DHS 131.17(4) (4) Patient acknowledgement and hospice acceptance. The person seeking admission to the hospice shall be recognized as being admitted after:

DHS 131.17(4)(a) (a) Completion of the assessment under sub. (3).

DHS 131.17(4)(b) (b) Completion of a service agreement in which:

DHS 131.17(4)(b)1. 1. The person or the person’s representative, if any, acknowledges, in writing, that he or she has been informed about admission policies and services.

DHS 131.17(4)(b)2. 2. The hospice agrees to provide care for the person.

DHS 131.17(4)(b)3. 3. The person or the person’s representative, if any, authorizes services in writing.

DHS 131.17(5) (5) Prohibition. Any person determined not to have a terminal illness as defined under s. DHS 131.13 (24) may not be admitted to the hospice.

DHS 131.17 History History: CR 10-034: cr. Register September 2010 No. 657, eff. 10-1-10.

DHS 131.18 DHS 131.18 Discharge.

DHS 131.18(1) (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.

DHS 131.18(2) (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:

DHS 131.18(2)(a) (a) The hospice may discharge a patient:

DHS 131.18(2)(a)1. 1. Upon the request or with the informed consent of the patient or the patient’s representative.

DHS 131.18(2)(a)2. 2. If the patient elects care other than hospice care at any time.

DHS 131.18(2)(a)3. 3. If the patient elects active treatment, inconsistent with the role of palliative hospice care.

DHS 131.18(2)(a)4. 4. If the patient moves out of the geographical area served by the hospice or into a facility that does not have a contract with the hospice.

DHS 131.18(2)(a)5. 5. If the patient requests services in a setting that exceeds the limitations of the hospice’s authority.

DHS 131.18(2)(a)6. 6. For nonpayment of charges, following reasonable opportunity to pay any deficiency.

DHS 131.18(2)(a)7. 7. For the patient’s safety and welfare or the safety and welfare of others, if the hospice determines that the behavior of the patient or 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.

DHS 131.18(2)(a)8. 8. If the hospice determines that the patient is no longer terminally ill.

DHS 131.18(2)(b) (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:

DHS 131.18(2)(b)1. 1. Advise the patient that a discharge for cause is being considered.

DHS 131.18(2)(b)2. 2. Make a serious effort to resolve the problem or problems presented by the patient’s behavior or situation.

DHS 131.18(2)(b)3. 3. Ascertain that the patient’s proposed discharge is not due to the patient’s use of necessary hospice services.

DHS 131.18(2)(b)4. 4. Document the matter and enter this documentation into the patient’s clinical record.

DHS 131.18(3) (3) Notice.

DHS 131.18(3)(a) (a) When a patient is being discharged for a reason given in sub. (2) (a) 1.,2., 3., 4., 5., 7., or 8., the hospice shall give written notice of the discharge to the patient or patient’s representative, if any, a family representative and the attending physician.

DHS 131.18(3)(b) (b) When a patient is being discharged for the reason given in sub. (2) (a) 6., the hospice shall give written notice of the discharge at least 14 days prior to the date of discharge, and indicate a proposed date for pre-discharge planning. The written notice shall be given to the patient or patient’s representative, if any, a family representative and the attending physician.

DHS 131.18(4) (4) Planning. The hospice shall conduct the pre-discharge planning 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.