Reporting the Death of a Shelter Resident Guidebook
1.0 Definition of Shelter Resident and Reportable Death
A death of a shelter resident is considered reportable to SSHA if it satisfies the following definition
“Shelter resident” means:
- a client of a shelter program with an active admission who dies on shelter property
- a client of a shelter program with an active admission who dies off shelter property
- a client with an inactive admission because they had been discharged from a shelter program directly to a health care facility such as a hospital or palliative care facility AND who dies within sixty (60) days of being discharged to said facility.
If a shelter resident dies within a shelter facility or outside of the facility but on the property of the shelter, an Incident Report is required in addition to a completed Death of a Shelter Resident Reporting Form.
The Incident Report should be completed in SMIS and a copy submitted with a completed reporting form; the Incident Report does not replace the reporting form (see next section for details).
2.0 Reporting Process
All deaths of shelter residents must be properly documented using the Death of a Shelter Resident Reporting Form (see Appendix). The most up-to-date version of this form is posted on the SSHA website under the “Information for Shelter Providers” expandable menu.
Note: Some steps of the process differ for staff at directly-operated and purchase-of-service shelters. The acronyms DOS (i.e., directly-operated shelter) and POS (i.e., purchase-of-service) are used to highlight a differentiation in process; if it is not indicated, the same step of the process applies to both DOS and POS.
Step 1 – Immediate Notification
When a death occurs, shelter staff should provide written notification via email as soon as possible.
For DOS staff, the email recipients are:
- Director, Homelessness Initiatives and Prevention (HIPS) Unit.
- Manager, Homelessness Initiatives and Prevention (HIPS) Unit
- Research Analyst, Homelessness Initiatives and Prevention (HIPS) Unit
- Coordinator, Programs, Homelessness Initiatives and Prevention (HIPS) Unit
For POS staff, the email recipients is:
- The Agency Review Officer (ARO) assigned to your shelter.
Step 2 – Submit Incident Report within 24 Hours, if applicable
If – and only if – the death occurred within the shelter facility or outside of the facility but on the shelter’s property, an Incident Report is required.
The details of the incident should be entered into the Shelter Management and Information System (SMIS) Incident Report module as per Section 12.5.2(f) of the 2016 Toronto Shelter Standards (TSS).
In addition to the requirements of Section 12.5.2, shelter staff should attempt to document the following:
- the circumstances leading up to death
- any available information on the manner and/or cause of and any contributing factors leading up to death
- the source(s) of the information, both medical and non-medical
- if Next of Kin and/or an Emergency Contact is known and if information was relayed to the proper authorities for notification
- whether wishes for cremation, burial, etc. are known
- how personal belongings and effects will be disbursed or disposed, including any pieces of identification, and
- whether a memorial service will be held.
A copy of the completed Incident Report should then be exported from SMIS and electronically forwarded to the above-noted email recipients – for DOS and POS, respectively – within twenty-four (24) hours of knowledge of death.
Step 3 – Submit Reporting Form Within 14 Calendar Days
For all deaths that satisfy the definition of “shelter resident,” submission of a Death of a Shelter Resident Reporting Form is required. Instructions for completing the form are outlined in the next section.
The completed form should include a hand-written signature of the supervisory- or management-level staff responsible for reporting the death and should be forwarded to the above-noted email recipients – for DOS and POS, respectively – within 14 calendar days of knowledge of death.
A Death of a Shelter Resident Reporting Form will not be accepted if
- it is not the most recent version available
- it is missing mandatory information
- it contains significant error(s)
- it is signed by someone who is not authorized to do so
- it does not contain a hand-written signature of the authorized staff.
When a completed reporting form is found to be unacceptable, follow-up with DOS staff will be conducted by a representative of the Homelessness Initiatives and Prevention (HIPS) Unit (typically, the Research Analyst); follow-up with POS staff will be conducted by their respective ARO.
Re-submission of an acceptable reporting form should occur within forty-eight (48) hours of follow-up.
3.0 Completing a Death of a Shelter Resident Reporting Form
Part 1 – Resident Information
Information for completing this part of the reporting form is obtained from SMIS.
Enter the date of birth of the deceased resident in the same format as SMIS: YYYY/MM/DD.
Part 2 – Most Recent Admission/Discharge Status
Information for completing this part of the reporting form is obtained from SMIS.
If the resident died with an active admission, enter the date of their most recent admission in YYYY/MM/DD format and calculate the Length of Stay in Shelter from the admission date to the date of death.
If the resident died with an inactive admission (i.e., they were discharged to a health care facility and died within 60 days, as per c) of the definition of “shelter resident”), enter the date of their most recent admission and date of discharge in YYYY/MM/DD format and calculate the Length of Stay in Shelter from the admission date to the date of discharge.
In the “Discharged to” drop-down menu of the reporting form, indicate whether the resident was discharged to: Hospital, Detox or Rehab, Hospice or Other Institution. If “Other Institution” is indicated, provide the name of the institution in the available text box.
When a shelter resident dies after discharge at a medical or other institution, shelter staff are expected to collect the above information to the best of their ability with the understanding of the ability of health care providers to share such information.
Part 3 – Date, Time and Location of Death
Obtain the necessary information to complete Part 3 from shelter staff, witnesses, staff from medical or other institutions (if the resident was under their care) and/or the completed Incident Report(s) regarding the death of the resident, if applicable.
Part 4 – Manner and Cause of Death
Indicate that the manner and cause of death is “Verified” only if such information was obtained directly from an original or known true copy of the resident’s Medical Certificate of Death.
If access to a Medical Certificate of Death is not possible or reasonably foreseen to be not possible within the reporting time limit (i.e., 14 calendar days), select “Unverified.”
In the course of completing the form, please keep in mind the following:
- SSHA expects that only factual information will be reported on the form (i.e., free from speculation, reliance on hearsay or undue confidence in non-medical sources)
- SSHA has delegated authority to shelter providers to collect the required information on behalf of the City and acknowledges that there may be limits on the ability to collect the information (e.g., from health care providers), and
- the deceased shelter resident’s privacy must be protected at all times, and that shelter staff responsible for collecting the required information ensure that they will do so with consideration of the sensitivities of the deceased’s next of kin.
Part 5 – Reporting Checklist
The checklist in this part is to ensure completeness of the reporting requirements of a death of a shelter resident. Check all of the boxes that apply.
Part 6 – Certification and Approval
Indicate the name and position of the supervisory- or management-level staff who are accountable for thoroughly reviewing the accuracy and completeness of the information provided in the reporting form.
Date the form at the time of signing in the format YYYY/MM/DD.
A hand-written signature is required to certify the document. Staff should make a hard copy of the reporting form for their record keeping purposes, sign it with dark ink and scan into pdf format in order to facilitate email submission to the appropriate recipients.
4.0 Contact Information
DOS staff with questions regarding this guide and the completion of the Death of a Shelter Resident Report should be forwarded the Research Analyst, HIPS Unit at email@example.com.
For POS staff with questions and/or seeking assistance with the reporting form should contact their respective ARO.