Caregiver Misconduct Reporting and Investigating Requirements

The Caregiver Law under Chapter DHS 13 (PDF, 66 KB) requires the following programs covered under Wisconsin Statutes Chapter 50 (PDF, 761 KB), Chapter 51 (PDF, 1.3 MB) and Chapter 146 (PDF, 515 KB) to report allegations of caregiver abuse, neglect or misappropriation:

  • Adult Family Homes (3-4 bed AFHs)
  • Ambulance Service Providers
  • Certified Personal Care Providers
  • Community-Based Residential Facilities (CBRFs)
  • Community Substance Abuse Services
  • Community Support Programs
  • Emergency Mental Health Services Programs
  • Facilities Serving People with Developmental Disabilities (FDDs)
  • Home Health Agencies (including personal care and supportive home care services provided by a licensed HHA)
  • Hospices
  • Hospitals (including clinics that are part of the hospital)
  • Mental Health Day Treatment Services for Children
  • Nursing Homes
  • Outpatient community Mental Health/Developmental Disabilities
  • Residential Care Apartment Complexes (RCACs)
  • Rural Medical Centers

These entities must:

  • Immediately protect clients from subsequent incidents of misconduct (abuse, neglect, misappropriation and injury of unknown source).
  • Investigate all allegations of misconduct.
  • Document the results of their investigation.
  • Report allegations/incidents to the Division of Quality Assurance (DQA) as appropriate.

Misconduct Definitions

Each resident has the right to be free from abuse, corporal punishment and involuntary seclusion. Residents must not be subjected to abuse by anyone, including, but not limited to, facility staff, other residents, consultants or volunteers, staff of other agencies serving the resident, family members or legal guardians, friends or other individuals.

Refer to Misconduct Definitions P-00976 (PDF, 46 KB) for federal definitions of misconduct under 42 C.F.R. §488.301 and state definitions under Chapter DHS 13. Participating Medicare and Medicaid nursing homes must first review the federal definitions.  If an incident potentially meets the federal definition, it is not necessary to review the state definitions found in DHS 13.05.

How to Report

A Misconduct Incident Report F-62447 (PDF, 102) must be submitted to the DQA Office of Caregiver Quality (OCQ) for allegations involving all staff (noncredentialed and credentialed) or other perpetrators (family member, friend, visitor, resident, etc.). OCQ will review reports involving noncredentialed staff (nurse aides, caregivers, housekeepers, etc.) for possible investigation and refer reports involving credentialed staff (doctors, RNs, LPNs, social workers, etc.) to the Department of Safety and Professional Services (DSPS) for review. OCQ will also refer reports to other agencies including the Department of Justice, county departments, adult-at-risk agencies, local law enforcement agencies, and others, as appropriate. One or more of these agencies may also respond to an allegation investigated by DQA.

Use the Injury of Unknown Source Flowchart P-00362 (PDF, 19 KB) to assist in identifying reporting requirements for injuries of unknown source.

Submit the Misconduct Incident Report to:

Department of Health Services
Division of Quality Assurance
Office of Caregiver Quality
PO Box 2969
Madison, WI 53701-2969
Fax: 608-264-6340
Email: DHSCaregiverIntake@wi.gov

Reporting requirements are fully outlined in the Wisconsin Caregiver Program Manual P-00038 (PDF, 321 KB). This publication contains important clarifications regarding:

  • Caregiver misconduct reporting requirements.
  • DQA's response to incident reports.

Additional Information

Refer to the following provider-specific tabs for information and resources related to reporting caregiver allegations of abuse, neglect or misappropriation.

All Entities Except
Nursing Homes

Reporting Requirements for All Entities Regulated by DQA (except Nursing Homes) P-00907 (PDF, 72 KB) – The DQA established consistent requirements that apply to entities covered under the Caregiver Law to conduct thorough internal investigations and report allegations of caregiver misconduct and injuries of unknown source.

Use Caregiver Misconduct Reporting Requirements Worksheet F-00161 (PDF, 48 KB) and Flowchart of Entity Investigation and Reporting Requirements for Caregiver Misconduct and Injuries of Unknown Source F-00161A (PDF, 22 KB) to assist in making reporting determinations.

 

Use Misconduct Incident Report F-62447 (PDF, 102 KB) to report misconduct allegation investigations.

Nursing Homes Only

Nursing Home Reporting Requirements for Alleged Incidents of Abuse, Neglect, and Misappropriation P-00981 (PDF, 49 KB) — The purpose of this publication is to clarify the reporting requirements for all nursing homes in Wisconsin. For purposes of this publication, an incident includes any allegation involving mistreatment, abuse or neglect of a resident: misappropriation of a resident’s property, or injuries to a resident of unknown source. This publication contains important clarification regarding:

Resident-to-Resident Altercation Flowchart P-00361 (PDF, 31 KB).

 

DQA Memo 11-032 (PDF, 86 KB), Guidance for Investigating & Reporting Alleged Violations in Nursing Homes.

 

DQA Memo 10-008 (PDF, 143 KB), Update: Nursing Home Reporting Requirements for Alleged Incidents of Abuse, Neglect and Misappropriation.

 

Nursing Homes,
Hospices and FDDs

DQA Memo 11-021 (PDF, 47 KB), CMS S&C Memo 11-30 Reporting Reasonable Suspicion of a Crime.

Use Misconduct Incident Report F-62447 (PDF, 102 KB) to report misconduct allegations investigations.

 

Last Revised: July 28, 2015