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Wisconsin Department of Health Services

If You Have Complaints about Wisconsin Health Care

Information about Division of Quality Assurance (DQA)

Consumer & Provider Information

Provider Types Regulated by DQA

DQA Listservs

Provider Search

Facility Directories

Provider Training

DQA Numbered Memos

DHS Forms

Construction/
Remodeling of Health Care Facilities

WI Nurse Aide Training and Registry Info

Caregiver Program/ Background Checks

WI Adult Programs Caregiver Misconduct Registry

Wisconsin Nursing Homes - Forms

Introduction | Rules_&_Regulations | Forms | Providers | Contacts | Publications | Webcasts | Related Sites


For questions regarding nursing homes, you may E-mail the Division of Quality Assurance

A Pre-admission Screen and Resident Review (PASARR) Level 1 Screen must be completed prior to admission to a nursing facility admission to determine if a person reasonably is suspected of having a serious mental illness or a developmental disability, which necessitates a PASARR Level II Screen prior to admission unless a short-term exemption, per Wisconsin PASARR policies, is appropriate

Pre-admission Screen and Resident Review (PASARR) Level 1 Screen: Word Fillable Format, PDF Format

Fire Report form DQA F-62500 (Word, 78 KB) - Fillable form with contacts to assist the reporting of fires in a healthcare facility.

Fire Watch memorandum DQA 12-013 - Outlines the minimum procedures for when a required sprinkler or fire alarm system is out of service.

Wisconsin Client Rights and Grievance Procedure

Construction/Remodeling of Health Care Facilities:  
Plan Review Requirements

 

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Last Updated: July 17, 2013