Admitting a resident in Belgium

The admission journey — pipeline, candidate’s file, wizard — is described in Admissions and works the same way in every country. This page gathers what Belgium adds to it: the sectors, the NISS, the MDA insurability check, the Katz assessment and the admission agreement sent to the mutuality.

Before the first admission

  • The facility’s approvals are recorded: they decide which stay types the file offers. Without them, the banner This establishment has no approval on file yet appears on the file, with a Record the approvals link.

  • The approval of the sector carries the INAMI number and an active eHealth certificate: the MDA and eAgreement need both. See Belgian settings and eHealth and eFact settings.

The stay type: MR, MRS or day care

The Desired stay type on the Resident Admission tab offers MR, MRS or day care (CSJ), according to the facility’s approvals. It is not required to fill in the file, but it is required to admit: it determines the bed and Annexe 7, the admission document sent to the mutuality.

  • An MRS bed only takes Katz categories B and above; a resident at O or A belongs in an MR bed. Keep the candidate’s dependency in mind when choosing the sector — see The Katz assessment.

  • A day care user is admitted with a CSJ stay in a day place — see Admitting a day care user.

Next to each sector, the file shows the free places against the approval (3/40 free, for example), or not licensed for a sector the establishment has no approval for.

Short stay: 90 days a year

The law caps short stays at 90 days per calendar year. Enter the days already used in number of short-stay days used — ask the family, or confirm with the mutuality — before accepting the admission. The mutuality answers a short-stay request with Annexe 15 or 16 — see Agreements (eAgreement).

The NISS

The NISS is entered with the candidate’s identity on the Resident Admission tab. Everything that follows depends on it: the MDA request and the admission agreement cannot be sent without it.

Rather than typing it, click Read eID Card in the header of the admission request: the card fills in the candidate behind the request — never the relative who enquires — with the NISS, the date of birth, the gender, the nationality and the place of birth, and the request takes the name read from the chip. See Reading the eID card.

  • Check insurability asks for the NISS first when it is missing.

  • If the NISS entered already belongs to a resident, a banner names the existing record and the admission is refused until you click Link to that resident — the normal path for readmitting a former resident. See Admitting a candidate.

  • Before any MDA reply, the identity fields are free: that is how the candidate is created. Once a reply exists, the insurer’s values for name, date of birth, sex and mutuality win and the fields lock — see Insurability (MDA).

Insurability before the admission (MDA)

The health insurer block of the file carries the Belgian fields:

  • Mutuelle, insurance regime, membership code, CT1, CT2, BIM status;

  • MDA Check: MDA check required, latest MDA, MDA status, Insured, last check.

The Check insurability button sends an MDA request and fills in the mutuality, the BIM status and the CT1/CT2 codes on its own.

The MDA gates the admission

As long as the check has not succeeded, moving to Admitted is refused. For a case that does not require it — a candidate with no NISS, for example — untick MDA check required.

If the answer comes back not insured, the admission is still possible: an orange banner warns that billing will have to be addressed to the resident, and the answer is recorded in the file’s history.

When the MDA fails, see MDA errors.

The Katz assessment

The Katz scale block, at the top of the Resident Admission tab, decides the orientation before the identity:

  • New Katz opens an assessment for the candidate;

  • Import a Katz attaches an assessment done elsewhere — a hospital, the previous home — with who assessed it and where.

The category is read in the sector the candidate asks for, and the assessment follows the resident once admitted. A resident who arrives without a validated Katz has no category: no INAMI allowance is billed for them until it is validated. See The Katz assessment and The INAMI allowance.

A readmission after a long hospital stay may require a new Katz assessment: WideCare flags it.

The waiting list checked with the mutualities

A long waiting list ages: some candidates die before a place frees up. Rather than phoning them, ask their mutualities.

  1. In the admission list, filter on Waiting list (requests not admitted, not refused or withdrawn, not given up).

  2. Select the requests and choose Check insurability (MDA) in the Actions menu. One request is checked at once; several open the batch wizard, pre-filled with the current month. Requests without a NISS are counted and listed.

  3. When a mutuality reports a death, the request is closed with the reason Died before admission, a dated note and an activity for the person in charge. An admitted request is never touched; an error or a “not insured” answer closes nothing.

To run this check every month on its own, turn on Waiting list check in the eHealth settings.

When the stay starts: the admission agreement

The wizard’s Stay start date starts the accommodation billing. The Admission Date, set when the stay is started (Start Stay), is the one from which the INAMI allowance runs.

Starting the stay is also what tells the mutuality: WideCare prepares the admission agreement (Annexe 7) as an eAgreement request, with nothing extra to enter. It needs a valid NISS, the mutuality and an active eHealth certificate; the request then follows Draft → Sent → Accepted or Rejected.

What’s next