Updates Regarding ch. DHS 88 Proposed Rule for Licensed 3-4 bed Adult Family Homes

As part of the Division's commitment to Teach, Learn, and Collaborate, the Division of Quality Assurance (DQA) is sharing updates regarding the ch. DHS 88 proposed rule for licensed 3-4 bed Adult Family Homes (AFH).

 Background

Licensed AFHs provide care, treatment, or services to three or four adults that are above the level of room and board, including up to seven hours per week of nursing care per resident. The department proposes to update ch. DHS 88 for the purpose of strengthening provisions related to the health, safety and rights of residents.

DQA held a public hearing on July 7, 2026, and accepted written public comments through July 10, 2026. DQA has made changes to the proposed rule in response to the public comments. Please note that the proposed rule is not yet approved or effective. We are sharing this update for informational purposes and will provide another update once the rule has been published.

Summary of Changes

• Removed sprinkler requirements for new class C AFHs. All class C AFHs will be required to have an interconnected smoke detection system. Class C AFHs will be required to have at least one qualified resident care staff who is awake, on duty, and available at all times if at least one resident requires more than 2 minutes to evacuate the building unless the AFH is equipped with an interconnected smoke detection system with external monitoring and battery backup power supply.
• The definition of class C has changed from 4 minutes or more for evacuation time to up to 4 minutes. Individuals with an evacuation capability that is not compatible with the license classification may not be admitted to or retained by an AFH. An evacuation time greater than 4 minutes was added as a reason for involuntary discharge. All occupants of an AFH must be evacuated in the event of a fire—removed the ability to utilize a designated location within the AFH for rescue.
• Removed registered nurse (RN) requirements for medication administration of other routes. Employees who have completed department-approved training in advanced medication administration and management specific to other administration and are listed on the Wisconsin Community-Based Care and Treatment Registry may administer nebulizers, stomal and enteral medications, and medications, treatments, or preparations delivered vaginally or rectally, and injectables.
• Narrowed the definition of limited health services. Any service or task involving clinical assessment, evaluation, or independent judgment must be performed exclusively by a licensed professional.
• Removed RN requirements for limited health services. Limited health services may be performed by a qualified resident care staff with training in the limited health services from a registered nurse or other licensed health care professional operating within the scope of their license.
• Health screening must be completed within 90 days before admission. Health screening should not be completed after admission. Some exceptions apply.
• New requirements that must be included in the program statement.
• Additional changes were made to the rule in response to public comments and departmental review. 
• The proposed rule order, if approved, will be effective January 1, 2029.

More information and resources to support implementation will be available in the coming months. Once the rule is published, DQA will hold a briefing in December 2026 on the changes made to ch. DHS 88. Briefing details will be shared in the coming weeks. Additional information and resources to support implementation will be available in the coming months.