A new Arizona law imposes several written disclosure requirements that Arizona health facilities must provide to emergency responders when transferring an individual into their care. The new Arizona law (“Arizona Assisted Living Law”) also calls for several written disclosure requirements that Arizona hospitals must provide to an assisted living facility when transferring and discharging an individual into the care of an assisted living facility.
Assisted Living Facility Disclosures to Emergency Responders
The Arizona Assisted Living Law requires that when assisted living providers contact an emergency responder on behalf of a resident, they must provide the emergency responder with a written document that contains:
- The reason or reasons the emergency responder was requested.
- If the resident receives medication services. If so, and if the resident has provided this information to the assisted living facility, the assisted living facility must provide a list of the resident’s prescription and over-the-counter medications, dosages and frequency of administration.
- The name, address and telephone number of the resident’s current pharmacy.
- A list of any known allergies to any medications, additives, preservatives or materials like latex or adhesive.
- The name and contact information of the resident’s primary care physician and power of attorney or authorized representative.
- 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, and dates of recent episodes, if known.
- The point-of-contact information for the assisted living facility, 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 24 hours per day, seven days per week.
- A copy of the resident’s HIPAA release authorizing a receiving hospital to communicate with the assisted living facility to plan for the resident’s discharge.
- A copy of the resident’s advance directives, if any, on file at the assisted living facility.
Each assisted living facility must maintain a standardized form for each resident that includes the information listed above, except that the reason or reasons the emergency responder was requested shall be provided at the time the emergency responder is contacted. Each assisted living facility shall periodically update this form for each resident as necessary.
An assisted living facility must maintain a copy of the document provided to the emergency responder and documentation of the actions required by the Arizona Assisted Living Law for a period of two years after the date of the emergency event.
If an emergency responder transports the resident to a hospital, the emergency responder must provide a copy of the written document required by the Arizona Assisted Living Law to the receiving hospital.
Assisted Living Facility Disclosures to Resident Representatives
The Arizona Assisted Living Law requires that when the assisted living provider transfers a resident to the hospital, the assisted living facility must notify the resident’s authorized representative that the resident was transported to a hospital and provide the name and location of the hospital.
Hospital Discharge Disclosure Requirements
The Arizona Assisted Living Law requires that a discharging hospital coordinate with the health care institution from which the patient has been transferred or another health care institution to which the patient will be discharged and shall provide a written discharge plan for each inpatient. The discharge plan shall be prepared by appropriate staff. The discharge plan will include point-of-contact information for the discharging hospital, and the hospital’s point of contact shall promptly respond to any inquiry made within 48 hours after discharge to assist in returning or admitting the patient or to clarify any needed information in the discharge plan.
The hospital must also provide a document regarding the patient’s discharge evaluation and provide an assessment of the patient’s medical or health conditions, including:
- Any documented pressure injuries or ulcers, including the location on the body and the assessed stage level.
- Cognitive or physical conditions or impairments.
- The patient’s weight-bearing status.
- Specified dietary requirements, if applicable.
- Whether the patient requires continuous medical services or continuous or intermittent nursing services or restraints.
- 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.
- Follow-up health care services and other services recommended for the patient.
The hospital must include, if applicable, a copy of any prescription transmitted to the patient’s current pharmacy as well as the medication summary or instructions. The copy of the prescription, 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.
The hospital must also document that it notified (i) the receiving assisted living facility of any new device orders for the patient; and (ii) the patient’s authorized representative that the patient was discharged and provided the name, location and contact information of the patient’s assisted living facility or other health care institution to which the patient was discharged.
Under the Arizona Assisted Living Law, each hospital shall develop a discharge document that encompasses the information outlined in the law for inpatient discharges. The discharge document shall be provided to the assisted living facility to which the patient is being discharged.
New Hospital Discharge Standards
The Arizona Assisted Living Law requires that a discharging hospital shall contact the patient’s assisted living facility after initial inpatient assessment to discuss an evaluation of the patient’s likely post-discharge health care needs. The hospital shall reevaluate and discuss with the patient’s assisted living facility 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 recommendations, if any, by the hospital to transfer the patient to a different facility to address the patient’s higher care needs.
The discharging hospital shall provide the patient’s assisted living facility with an opportunity to conduct a patient screening before discharge of the patient back to such assisted living facility or a different facility to which the patient is being referred. The patient’s assisted living facility shall use this screening and a review of or discussion about medical records to determine whether the patient’s post‑discharge care needs, including additional ordered services, are within the assisted living facility’s scope of services.
After receiving notification from the discharging hospital, the patient’s assisted living facility shall perform the screening promptly. For on-site screenings, the staff of the patient’s assisted living facility may be required to follow standard hospital security and identification requirements. If the patient’s assisted living facility can no longer meet the patient’s needs, the assisted living facility shall provide documentation to the hospital demonstrating the reasons why it cannot re-accept the patient.
Coordination with Resident’s Health Care Team
Under the Arizona Assisted Living Law, for patients being transferred from a hospital to an assisted living facility who have not previously been admitted to the assisted living facility, the hospital shall coordinate with the assisted living facility to allow time to obtain documentation from a physician and other health care practitioners coordinating the level of care needed in the assisted facility.
Emergency Department or Observation Patients
The Arizona Assisted Living Law requires that, for emergency department or observation patients, the hospital shall provide the patient’s assisted living facility with a point of contact. The hospital’s point of contact shall promptly respond to any inquiry. For 48 hours after discharge, the discharging hospital’s designated point of contact must be available to respond to the patient’s assisted living facility to assist in returning or admitting the patient to the assisted living facility and to clarify any needed information in the discharge plan.
The Arizona Assisted Living Law requires that the hospital shall also provide the patient’s assisted living facility with any new prescription orders, a record of medications administered and any identified follow-up care services recommended for the patient. The patient’s assisted living facility shall readmit the patient if it can meet the care needs of the patient.
Effective Date
The new Arizona law becomes effective on December 31, 2023.
Practical Takeaways
- All Arizona assisted living facilities should review and update their written policies and procedures regarding emergency assistance, admission criteria and the other required elements under the Arizona Assisted Living Law.
- All Arizona hospitals should review and update their written policies and procedures regarding discharge documentation and criteria and the other required elements under the Arizona Assisted Living Law.
Should you have any questions about this topic or would like assistance with updating or creating a set of policies and procedures, please contact:
- Sean Fahey at (317) 977-1472 or sfahey@hallrender.com;
- Brian Jent at (317) 977-1402 or bjent@hallrender.com;
- Todd Selby at (317) 977-1440 or tselby@hallrender.com; or
- Your primary Hall Render contact.
More information about Hall Render’s Post-Acute and Long-Term Care services can be found here.
Hall Render blog posts and articles are intended for informational purposes only. For ethical reasons, Hall Render attorneys cannot—outside of an attorney-client relationship—answer specific questions that would be legal advice.
