Certain admissions to facilities
Wis. Stat. § 50.06
in effect(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.
(e)
1. Any person, including the adult-at-risk agency for the county in which the incapacitated individual resides or the corporation counsel for the county in which the incapacitated individual resides, may petition the court to review whether the patient’s representative is acting in accordance with the known wishes or in the best interest of the incapacitated individual and is exercising the degree of care, diligence, and good faith when acting on behalf of the incapacitated individual that an ordinarily prudent person exercises in his or her own affairs.
2. Notice of a petition under this paragraph shall be in writing. A copy of the petition and any related motion or other documents filed with the court shall be attached to the notice. Unless otherwise provided, notice may be delivered in person, by certified mail with return receipt requested, or by facsimile transmission. Notice is considered to be given by proof of personal delivery or by proof that the notice was mailed to the last-known address of the recipient or was sent by facsimile transmission to the last-known facsimile transmission number of the recipient. Failure of the petitioner to provide notice to all interested persons shall deprive the court of jurisdiction unless receipt of notice is waived by the interested person or by the court under subd. 3. b.
3. Upon the filing of a petition under this paragraph, the court shall, except as provided in subd. 4., order the petitioner to serve notice on the incapacitated individual and to deliver notice to interested persons of the time and place of the hearing as follows:
a. On the incapacitated individual by personal service at least 10 days before the time set for hearing. The process server shall inform the incapacitated individual of the complete contents of the notice and petition, motion, or other required document; certify on the notice that the process server served and informed the incapacitated individual; and return the certificate and notice to the court.
b. Personally or by mail at least 10 days before the time set for hearing to the incapacitated individual’s counsel, if any; the incapacitated individual’s guardian ad litem, if any; any presumptive adult heirs, as specified in s. 851.09, of the incapacitated individual; any other interested persons, unless specifically waived by the court; any public or private agency, charity, or foundation from which the incapacitated individual is receiving aid or assistance; and any other person that the court requires.
4. The court may, in response to a petition filed under subd. 1., after a hearing, issue any order that the court determines necessary to protect the incapacitated individual, including an order that does any of the following:
a. Directs the patient’s representative to act in the best interest of the incapacitated individual.
b. Requires the patient’s representative to report to the court periodically on the incapacitated individual’s status. The court may require that the report include a financial accounting of expenditures authorized under sub. (5) (am) within 72 hours of the court’s order.
c. Directs the patient’s representative not to make certain decisions or authorize certain expenditures under sub. (5) (am).
5. The court may appoint a guardian ad litem for purposes of proceedings under this paragraph. A guardian ad litem appointed under this subdivision shall be an attorney admitted to practice in this state and in compliance with the standards required for a guardian ad litem under ch. 54 set forth under SCR chapter 36. No one who is an interested person in a proceeding, appears as counsel in a proceeding on behalf of any party, or is a relative or representative of an interested person may be appointed guardian ad litem in that proceeding or in any other proceeding that involves the same incapacitated individual. The guardian ad litem shall be an advocate for the best interests of the incapacitated individual. The guardian ad litem shall function independently, in the same manner as an attorney for a party to the action, and shall consider, but is not bound by, the wishes of the incapacitated individual or the positions of others as to the best interests of the incapacitated individual. The guardian ad litem has none of the rights or duties of a guardian. The guardian ad litem shall perform all acts that are reasonably necessary to promote the incapacitated individual’s best interests.
6. Except as otherwise provided under subd. 7., in any proceeding under this paragraph, the court may require the patient’s representative to pay personally any costs of the proceeding, including costs of service and attorney fees.
7. If the court appoints a guardian ad litem under subd. 5., unless the court otherwise directs, the court may order reasonable compensation to be paid to the guardian ad litem from the incapacitated individual’s income or assets, if sufficient, or, if insufficient, by the county of venue, except that if court finds that the patient’s representative is not acting in accordance with the standards described under subd. 1., the court shall order the patient’s representative to pay the compensation of the guardian ad litem. If a petition to the court under this paragraph is dismissed or the court otherwise finds that the patient’s representative is acting in accordance with the standards described under subd. 1., the court shall order the petitioner to pay the compensation of the guardian ad litem. If the court orders a county to pay the compensation of the guardian ad litem, the amount ordered may not exceed the compensation paid to a private attorney under s. 977.08 (4m). The guardian ad litem shall receive compensation for performing all acts that are reasonably necessary to promote the incapacitated individual’s best interests.
(f) If an incapacitated individual is admitted to a facility pursuant to this subsection, any person, including the adult-at-risk agency for the county in which the incapacitated individual resides, the corporation counsel for the county in which the incapacitated individual resides, or any facility staff, may request that the incapacitated individual be reevaluated under sub. (4). The authority of a patient’s representative to make health care decisions or authorize expenditures under sub. (5) (am) ends if the individual is determined to no longer be incapacitated.
(g)
1. In this paragraph:
a. “Health care facility” has the meaning given in s. 155.01 (6).
b. “Health care provider” has the meaning given in s. 155.01 (7).
2. No health care facility or health care provider may be charged with a crime, held civilly liable, or found guilty of unprofessional conduct for any of the following:
a. Certifying incapacity under sub. (4) if the certification is made in good faith based on a thorough examination of the individual.
b. Failing to comply with a decision of a patient’s representative except that failure of a health care professional, as defined in s. 154.01 (3), to comply constitutes unprofessional conduct if the health care professional refuses or fails to make a good faith attempt to transfer the incapacitated patient to another health care professional who will comply.
c. Complying, in the absence of actual knowledge of a limitation or revocation of decision-making authority under par. (e), with the decisions of a patient’s representative that is made in compliance with this subsection.
d. Acting contrary to or failing to act pursuant to any orders issued under par. (e), unless the health care facility or health care provider has actual knowledge of the order.
e. Failing to obtain a health care decision for a patient from a patient’s representative if the health care facility or health care provider has made a reasonable attempt to contact the patient’s representative and obtain the health care decision but has been unable to do so.
3. In the absence of actual notice to the contrary, a health care facility or health care provider may presume that a patient’s representative is authorized to make decisions on behalf of the incapacitated patient if the patient’s representative has provided the signed declaration required under par. (a) 2.
4. No patient’s representative may be charged with a crime or held civilly liable for making a decision in good faith that is in compliance with this subsection, except when the patient’s representative has acted in bad faith or has authorized health care expenditures for the benefit of a person other than the incapacitated patient. No patient’s representative who is not the spouse of the incapacitated patient may be held personally liable for any goods or services for which expenditure was authorized or contracted for pursuant to the patient’s representative’s authority under sub. (5) (am).
(h) Annually, upon request by the department, each register in probate shall submit to the department the number of declarations received under this subsection. By April 1, 2027, and annually thereafter, the department shall submit a report to the appropriate standing committees of the legislature under s. 13.172 (3) on the number of patients admitted into a facility under this subsection.
Source: WI Statutes (Official Site)URL: https://docs.legis.wisconsin.gov/document/statutes/50.06Fetched: 10/7/2026