Wisconsin Act 115 (2025): Admission to Nursing Homes or CBRFs Without Power of Attorney for Health Care or Guardianship

Effective June 1, 2026, Wisconsin Act 115 (the Act) creates an alternative procedure for a patient’s representative to consent to an incapacitated individual’s admission to a nursing home or community-based residential facility (CBRF) in the absence of an activated Health Care Power of Attorney document or a Guardianship. This “Next-of-Kin” legislation is intended to help eligible incapacitated individuals move from hospitals to nursing homes or CBRFs more efficiently.

What the Act Does

The Act generally keeps existing Wisconsin state law requirements in place, which permits certain family members and next of kin, based on a hierarchical order of priority, to consent to an incapacitated individual’s admission when the individual does not have a valid Health Care Power of Attorney document or a Guardianship, does not object to the admission and has not been adjudicated incompetent. However, the Act provides for two important updates.

First, a hospital patient’s representative may consent to an incapacitated individual’s admission directly from a hospital to a nursing home or a CBRF without filing a petition for guardianship or protective placement. The patient’s representative can also make health care decisions, enroll the incapacitated individual in a Medical Assistance program and authorize expenditures relating to the individual’s health care.

Second, the Act changes how long the patient’s representative’s health care decision-making authority lasts. Instead of ending after the existing 90-day maximum period, the patient representative’s authority continues until:

1. A court appoints the incapacitated individual a guardian;
2. The incapacitated individual is discharged to a setting that is not a nursing home or CBRF;
3. A previously-executed Health Care Power of Attorney document is found; or
4. A physician or advanced practice clinician determines the individual is no longer incapacitated.

Requirements for Patient’s Representatives and Providers

To use the Act’s alternative procedure to consent to the incapacitated individual’s admission to a nursing home or CBRF, a patient’s representative must meet existing state law requirements and sign a declaration under oath on a form prescribed by the Wisconsin Department of Health Services (DHS) “Patient’s Representative Declaration to Act.” Two physicians or a physician and an advanced practice clinician must determine incapacity of the patient and both must also complete and sign a written statement on a DHS-prescribed form, “Medical Certification of Capacity for Determining a Patient’s Representative Authority to Act.”

Other Important Changes

The Act makes several additional changes, which include authorizing either two physicians or one physician and one advanced practice clinician to determine incapacity rather than requiring one physician and one psychologist as provided under prior state law. Importantly, this applies regardless of whether the patient’s representative is acting pursuant to existing state law or the Act’s alternative procedure. The Act also specifies that any person may request reevaluation of the individual’s incapacity determination and it creates a judicial remedy where any person can petition the court to review whether the patient’s representative is acting consistent with the individual’s known wishes or best interests and is satisfying the requirements outlined in the patient’s representative’s declaration. The Act authorizes admissions under the alternative procedure until June 1, 2029.

Recommended Next Steps for Facilities

Nursing homes and CBRFs should review and update their policies, procedures and forms, including those related to admission, consent, documentation practices and discharge planning to align with the Act. Facilities should also ensure staff understand when the alternative procedure may be used, what forms are required, how the patient’s representative’s authority is documented and when legal or clinical review may be appropriate.

If you have questions about the Act, how it may affect your facility or need assistance with implementation of this new procedure, please contact Shareholder Bob Lightfoot or your Reinhart attorney.