SB1157 - 561R

Be it enacted by the Legislature of the State of Arizona:

Section 1. Title 36, chapter 4, article 1, Arizona Revised Statutes, is amended by adding section 36-420.04, to read:

START_STATUTE36-420.04. Emergency responders; patient information; hospitals; discharge planning; patient screenings; discharge document

A. An assisted living center or assisted living home that contacts an emergency responder on behalf of a resident shall provide to the emergency responder a written document that includes all of the following:

1. The reason or reasons the emergency responder was requested on behalf of the resident.

2. Whether the resident receives medication services and, if the resident has provided this information to the assisted living center or assisted living home, a list of all the resident's prescription and over-the-counter medications, their dosages and how frequently they are administered.

3. The name, address and telephone number of the resident's current pharmacy.

4. A list of any known allergies to any medications, additives, preservatives or materials like latex or adhesive.

5. The name and contact information for the resident's primary care physician and power of attorney or authorized representative.

6. Basic information about the resident's physical and mental conditions and basic medical history, such as having diabetes or a pacemaker or EXPERIENCING frequent falls or cardiovascular and cerebrovascular events, as well as dates of recent episodes, if known.

7. The point-of-contact information for the assisted living center or assisted living home, including the telephone number, if available, cell phone number and email address. A point of contact must be available to respond to questions regarding the information provided twenty-four hours a day, seven days a week.

8. A copy of the resident's health insurance portability and accountability act release authorizing a receiving hospital to communicate with the assisted living center or assisted living home to plan for the resident's discharge. This paragraph does not preclude a resident from revoking the resident's health insurance portability and accountability act release authorization.

9. A copy of the resident's advance directives, if any, on file at the assisted living center or assisted living home. This paragraph does not preclude a resident from revoking or modifying the resident's advance directives.

B. The assisted living center or assisted living home must notify the resident's authorized representative that the resident was transported to a hospital and provide the name and location of the hospital.

C. Each assisted living center and assisted living home must maintain a standardized form for each resident that includes the information prescribed in subsection A of this section, except for the information prescribed in subsection A, paragraph 1 of this section, which shall be provided at the time the emergency responder is contacted. Each assisted living center and assisted living home shall periodically update this form for each resident as necessary.

D. An assisted living center or assisted living home shall maintain a copy of the document provided to the emergency responder and documentation of the actions required by subsection B of this section for a period of two years after the date of the emergency.

E. If the emergency responder transports the resident to a hospital, the emergency responder shall provide a copy of the written document required by subsection A of this section to the receiving hospital.

F. To protect the health and safety of patients being transferred by a hospital to an assisted living center or assisted living home, a discharging hospital shall coordinate with the health care institution from which the patient has been transferred or the health care institution to which the patient will be discharged and shall provide a written discharge plan for each inpatient. The discharge plan shall:

1. Be prepared by appropriate staff.

2. Include point-of-contact information for the discharging hospital, including a telephone number and, if available, AN email address. The hospital's point of contact shall monitor the telephone and, if available, the email address provided and shall promptly respond to any inquiry. For forty-eight hours after discharge, The discharging hospital's designated point of contact must be available to respond to the receiving assisted living center or assisted living home to assist in returning or admitting the patient to the facility and to clarify any needed information in the discharge plan. Hospitals shall have a qualified hospital representative respond to discharge plan questions received from the assisted living center or assisted living home.

3. Document the patient's discharge evaluation and provide an assessment of the patient's medical or health conditions, including:

(a) Any documented pressure injuries or ulcers, the location on the body and the assessed stage level.

(b) Cognitive or physical conditions or impairments.

(d) Specified dietary requirements, if applicable.

(e) Whether the patient requires continuous medical services or continuous or intermittent nursing services or restraints.

(f) Whether the patient requires specialized medical equipment or home health services and a copy of the hospital's orders for that equipment or those services.

(g) Follow-up health care services and other services recommended for the patient.

4. Include, if applicable, a copy of any prescription that was transmitted to the patient's current pharmacy as designated in subsection A of this section or the medication summary or medication instructions. The copy of the prescription or medication summary or medication instructions shall include the patient's name, medication administration instructions and the signature of the prescriber or a record that the prescription was electronically signed by the prescriber.

5. Document that the hospital notified the receiving assisted living center or assisted living home of any new device orders for the patient.

6. Document that the discharging hospital notified the patient's authorized representative that the patient was discharged and provided the name, location and contact information of the receiving facility.

g. The discharging hospital shall contact the assisted living center or assisted living home from which the patient entered the hospital, after initial inpatient assessment, to discuss an evaluation of the patient's likely postdischarge health care needs. The hospital shall reevaluate and discuss with the assisted living center or assisted living home 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 postdischarge health care needs, including recommendations, if any, by the hospital to transfer the patient to a different facility other than the facility from which the patient entered the hospital to address the patient's higher care needs. The discharging hospital shall provide an opportunity for a patient SCREENING BEFORE discharge by the assisted living center or assisted living home from which the patient entered the hospital or to which the patient is being referred. The assisted living center or assisted living home shall determine through a screening and a review of or discussion about medical records whether the patient's postdischarge care needs, including additional ordered services, are within the facility's scope of services. After receiving notification from the discharging hospital, the assisted living center or assisted living home shall perform the screening promptly. For on-site screenings, the staff of the assisted living center or assisted living home may be required to follow standard hospital security and identification requirements. If the assisted living center or assisted living home from which the patient entered the hospital can no longer meet the patient's needs, the facility shall provide documentation to the hospital demonstrating the reasons why the facility cannot accept the patient back to the facility.

H. For patients being transferred from a hospital to an assisted living center or assisted living home who have not previously been admitted to the assisted living center or assisted living home, the hospital shall coordinate with the assisted living center or assisted living home 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 center or assisted living home.

I. For emergency department or observation patients, the hospital shall provide the assisted living center or assisted living home from which the patient entered the hospital with a point of contact, including a telephone number and, if available, an email address. The hospital's point of contact shall monitor the telephone and, if available, the email address provided and promptly respond to any inquiry. For forty-eight hours after discharge, the discharging hospital's designated point of contact must be available to respond to the receiving assisted living center or assisted living home to assist in returning or admitting the patient to the assisted living center or assisted living home and to clarify any needed information in the discharge plan. Hospitals shall have a qualified hospital representative respond to discharge plan questions received from the assisted living center or assisted living home. The hospital shall also provide the patient's assisted living center or assisted living home with any new prescription orders as prescribed in subsection F, paragraph 4 of this section, a record of medications administered and any identified follow-up care services recommended for the patient. The hospital shall provide the additional information outlined in subsection F, paragraph 3 of this section if the hospital determines it is applicable. An assisted living center or assisted living home from which the patient entered the hospital shall readmit the patient if the assisted living center or assisted living home can meet the care needs for the patient.

J. Each hospital shall develop a discharge document that encompasses the information outlined in subsection F of this section for inpatient discharges. The discharge document shall be provided to the assisted living center or assisted living home to which the patient is being discharged. END_STATUTE

Sec. 2. Effective date

This act is effective from and after December 31, 2023.