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REFERENCE TITLE: hospitals; discharge planning; patient assessments |
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State of Arizona Senate Fifty-sixth Legislature First Regular Session 2023
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SB 1157 |
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Introduced by Senators Shope: Shamp
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An Act
amending title 36, chapter 4, article 1, Arizona Revised Statutes, by adding section 36-420.04; relating to health care institutions.
(TEXT OF BILL BEGINS ON NEXT PAGE)
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:
36-420.04. Emergency responders; patient information; hospitals; discharge planning; patient assessments; checklist
A. An assisted living center, assisted living home or behavioral health residential facility 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, assisted living home or behavioral health residential facility, a list of all the resident's prescription and over-the-counter medications, their dosages and how frequently they are administered.
3. A list of any known allergies to any medications, additives, preservatives or materials like latex or adhesive.
4. The name and contact information for the resident's primary care physician and power of attorney or authorized representative.
5. Basic information about the resident's physical and mental conditions and medical history, such as having diabetes or a pacemaker or EXPERIENCING frequent falls or cardiovascular and cerebrovascular events, as well as dates, if known.
6. Insurance information, including copies of medicare insurance, medicare supplement insurance and medicare prescription drug plan cards, if applicable.
7. The point-of-contact information for the assisted living center, assisted living home or behavioral health residential facility, including the person's telephone number, cell phone number and email address. This person must be available to respond to questions regarding the information provided.
B. 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.
C. To protect the health and safety of patients being transferred by a hospital to an assisted living center, assisted living home or behavioral health residential facility, a discharging hospital shall provide written discharge plans for patients receiving hospital services, including services provided during observation, inpatient services, outpatient services or services provided by the hospital's urgent care facility. The discharge plans must:
1. Be prepared by appropriate staff and signed and approved by a nurse practitioner, physician assistant, hospitalist or other physician.
2. Include the name, telephone number, email address and cell phone number of a physician, nurse practitioner, nurse or other qualified licensed medical or nursing professional at the discharging hospital who is available for consultation with the receiving assisted living center, assisted living home or behavioral health residential facility to assist in the return or admission of the patient to the facility and to clarify any needed information in the discharge plan before or immediately after the patient is discharged in order for the receiving facility to provide appropriate care to the patient.
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.
(c) The patient's ability to provide self-care and perform activities of daily living, including personal hygiene and grooming, dressing, undressing, feeding, voluntary control over bowel and bladder functions and ambulation.
(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) The level of care and services recommended for the patient, including whether the patient requires a change in the level of care.
4. Document whether the assisted living center, assisted living home or behavioral health residential facility from which the patient entered the hospital has determined that the facility cannot meet the patient's needs. If the facility from which the patient entered the hospital cannot meet the patient's needs, the hospital shall Document the hospital's assistance to the patient and the patient's representative in selecting an appropriate provider.
5. Document the hospital's assistance to the patient and the patient's representative in selecting an appropriate provider if the patient was not a resident of a facility before entering the hospital, including providing a list of health care institutions in the desired geographic vicinity for all patients who are discharged and need placement.
6. Include the admission order, which is signed and dated by a physician, to the assisted living center, assisted living home or behavioral health residential facility.
7. Include the current medication administration record and medication reconciliation form.
8. Include a medication order from a medical practitioner for each medication that was administered to the patient while in the hospital and the time of the last administration of the medication.
9. Document that the hospital notified the receiving assisted living center, assisted living home or behavioral health residential facility of the name and location of the pharmacy for any new prescription drug or device orders for the patient.
D. The discharging hospital shall provide an opportunity for a patient assessment BEFORE discharge by the assisted living center, assisted living home or behavioral health residential facility from which the patient entered the hospital or to which the patient is being referred. The assisted living center, assisted living home or behavioral health residential facility shall determine through a visual screening and a review of medical records whether the patient's postdischarge care needs, including additional ordered services, are within the facility's scope of services. The discharging hospital shall coordinate the assessment by contacting the assisted living center, assisted living home or behavioral health residential facility at least twelve hours before the patient's discharge. If the patient's discharge is planned to be less than twelve hours after entering the hospital, the hospital shall coordinate the assessment with the assisted living center, assisted living home or behavioral health residential facility and may not discharge the patient until the assessment is completed by the receiving facility.
E. On request of the patient or the patient's representative, the discharging hospital shall provide a list of referral agencies. A referral agency may not be used by the hospital solely to fulfill the discharge planning requirements pursuant to this section. If a referral agency or hospice agency services are used to facilitate the transfer of the patient to a health care institution other than the facility from which the patient entered the hospital, the hospital shall provide the patient's former facility with the name and contact number of the referral agency or hospice agency before discharge.
F. Each hospital shall develop a checklist to be used during the discharge planning process that encompasses the information outlined in subsection C of this section. The checklist shall be provided to the assisted living center, assisted living home or behavioral health residential facility to which the patient is being discharged.