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ARIZONA HOUSE OF REPRESENTATIVESFifty-sixth Legislature First Regular Session |
Senate: HHS DPA 7-0-0-0 | 3rd Read 30-0-0-0
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SB 1157: hospitals; discharge planning; patient assessments
Sponsor: Senator Shope, LD 16
House Engrossed
Overview
Requires, effective January 1, 2024, assisted living centers and homes (assisted living facilities) and hospitals to provide and exchange written discharge plans with each other when discharging and transferring a patient. Prescribes standards and procedures for hospitals and assisted living facilities discharge plans.
History
The Arizona Department of Health Services Bureau of Residential Facilities Licensing is responsible for the licensure and regulation of residential care institutions, including assisted living centers or homes amongst other facilities.
Under current law, a residential care institution means a health care institution other than a hospital or nursing care institution that provides resident beds or residential units, supervisory or personal care services, behavioral health, directed care or health-related services for persons who do not need continuous nursing services. Additionally, an assisted living center means an assisted living facility that provides resident rooms or residential units to 11 or more residents and assisted living homes means an assisted living facility that provides resident rooms to 10 or fewer residents (A.R.S. § 36-401).
Provisions
Assisted Living Facility Discharge Plans
1. Directs assisted living facilities to provide an emergency responder with a written document that contains specific resident contact and medical information, including a copy of the resident's signed Health Insurance Portability and Accountability Act (HIPAA) release and any advanced directives if the facility contacts the emergency responder on behalf of the resident. (Sec. 1)
2. Clarifies that nothing precludes a resident of an assisted living facility from revoking or modifying their HIPAA release authorization or advance directives. (Sec. 1)
3. Instructs assisted living facilities to notify the resident's authorized representative that the resident was transported to a hospital and provide the name and location of the hospital. (Sec. 1)
4. Requires assisted living facilities to maintain and periodically update their standardized form for each resident that includes their personal contact and medical information, except for the reason the emergency responder was requested which must be provided at the time the emergency responder is contacted. (Sec. 1)
5.
Requires assisted living facilities to
maintain a copy of the discharge document provided to the emergency responder
and documentation of the facility's compliance with resident transfers for a
period of two years after the date of the emergency. (Sec. 1)
6. Specifies that if the emergency responder transports the resident to a hospital, they must provide a copy of the written discharge document to the receiving hospital. (Sec. 1)
7. Requires an assisted living facility to provide documentation to the discharge hospital demonstrating the reasons why they cannot accept the patient back to their facility if it is determined they can no longer meet the patient's needs. (Sec. 1)
Hospital Discharge Plans
9. Requires hospital discharge plans to:
a) be prepared by appropriate staff;
b) include point-of-contact information for the discharging hospital, including a telephone number and, if available, an email address; and
c) include, if applicable, a copy of any prescription that was transmitted to the patient's current pharmacy or medication summary or medication instructions. (Sec. 1)
10. Specifies that the copy of the prescription, medication summary or medication instructions must also include the patient's name, medication administration instructions, prescriber's signature or a record that the prescription was electronically signed by the prescriber. (Sec. 1)
11. Requires a hospital's discharge plan to document:
a) the patient's discharge evaluation and assessment of the patient's medical or health conditions;
b) that the hospital notified the receiving assisted living facility of any new device orders for the patient; and
c) that the discharging hospital notified the patient's authorized representative that the patient was discharged and provided the receiving facilities name, contact and location information. (Sec. 1)
12. Outlines the type of information the patient's discharge evaluation and assessment must include. (Sec. 1)
13. Tasks a discharging hospital's point of contact with monitoring the telephone and, if available, the email address provided and promptly respond to any inquiries. (Sec. 1)
14. Delegates a discharging hospital's point of contact with being available to respond to the receiving assisted living facility to assist in returning or admitting the patient to the facility and clarify any needed information in the discharge plan for 48 hours after discharge. (Sec. 1)
15. Requires hospitals to have a qualified hospital representative to respond to discharge plan questions received from the assisted living facilities. (Sec. 1)
16. Outlines hospital point of contact procedures and discharging processes for outpatient emergency services and observation patients. (Sec. 1)
17. Instructs hospitals to coordinate with an assisted living facility to allow time to expeditiously obtain documentation from a physician, registered nurse practitioner, registered nurse or physician assistant coordinating the level of care needed in the assisted living facility for patients being transferred from a hospital to an assisted living facility who have not been previously admitted to the facility. (Sec. 1)
Patient Screening
18. Tasks discharging hospitals with contacting assisted living facilities from which the patient entered the hospital, after initial inpatient assessment, to discuss an evaluation of the patient's likely post discharge health care needs. (Sec. 1)
19. Requires hospitals to reevaluate and discuss with assisted living facilities from which the patient entered the hospital the patient's condition, as appropriate, to identify changes to the patient's condition that may impact the patient's post discharge health care needs, including, if any, recommendations by the hospital to address the patient's high care needs. (Sec. 1)
20. Directs discharging hospitals to provide an opportunity for patient screenings before discharging by the assisted living facility from which the patient entered the hospital or to which the patient is being referred. (Sec. 1)
21. States that an assisted living facility must determine through a screening and a review of or discussion about medical records whether the patient's post discharge care needs, including additional ordered services, are within the facility's scope of services. (Sec. 1)
22. Requires, after receiving notification from the discharging hospital, the assisted living facility to perform the screening promptly. (Sec. 1)
23. Specifies that for on-site screenings, the staff of assisted living facilities may be required to follow standard hospital security and identification requirements. (Sec. 1)
24. Requires each hospital to develop a discharge document that encompasses all required discharge planning information for inpatient discharges. (Sec. 1)
25. Requires a hospital's discharge document to be provided to the assisted living facility to which the patient is being discharged. (Sec. 1)
26. Contains an effective date of January 1, 2024. (Sec. 2)
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30. SB 1157
31. Initials AG/BSR Page 0 House Engrossed
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