Admission and discharge requirements

The discharge or transfer process

In the state of Wisconsin, community based residential facilities have the right to discharge a resident based upon factors such as violation of resident agreement, inability to meet the residents needs and other issues such as behavioral tendencies. Be sure to be well versed in the following regulation provided by the Wisconsin Department of Health and Family Services before issuing a discharge notice to residents:

DHS 83.31 Discharge or transfer.

(1)  Applicability. This section applies to all resident discharges except for persons in respite care.

(2) Emergency or temporary transfers. If a condition or action of a resident requires the emergency transfer of the resident to a hospital, nursing home or other facility for treatment not available from the CBRF, the CBRF may not involuntarily discharge the resident unless the requirements under sub. (4) are met.

(3) Discharge or transfer initiated by resident.

(a) Any competent resident may initiate transfer or discharge at any time in accordance with the terms of the admission agreement if the resident is not in the custody of a government correctional agency, committed under s. 51.20, Stats., or under a court-ordered protective placement under s. 55.12, Stats.

(b) If a resident found incompetent under ch. 54, Stats., protests the resident’s admission or continued stay, the licensee or designee shall immediately notify the legal representative and the county protective services agency to obtain a determination about whether to discharge the resident under s. 55.055 (3), Stats.

(4) Discharge or transfer initiated by CBRF.

(a) Notice and discharge requirements.

  1. Before a CBRF involuntarily discharges a resident, the licensee shall give the resident or legal representative a 30 day written advance notice. The notice shall explain to the resident or legal representative the need for and possible alternatives to the discharge. Termination of placement initiated by a government correctional agency does not constitute a discharge under this section.
  2. The CBRF shall provide assistance in relocating the resident and shall ensure that a living arrangement suitable to meet the needs of the resident is available before discharging the resident.

(b) Reasons for involuntary discharge. The CBRF may not involuntarily discharge a resident except for any of the following reasons:

  1. Nonpayment of charges, following reasonable opportunity to pay.
  2. Care is required that is beyond the CBRF’s license classification.
  3. Care is required that is inconsistent with the CBRF’s program statement and beyond that which the CBRF is required to provide under the terms of the admission agreement and this chapter.
  4. Medical care is required that the CBRF cannot provide.
  5. There is imminent risk of serious harm to the health or safety of the resident, other residents or employees, as documented in the resident’s record.
  6. As provided under s. 50.03 (5m), Stats.
  7. As otherwise permitted by law.

(c) Notice requirements. Every notice of involuntary discharge shall be in writing to the resident or resident’s legal representative and shall include all of the following:

  1. A statement setting forth the reason and justification for discharge listed under par. (b).
  2. A statement that the resident or the resident’s legal representative may ask the department to review the involuntary discharge by sending a written request within 10 days of receipt of the discharge statement to the department’s regional office with a copy to the CBRF. The notice shall state that the request must provide an explanation why the discharge should not take place.
  3. The name, address and telephone number of the department’s regional office director.
  4. The name, address and telephone number of the regional office of the board on aging and long term care’s ombudsman program. For residents with developmental disability or mental illness, the notice shall include the name, address and telephone number of the protection and advocacy agency designated under s. 51.62 (2) (a), Stats.

(d) Department review of discharge.

  1. A resident may request department review of an involuntary discharge within 10 days of receipt of such notice. If a timely request is sent to the department, the CBRF may not proceed with an involuntary discharge until the department has completed its review and notified the resident or the resident’s legal representative and the CBRF of the department’s decision.
  2. Within 7 days after receiving the copy of the letter requesting the review, the CBRF may provide to the department’s regional office, additional information justifying the discharge.
  3. The department shall complete its review within 10 days after the CBRF submits additional information under subd. 2., if any, and will notify in writing the resident or the resident’s legal representative and the CBRF of the department’s decision.

Note: See Appendix A for the addresses and phone numbers of the Department’s Division of Quality Assurance, Bureau of Assisted Living regional offices.

(e) Coercion and retaliation prohibited. Any form of coercion to discourage or prevent a resident or legal representative from requesting a department review of any notice of involuntary discharge is prohibited. Any form of retaliation against a resident or legal representative for requesting a department review, or against an employee who assists in submitting a request for department review or otherwise provides assistance with a request for review, is prohibited.

(5) Removal or disposal of resident’s belongings. If a resident or the resident’s representative does not remove the resident’s belongings within 30 days after discharge, the CBRF may dispose of the belongings. This subsection does not apply to a resident who absconds from the CBRF and who is under the custody of a government correctional agency or under the legal jurisdiction of a criminal court and for whom there is an apprehension order.

(6) Disbursement of funds.

(a) The CBRF shall return all refunds due a resident within 30 days of the date of discharge as required under s. DHS 83.29 (3).

(b) The CBRF shall return all resident funds held by the CBRF to the resident or the resident’s legal representative within 14 days after discharge as required under s. DHS 83.34 (4).

(7) Information provided at the time of transfer or discharge. At the time of a resident’s transfer or discharge, the CBRF shall inform the resident or the resident’s legal representative and the resident’s new place of residence that all of the following information is available in writing upon request:

(a) Facility information. The name and address of the CBRF, the dates of admission, and discharge or transfer, and the name and address of a person to contact for additional information.

(b) Medical providers. Names and addresses of the resident’s physician, dentist and other medical care providers.

(c) Emergency contacts. Names and addresses of the resident’s relatives or legal representative to contact in case of emergency.

(d) Other contacts. Names and addresses of the resident’s significant social or community contacts.

(e) Assessment and individual service plan. The resident’s assessment and individual service plan, or a summary of each.

(f) Medical needs. The resident’s current medications and dietary, nursing, physical and mental health needs, if not included in the assessment or individual service plan.

(g) Reason for discharge or transfer. The reason for the resident’s discharge or transfer.

Top Takeaways:

  • The CBRF shall provide assistance in relocating the resident and shall ensure that a living arrangement suitable to meet the needs of the resident is available before discharging the resident.

It is best to work with the resident family to find placement for them upon giving a notice of discharge. You do not want to be accused of “dumping” a resident or not assisting them with finding proper arrangements.

  • (b) Reasons for involuntary discharge. The CBRF may not involuntarily discharge a resident except for any of the following reasons:
  1. Nonpayment of charges, following reasonable opportunity to pay.
  2. Care is required that is beyond the CBRF’s license classification.
  3. Care is required that is inconsistent with the CBRF’s program statement and beyond that which the CBRF is required to provide under the terms of the admission agreement and this chapter.
  4. Medical care is required that the CBRF cannot provide.
  5. There is imminent risk of serious harm to the health or safety of the resident, other residents, or employees, as documented in the resident’s record.

These are the only reasons why a resident can be discharged from the facility. If you believe a resident falls under any of these categories you need to meet with the resident/family and develop a discharge plan immediately.

  • (2) The CBRF shall return all refunds due a resident within 30 days of the date of discharge as required under s. DHS 83.29 (3).

After you discharge a resident from the CBRF you have certain loose ends that need to be finalized. These obligations must be handled within a period of 30 days post discharge.

 

 

 

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