by Sarah Volpenhein
A bill passed by the Wisconsin Legislature will make it easier for hospitals to discharge certain patients deemed incapacitated to nursing homes, freeing up hospital beds that might otherwise be tied up for weeks.
The bill, which Gov. Tony Evers signed into law on March 20, has the support of hospital systems that complain of long, costly delays in discharging patients who can no longer make medical decisions for themselves and haven’t designated someone to act on their behalf. At present, they remain in the hospital while awaiting court proceedings to appoint a guardian.
“This legislation will help ensure patients can move more quickly to the most appropriate setting for their recovery, while also improving hospital capacity for those who need hospital care,” said Kyle O’Brien, president and chief executive of the Wisconsin Hospital Association, a trade group representing hospitals.
The legislation was opposed by disability and aging rights advocates, who say it circumvents the guardianship process, designed to protect the rights of vulnerable individuals, and could result in patients becoming confined to institutions against their will.
“The guardianship process is complex for a reason,” Lisa Hassenstab, public policy manager at Disability Rights Wisconsin, said during a November hearing on the bill. “That reason is due process.”
The Senate voted 28-5 in favor of the legislation on March 17 during what could be the body’s last floor session for the year.
The bill passed the Assembly in February with bipartisan support, following an amendment adding price transparency requirements for hospitals.
Health systems engaged in heavy lobbying for bill
The legislation received a major push from Wisconsin health systems, hospitals and industry trade groups, which collectively spent more than 400 hours lobbying in favor of the bill, according to reports made to the Wisconsin Ethics Commission.
Wisconsin hospitals spend hundreds of millions of dollars every year housing patients who no longer need hospital care and are awaiting discharge or transfer to nursing homes or other facilities. While the reasons behind
discharge delays are many, the bill addresses only the guardianship issue.
It does not address other underlying causes, such as limited bed availability at nursing homes or the lack of medical facilities accepting complex patients.
Up until now, if physicians deemed a patient no longer able to make medical decisions for themselves and they did not have a power of attorney, the hospital could not discharge the patient to a nursing home until a guardianship petition was filed with a court, even when family members agreed to the transfer. Those proceedings could take weeks or months, hospital officials said.
The patient may be someone who had a stroke, suffered a traumatic brain injury, or has dementia or another agerelated disease and lacks the ability to manage their own health care, whether temporarily or permanently.
The new law removes the requirement to file for guardianship and allows a family member, called a patient representative, to agree to the patient’s admission to a nursing home, make health care decisions for them and approve health-related spending.
Disability advocates argue the legislation removes protections like court oversight that come with the guardianship process while also granting a lot of the same authority as a guardian. They say the legislation does not require that the patient be notified of the representative’s appointment or of their rights to ask for a reevaluation of their mental capacity. Nor does it require the representative to consider the wishes of the patient, they say.
The legislation, they said, also lacks protections against an abuser or estranged relative assuming the role.
“Oftentimes the person who is an abuser is the person who is really keeping an eye on the person in the hospital,” said Tami Jackson, public policy analyst and legislative liaison with the WisconVon sin Board for People with Developmental Disabilities. “Somebody who gets picked under this bill ends up with a whole lot of authority.”
Under the new law, the patient or another family member may object to the nursing home placement, if aware.
Anyone may ask a court to review the patient representative’s actions or may request a reevaluation of the patient’s capacity.
Extended hospital stays can contribute to overcrowding
While promoting the bill, health systems argued that patients may miss out on crucial rehabilitation or other health care while waiting in the hospital for discharge. By remaining in the hospital, they also are at increased risk of hospital-acquired infections or falls especially dangerous for elderly patients.
From January to October 2025, Mayo Clinic Health System counted about 35 patients with extended stays at its northwest Wisconsin hospitals, Gina
Ruden, a Mayo senior nurse administrator, said at a November hearing on the bill. At Mayo’s Eau Claire hospital, that added up to patients spending a collective 1,200 days in the hospital because of guardianship delays, she said.
The extended stays contribute to hospital overcrowding. Mayo Clinic has seen an influx of patients, Von Ruden said, ever since the abrupt closure in 2024 of two area hospitals by Hospital Sisters Health System, a competing health system.
When overcrowded, the Mayo hospital in Eau Claire has to board patients in the emergency department, Von Ruden said, where they may spend the rest of their hospital visit if no bed becomes available on an inpatient floor.
“They might be in a hallway in the emergency department or even in the ambulance bay when things get real tight,” Von Ruden said.
The bill has a three-year sunset provision, which allows legislators to check if the bill is working as intended before renewing it.
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Hospital discharge law concerns advocates
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