Wis. Stat. § 50.06 — WI Code / Chapter 50 / Section 50.06
Certain admissions to facilities.
Status: in_force

(1) In this section:

(a) “Adult-at-risk agency” has the meaning given in s. 55.01 (1f) .

(b) “Advanced practice clinician” has the meaning given in s. 155.01 (1g) .

(c) “Incapacitated” means unable to receive and evaluate information effectively or to communicate decisions to such an extent that the individual lacks the capacity to manage his or her health care decisions, including decisions about his or her post-hospital care.

(d) “Patient’s representative” means the individual described under sub. (3) who may consent to an admission of an incapacitated individual under sub. (2) .

(2) An individual under sub. (3) may consent to admission, directly from a hospital to a facility, of an incapacitated individual who does not have a valid power of attorney for health care and who has not been adjudicated incompetent in this state, if all of the following apply:

(a) No person who is listed under sub. (3) in the same order of priority as, or higher in priority than, the individual who is consenting to the proposed admission disagrees with the proposed admission.

(am)

1. Except as provided in subd. 2. , no person who is listed under sub. (3) and who resides with the incapacitated individual disagrees with the proposed admission.

2. Subdivision 1. does not apply if any of the following applies:

a. The individual who is consenting to the proposed admission resides with the incapacitated individual.

b. The individual who is consenting to the proposed admission is the spouse or domestic partner under ch. 770 of the incapacitated person.

(b) The individual for whom admission is sought is not diagnosed as developmentally disabled or as having a mental illness, as defined in s. 51.01 (13) (a) , at the time of the proposed admission.

(c) Unless the incapacitated individual is admitted to a facility under sub. (8) , a petition for guardianship for the individual under s. 54.34 and a petition under s. 55.075 for protective placement of the individual are filed prior to the proposed admission.

(d) The incapacitated individual does not verbally object to or otherwise actively protest the admission. If he or she makes such an objection or protest, he or she may be admitted to the facility, but the person in charge of the facility shall immediately notify the county department under s. 55.02 (2) for the county in which the individual is living or the agency with which the county department contracts. Representatives of the county department or agency shall visit the individual as soon as possible, but not later than 72 hours after notification, and do all of the following:

1. Determine whether the protest persists or has been voluntarily withdrawn and consult with the person who consented to the admission regarding the reasons for the admission.

2. Attempt to have the incapacitated individual released within 72 hours if the protest is not withdrawn and the individual does not satisfy all of the criteria under s. 55.08 (1) or 55.135 (1) , and provide assistance in identifying appropriate alternative living arrangements.

3. Comply with s. 55.135 if the requirements of s. 55.135 (1) are met and emergency protective placement in that facility or another facility is necessary. The court, with the permission of the facility, may order the incapacitated individual to remain in the facility pending the outcome of the protective placement proceedings.

(3) The following individuals, in the following order of priority, may consent to an admission under sub. (2) :

(a) The spouse or domestic partner under ch. 770 of the incapacitated individual.

(b) An adult son or daughter of the incapacitated individual.

(c) A parent of the incapacitated individual.

(d) An adult brother or sister of the incapacitated individual.

(e) A grandparent of the incapacitated individual.

(f) An adult grandchild of the incapacitated individual.

(g) An adult close friend of the incapacitated individual.

(4)

(a) A determination that an individual is incapacitated for purposes of sub. (2) shall be made by 2 physicians, as defined in s. 448.01 (5) , or by one physician and one advanced practice clinician, who personally examine the individual and sign a statement specifying that the individual is incapacitated. Mere old age, eccentricity, or physical disability, either singly or together, are insufficient to make a finding that an individual is incapacitated. Neither of the individuals who make a finding that an individual is incapacitated may be a relative, as defined in s. 242.01 (11) , of the individual or have knowledge that he or she is entitled to or has a claim on any portion of the individual’s estate. A copy of the statement shall be included in the individual’s records in the facility to which he or she is admitted.

(b) A physician or advanced practice clinician who has determined that an individual is incapacitated for purposes of sub. (2) shall, if the individual is admitted to a facility under sub. (8) , prepare a written statement on a form prescribed by the department stating that they personally examined the incapacitated individual, the date and location that the physician or advanced practice clinician determined the individual is incapacitated for purposes of sub. (2) , the medical conditions of the individual, if any, that led the physician or advanced practice clinician to conclude that the individual is incapacitated, the physician’s or advanced practice clinician’s office address and contact information, and any other information identified by the department. A copy of the written statement shall be included in the incapacitated individual’s patient health care records and shall, within 72 hours following admission of the incapacitated individual to a facility under sub. (8) , be filed with the register in probate for the county in which the incapacitated individual resides and sent to the adult-at-risk agency for the county in which the incapacitated individual resides. An adult-at-risk agency receiving a written statement is under no obligation to take any action with respect to the statement.

(c) A physician or advanced practice clinician who determines that an individual is no longer incapacitated for purposes of sub. (8) (f) shall, if the individual was admitted as an incapacitated individual to a facility under sub. (8) , prepare a written statement that they personally examined the individual, the date and location that the physician or advanced practice clinician determined the individual is no longer incapacitated for purposes of sub. (8) (f) , the medical conditions of the individual, if any, that led the physician or advanced practice clinician to conclude that the individual is no longer incapacitated, the physician’s or advanced practice clinician’s office address and contact information, and any other information identified by the department. A copy of the written statement shall be included in the individual’s patient health care records and shall, within 72 hours of a determination made under this paragraph, be filed with the register in probate for the county in which the individual resides and sent to the adult-at-risk agency for the county in which the individual resides. An adult-at-risk agency receiving a written statement is under no obligation to take any action with respect to the statement.

(5)

(a) Except as otherwise provided in pars. (am) and (b) , a patient’s representative may, for the incapacitated individual, make health care decisions to the same extent as a guardian of the person may, enroll the incapacitated individual in the Medical Assistance program under subch. IV of ch. 49 to the same extent as a guardian of the estate may, and authorize expenditures related to health care to the same extent as a guardian of the estate may, until the earliest of the following:

1. Sixty days after the admission to the facility of the incapacitated individual.

2. Discharge of the incapacitated individual from the facility.

3. Appointment of a guardian for the incapacitated individual.

(am) Except as otherwise provided in pars. (ar) and (b) , a patient’s representative may, for the incapacitated individual, make health care decisions to the same extent as a guardian of the person may, enroll the incapacitated individual in the Medical Assistance program under subch. IV of ch. 49 to the same extent as a guardian of the estate may, and authorize expenditures related to health care to the same extent as a guardian of the estate may if the patient’s representative consents to admission for the incapacitated individual in the manner provided in sub. (8) . Any authority of a patient’s representative under this paragraph ends if any of the following occurs:

1. A court appoints a guardian to make such decisions for the incapacitated individual.

2. The incapacitated individual is discharged to a setting that is not a facility.

3. A health care power of attorney that was not identified at the time that the patient’s representative was established is identified.

4. The incapacitated individual is determined to no longer be incapacitated as provided in sub. (8) (f) .

(ar) No patient’s representative may consent to admission for an incapacitated individual in the manner provided in sub. (8) after June 1, 2029.

(b) A patient’s representative may not authorize expenditures related to health care if the incapacitated individual has an agent under a durable power of attorney, as defined in s. 244.02 (3) , who may authorize expenditures related to health care.

(6) Unless the incapacitated individual was admitted to a facility under sub. (8) , if the incapacitated individual is in the facility after 60 days after admission and a guardian has not been appointed, the authority of the patient’s representative to make decisions and, if sub. (5) (a) applies, to authorize expenditures is extended for 30 days for the purpose of allowing the facility to initiate discharge planning for the incapacitated individual.

(7) A patient’s representative may request a functional screening and a financial and cost-sharing screening to determine eligibility for the family care benefit under s. 46.286 (1) . If admission is sought on behalf of the incapacitated individual or if the incapacitated individual is about to be admitted on a private pay basis, the patient’s representative may waive the requirement for a financial and cost-sharing screening under s. 46.283 (4) (g) , unless the incapacitated individual is expected to become eligible for medical assistance within 6 months.

(8)

(a) A patient’s representative may consent to an admission of an incapacitated individual under sub. (2) without a petition for guardianship or protective placement of the incapacitated individual being filed if all of the following apply:

1. The incapacitated individual is admitted directly from a hospital inpatient unit.

2. The patient’s representative signs a declaration under oath and promptly submits the signed declaration to the discharging hospital and the accepting facility, to the adult-at-risk agency for the county in which the incapacitated individual resides, to all of the incapacitated individual’s family members that can be reasonably contacted following admission of the incapacitated individual to a facility under this subsection, and to the register in probate for the county in which the incapacitated individual resides for filing. An adult-at-risk agency receiving a declaration is under no obligation to take any action with respect to the declaration. The department shall prescribe a form declaration for use by a patient’s representative under this subdivision. A declaration submitted under this subdivision shall include all of the following:

a. A written acknowledgment that the patient’s representative may make decisions or authorize expenditures under sub. (5) (am) .

b. A written statement that the patient’s representative agrees to make health care decisions regarding the admission to and care and treatment at the accepting facility on the incapacitated individual’s behalf and agrees to authorize expenditures related to health care received at the accepting facility on the incapacitated individual’s behalf under sub. (5) (am) .

c. A written statement that, to the best knowledge of the patient’s representative, the incapacitated individual does not have a health care agent, as defined in s. 155.01 (4) , or guardian of the person, as defined in s. 54.01 (12) .

d. A written statement that, to the best knowledge of the patient’s representative, the patient’s representative does not have an activated power of attorney for health care and has not been adjudicated incompetent in this state.

e. A written statement that, when acting on behalf of the incapacitated individual under sub. (5) (am) , the patient’s representative agrees to exercise the degree of care, diligence, and good faith that an ordinarily prudent person exercises in his or her own affairs.

f. A written statement that the patient’s representative understands his or her role and responsibilities as the patient’s representative under sub. (5) (am) .

g. A written statement that, to the best knowledge of the patient’s representative, a family member in a higher priority class under sub. (3) does not exist or no family member in a higher priority class is willing to make health care decisions on the incapacitated individual’s behalf under sub. (5) (am) .

h. A list of all of the incapacitated individual’s family members to whom the patient’s representative will send the signed declaration under this subdivision.

(b) A hospital discharging an incapacitated patient to a facility under this subsection shall be in compliance with 42 CFR 482.13 (b) (3) or 42 CFR 485.608 (a) regarding the implementation of the patient’s rights to formulate advance directives. A nursing home admitting the incapacitated individual shall be in compliance with the requirements under 42 CFR 483.10 (b) (3) to (6) that a resident be afforded the right to designate a representative, including the requirement that if the nursing home has reason to believe that a resident representative is making decisions or taking actions that are not in the best interests of the resident then the nursing home shall report such concerns as required by state law.

(c) Nothing in this subsection or sub. (5) (am) may be construed to preclude the administration of health care treatment in accordance with accepted standards of medical practice and as otherwise provided by law.

(d) The discharging hospital and the accepting facility shall include a copy of the signed declaration under par. (a) 2. in the incapacitated individual’s health care record.