Definitions in Wisconsin Statute
For the purpose of reporting a death to the Department under 1989 Wisconsin Act 336, the following definitions of "physical restraint" and "psychotropic medication" are found in Wis. Stats. §§ 50.035(5), 50.04(2t), and 51.64(1).
"Physical restraint" includes all of the following:
- A locked room.
- A device or garment that interferes with an individual's freedom of movement and that the individual is unable to remove easily.
- Restraint by a treatment facility staff member of a person admitted or committed to the treatment facility by use of physical force.
"Psychotropic medication" means an antipsychotic, antidepressant, lithium carbonate or a tranquilizer.
Adult Family Home
"Adult Family Home" under Wis. Stat. § 50.01(1)(b) means a place where 3 or 4 adults who are not related to the operator reside and receive care, treatment or services that are above the level of room and board and that may include up to 7 hours per week of nursing care per resident.
Community-Based Residential Facility (CBRF)
"Community-based residential facility" under Wis. Stat. § 50.01(1g) means a place where 5 or more adults who are not related to the operator or administrator and who do not require care above intermediate level nursing care reside and receive care, treatment or services that are above the level of room and board but that include no more than 3 hours of nursing care per week per resident.
"Nursing home" under Wis. Stat. § 50.01(3) means a place where 5 or more persons who are not related to the operator or administrator reside, receive care or treatment and, because of their mental or physical condition, require access to 24-hour nursing services, including limited nursing care, intermediate level nursing care and skilled nursing services.
Treatment Facility (mental health or substance abuse program/service)
"Treatment facility" under Wis. Stat. § 51.01(19) means any publicly or privately operated facility or unit thereof providing treatment of alcoholic, drug dependent, mentally ill or developmentally disabled persons, including but not limited to inpatient and outpatient treatment programs, community support programs and rehabilitation programs.
Providers Required to Report
For a full list of programs/services that are required to report deaths to DHS under this reporting requirement, please refer to the column labeled "Provider Type" in Section II on page 1 of Client / Patient / Resident Death Determination, F-62470.
The term "client/patient/resident," for the purpose of reporting a death, applies to the deceased person when any of the following occurred prior to his or her death:
- The person was formally admitted to the program or facility prior to his or her death.
- The person was court ordered to participate in the program or was protectively placed in a facility.
- The person had received services from the program/service provider.
The deceased person is no longer a "client/patient/resident," for the purpose of reporting his or her death, when any of the following occurred prior to his or her death:
- The person was discharged from the program in accordance with an appropriate individualized discharge plan.
- The person had indicated his or her intent, in writing, to withdraw from the program.
- The person was discharged due to a violation of a specific condition detailed in the admission agreement. In these instances the provider must have attempted to arrange for an alternate placement appropriate to the person's immediate needs.
- The person was discharged in accordance with statutory or regulatory requirements dealing with involuntary discharge.
- The person was discharged pursuant to a court order requiring an alternate placement; or
- The person may have been considered an active case by the provider but did not receive services from the provider during the past 60 days prior to his or her death.
Providers are expected to have made reasonable attempts (including written attempts, telephone contacts, and when appropriate, outreach efforts) to determine the client's location and his or her intent to withdraw from the program.
A "client/patient/resident" is considered to not have been discharged from a provider if:
- he or she is transferred from one provider to another (e.g., a nursing home to a hospital) due to a sudden or temporary change in the client's/patient's condition,
- unless the client/patient/resident was discharged as noted in the "Client/Patient/Resident Discharge" section above.
Client/Patient/Resident Death after Transfer
If a client/patient/resident dies after having been transferred to a provider (due to a sudden or temporary change in the client/patient's condition), and there is cause to believe that the death was related to:
- the use of a restraint or seclusion by that facility
- the use of one or more psychotropic medications
- a suspected suicide
Then the provider to which the person was transferred (other than a medical hospital) must report the death to the DHS.
Both providers involved in the transfer may be included in the Department's investigation of the death.