Attn: All Regulated Health and Residential Care Providers
Reporting of Client/Patient/Resident Death
The Division of Quality Assurance (DQA) is sending this message as a part of our commitment to Collaboration, Innovation and Quality.
Under Wisconsin statutes, a program or facility must report the death of a client/patient/resident to the Wisconsin Department of Health Services (DHS) if there is cause to believe the death was related to:
- The use of a physical restraint or seclusion.
- The use of one or more psychotropic medications.
- A suspected suicide.
Effective April 1, 2024, reporting of client/patient/resident death will be submitted via the ACCESSGOV Client/Patient/Resident Death Determination, F-62470.
This form includes guidelines to help you determine if the death is a reportable death, such as:
- The types of providers required to report a death.
- General information and death determination guidelines.
Additional information can be found on the Regulations: Reporting of Client/Patient/Resident Death webpage.
If you have a question about this information, email DHSDqaDeathReporting@dhs.wisconsin.gov.
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