what you must document about each resident

Wisconsin does not license anything called an "assisted living facility." Its assisted living settings are community-based residential facilities, residential care apartment complexes and adult family homes, each with its own chapter. This page focuses on CBRFs, the largest group, with a short section on RCACs. Adult family homes (DHS 88) are not covered here.

Who these rules cover

A CBRF is defined by Wis. Stat. s. 50.01 (1g) and licensed under DHS 83. CBRFs are licensed to serve one or more "client groups," such as people with "irreversible dementia, such as Alzheimer's disease," people with functional impairments of advanced age, and people with developmental disabilities or mental illness. Staff must receive training specific to each client group served, including its "physical, social and mental health needs" and activities.⁴

Wisconsin has no separate memory-care license or dementia-unit rule in DHS 83. A CBRF serving the dementia client group follows the same assessment and service plan rules, plus client-group training, staffing and, if approved, delayed-egress requirements.

The CBRF assessment

DHS 83.35 requires the CBRF to assess each resident's "needs, abilities, and physical and mental condition before admitting the person to the CBRF, when there is a change in needs, abilities or condition, and at least annually." The information-gathering rule is unusually resident-centered:

"The administrator or designee shall hold a face-to-face interview with the person and the person's legal representative, if any, and family members, as appropriate, to determine what the person views as his or her needs, abilities, interests, and expectations."DHS 83.35 (1) (b)

The assessment must also draw on the person's "current diagnostic, medical and social history" from health care providers, the case manager and other service providers. It must cover ten areas, including physical health, medications, pain, nursing needs, behavior, risks, self-care and self-direction, and two that reach into who the person is:

"5. Mental and emotional health, including the resident's self-concept, motivation and attitudes, symptoms of mental illness and participation in treatment and programming." ... "10. Social participation, including interpersonal relationships, communication skills, leisure time activities, family and community contacts and vocational needs."DHS 83.35 (1) (c)

The results go into a written report kept in the resident's record, and all care staff must have "continual access" to the assessment and service plan.

The individual service plan

On admission the CBRF writes a temporary service plan for immediate needs. Then:

"Within 30 days after admission and based on the assessment under sub. (1), the CBRF shall develop a comprehensive individual service plan for each resident."DHS 83.35 (3) (a)

The plan must identify the resident's "needs and desired outcomes," the program services and approaches the CBRF will provide, measurable goals with time limits, and who delivers care. The resident or legal representative is involved and signs it. It is reviewed annually or when needs, abilities or condition change, with input from the resident, case manager and care staff.¹ Once a year the CBRF must also offer the resident a satisfaction evaluation.

Activities and social contact

Under DHS 83.38, the CBRF must provide or arrange services in several areas beyond the assessed needs, including:

"(c) Leisure time activities. The CBRF shall provide a daily activity program to meet the interests and capabilities of the residents." ... "(e) Family and social contacts. The CBRF shall encourage and assist residents in maintaining family and social contacts."DHS 83.38 (1)

The activity schedule must be posted, and monthly schedules of community activities must be made available. Resident rights add the right to "Make decisions relating to care, activities, daily routines and other aspects of life which enhance the resident's self reliance and support the resident's autonomy and decision making" (DHS 83.32 (3) (k)).²³

Residential care apartment complexes

RCACs, which serve tenants in independent apartments, use a comprehensive assessment performed before admission, with the tenant's active participation. It must evaluate factors "relating to the person's need and preference for services," including "Social and leisure needs and preferences" and the "Type, amount and timing of services desired by the tenant." The resulting service agreement must identify "The activities and social connections the tenant will be assisted in maintaining." Capabilities, needs and preferences are reviewed at least annually.⁵

What surveyors tend to look for

Based only on what the rule text requires you to document:

• A written pre-admission assessment covering all ten DHS 83.35 areas, including social participation, and evidence of the face-to-face interview about the person's own interests and expectations.
• A temporary service plan on admission and a signed comprehensive individual service plan within 30 days.
• Annual and change-of-condition reassessments and plan reviews, documented.
• A posted daily activity schedule that reflects residents' interests, and support for family and social contacts.
• For RCACs, a pre-admission comprehensive assessment and a service agreement naming the activities and social connections to be maintained.

Gathering interests and life story well

• Let the interview do its job. The rule asks what the person views as their interests. Open questions work: "Tell me about the work you did." "Who do you most like to hear from?"
• Cover all of "social participation." Relationships, leisure, family and community contacts and vocational needs are four separate things. Ask about each.
• Include family as appropriate. Especially for residents in the dementia client group, relatives can fill in history the resident no longer recalls.
• Record comfort and what to avoid. Both are useful to caregivers and fit the "self-concept, motivation and attitudes" part of the assessment.
• Revisit at the annual review. Pair it with the satisfaction evaluation and ask what they would like more of.

How Porchlight can help

Porchlight is a life-story tool for senior-care communities. A resident taps one large button on a tablet, a life question is read aloud and shown in large type, and they talk; the answer is recorded and transcribed. More than 800 human-written questions are organized by life chapter, any question can be skipped, and nothing is scored. Staff can record profile facts, including topics to avoid. Family get a private page to listen, reply by voice and add their own questions and photos. Staff get a "Know Your Resident" briefing with conversation starters, story highlights, a printable biography and a Monday email digest.

It helps you gather and keep the interests, relationships and personal history that the social participation part of the assessment asks about. The assessment, service plan and compliance with DHS 83 remain your community's responsibility.

Frequently asked questions

When must a Wisconsin CBRF assess a new resident?

Before admitting the person, under DHS 83.35 (1), or within 5 days after admission for an emergency admission. The CBRF must reassess when there is a change in needs, abilities or condition, and at least annually.

When is the CBRF individual service plan due?

A temporary service plan is required upon admission, and the comprehensive individual service plan must be developed within 30 days after admission, based on the assessment, under DHS 83.35 (3). It is reviewed annually or when the resident's needs, abilities or condition change.

Does Wisconsin require a life history for CBRF residents?

No specific life history is required. The assessment must include social participation, covering interpersonal relationships, communication skills, leisure time activities, family and community contacts and vocational needs, and the face-to-face interview must determine what the person views as his or her needs, abilities, interests and expectations.

Does Wisconsin have a memory care license?

No. Chapter DHS 83 treats people with irreversible dementia as a client group a CBRF may be licensed to serve, with client-group-specific staff training. The same assessment and service plan rules apply.

Does Porchlight complete the DHS 83.35 assessment?

No. Porchlight helps residents and families share interests and life stories in the resident's own voice and gives staff a briefing built from them. Your team still conducts the assessment and writes the individual service plan.