Section 131.18. Discharge.

 

(1)   Obligation. Once a hospice has admitted a patient to the program, and the patient or the patient's representative, if any, has signed the acknowledgement and authorization for services under s. DHS 131.17 (4) (b) , the hospice is obligated to provide care to that patient.

(2)   Written policy. The hospice shall have a written policy that details the manner in which the hospice is able to end its obligation to a patient. This policy shall be provided to the patient or patient's representative, if any, as part of the acknowledgement and authorization process at the time of the patient's admission. The policy shall include all of the following as a basis for discharging a patient:

(a) The hospice may discharge a patient:

1. Upon the request or with the informed consent of the patient or the patient's representative.

2. If the patient elects care other than hospice care at any time.

3. If the patient elects active treatment, inconsistent with the role of palliative hospice care.

4. If the patient moves beyond the geographical area served by the hospice.

5. If the patient requests services in a setting that exceeds the limitations of the hospice's authority.

6. For nonpayment of charges, following reasonable opportunity to pay any deficiency.

7. For the patient's safety and welfare or the safety and welfare of others.

8. If the hospice determines that the patient is no longer terminally ill.

(b) The hospice shall do all of the following before it seeks to discharge a patient whose behavior or the behavior of other persons in the patient's home, is disruptive, abusive, or uncooperative to the extent that delivery of care to the patient or the ability of the hospice to operate effectively is seriously impaired:

1. Advise the patient that a discharge for cause is being considered.

2. Make a serious effort to resolve the problem or problems presented by the patient's behavior or situation.

3. Ascertain that the patient's proposed discharge is not due to the patient's use of necessary hospice services.

4. Document the matter and enter this documentation into the patient's clinical record.

(3)   Procedure. When a patient is being discharged pursuant to sub. (2) (a) 2. , 3. , 4. , 5. , or 6. , the hospice shall give written notice to the patient or patient's representative, if any, family representative and attending physician at least 14 days prior to the date of discharge, with a proposed date for a pre-discharge planning conference.

(4)   Planning conference. The hospice shall conduct the pre-discharge planning conference with the patient or the patient's representative and review the need for discharge, assess the effect of discharge on the patient, discuss alternative placements and develop a comprehensive discharge plan.

History: CR 10-034 : cr. Register September 2010 No. 657 , eff. 10-1-10.