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; checklist

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.

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.

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 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 point-of-contact information for the discharging hospital, including a telephone number, AN email address and, if available, a cell phone number, that will be monitored and responded to twenty-four hours a day, seven days a week. The discharging hospital's designated point of contact must be available to consult with 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 before or WITHIN FORTY-EIGHT HOURS after the patient is discharged in order for the receiving facility to provide appropriate care to the patient. If the point of contact is not a licensed medical or nursing professional and the consultation requires a qualified licensed medical or nursing professional, the discharging hospital will implement procedures to provide such consultation.

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) 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 or assisted living home 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 or assisted living home.

7. Include the current medication administration record and medication reconciliation form.

8. Include a medication order from a medical practitioner for any new medication that was prescribed to the patient while in the hospital and that the patient is expected to continue after discharge.

9. Include a copy of the prescription and a confirmation that the prescription was transmitted to the patient's current pharmacy as designated in subsection A of this section.

10. Document that the hospital notified the receiving assisted living center or assisted living home of the name and location of the pharmacy for any new prescription drug or device orders for the patient.

11. 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 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 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 SCREENING WITH the assisted living center or assisted living home. The hospital may not discharge the patient until the SCREENING is completed by the receiving facility. After receiving notification from the discharging hospital, the assisted living center or assisted living home shall perform the screening within four hours for patients being discharged from inpatient services and within two hours for patients being discharged from the emergency room, outpatient treatment, urgent care or observation.

H. An assisted living center or assisted living home from which the patient entered the hospital shall readmit the patient after hospital discharge if that assisted living center or assisted living home can meet the care needs for the patient.

i. 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.

j. Each hospital shall develop a checklist to be used during the discharge planning process that encompasses the information outlined in subsection g of this section. The checklist shall be provided to the assisted living center or assisted living home to which the patient is being discharged.END_STATUTE