S4894-2011 Actions

• Jun 17, 2011: SUBSTITUTED BY A7439A
• Jun 1, 2011: AMENDED ON THIRD READING 4894A
• May 25, 2011: ADVANCED TO THIRD READING
• May 24, 2011: 2ND REPORT CAL.
• May 23, 2011: 1ST REPORT CAL.794
• Apr 28, 2011: REFERRED TO AGING

S4894-2011 Meetings

S4894-2011 Calendars

S4894-2011 Votes

S4894-2011 Memo

BILL NUMBER:S4894

TITLE OF BILL:
An act to amend the public health law and the social services law, in
relation to assisted living residence pre-admission simplification

PURPOSE:
This bill would help simplify and expedite the admission process for
senior residents of assisted living and adult care facilities by
reducing paperwork requirements.

SUMMARY OF PROVISIONS:
Section one of the bill would amend Public Health Law � 4657 to allow
a nurse practitioner or physician's assistant to conduct the medical
exam - and complete the report - required prior to admission to an
assisted living residence (ALR). In addition, the bill would amend
section 4657 to authorize a shorter form to be used when a current ALR
resident is returning to the facility following a stay in any hospital
or nursing home.

Section two of the bill would amend Social Services Law 461-c(7) to
allow a nurse practitioner or physician's assistant to conduct the
medical exam - and complete the report - required prior to admission
to an adult care facility (ACF). In addition, the bill would amend
section 4657 to authorize a shorter form to be used when a current ACF
resident is returning to the facility following a stay in any hospital
or nursing home.

Section three of the bill provides that the bill would take effect
immediately after becoming law.

EXISTING LAW:
Social Services Law � 460-d(7) provides that, upon admission to an
ACF, the prospective senior resident must provide a written report
from a physician which states that the physician has physically
examined such resident within the last 30 days and the such resident
is appropriate for admission to the facility.

LEGISLATIVE HISTORY:
This is a new bill.

JUSTIFICATION:
Nurse practitioners and many physician's assistants have the requisite
training and education to conduct.basic medical exams, and typically
conduct such exams for their patients within their current scope of
practice. However, under current law, prior to admission to an ACF or
ALR, a prospective resident must present a "medical evaluation" signed
by a physician stating that he or she is appropriate for admission to
the facility (Social Services Law � 460-c[7]). Since nurse
practitioners and many physician's assistants are already authorized
to conduct such basic medical exams in most other settings, it makes
sense to allow them to conduct such an exam for the specific purpose
of determining whether a senior resident is appropriate for admission
to an ACF or ALR. In addition, by allowing nurse practitioners and
physician's assistants to conduct the preadmission exam (and complete
the pre-admission report), it can help save time and expense for


senior residents who currently must have a physician perform the exam
and complete the report. Consistent with their current scope of
practice, nurse practitioners and physician's assistants would also be
authorized to sign such reports without having to obtain the
co-signature of a physician.

Upon initial admission to an ACF or ALR, the current medical
evaluation form must also include an extensive medical history on the
prospective resident (in addition to assessing the appropriateness of
the resident for admission). Currently, the same form for new
admissions must also be used for all current residents returning to
the facility following a stay in a hospital or nursing home. However,
since current residents are already well known to the facility, there
is often no need to provide an extensive medical history.
Accordingly, this bill would authorize the use of a shorter form when
a current resident is returning to the facility that is better
tailored to such a situation and focuses on the reason for the stay,
the treatment plan to be followed, and any new or changed orders for
the resident.

BUDGET IMPLICATIONS:
None.

EFFECTIVE DATE:
This bill would take immediately after becoming law.

S4894-2011 Text

 S T A T E   O F   N E W   Y O R K
 
 
                                         4894
 2011-2012 Regular Sessions
 I N  SENATE
 April 28, 2011
 
 Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
 printed to be committed to the Committee on Aging
 

AN ACT to amend the public health law and the social  services  law,  in
 relation to assisted living residence pre-admission simplification
 

THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM
 BLY, DO ENACT AS FOLLOWS:

 

Section 1.

Section 4657 of the public health law, as added by  chapter
 2  of the laws of 2004, is amended by adding a new subdivision 3 to read
 as follows:

 3. (A) AT THE TIME OF THE ADMISSION TO AN ASSISTED LIVING RESIDENCE, A
 RESIDENT SHALL SUBMIT TO THE FACILITY A WRITTEN REPORT FROM A PHYSICIAN,
 A PHYSICIAN'S ASSISTANT OR A  NURSE  PRACTITIONER,  WHICH  REPORT  SHALL
 STATE:

 (I)  THAT  THE  PHYSICIAN, PHYSICIAN'S ASSISTANT OR NURSE PRACTITIONER
 HAS PHYSICALLY EXAMINED THE RESIDENT WITHIN ONE MONTH AND  THE  DATE  OF
 SUCH EXAMINATION;
 (II) THAT THE RESIDENT IS NOT IN NEED OF ACUTE OR LONG TERM MEDICAL OR
 NURSING  CARE WHICH WOULD REQUIRE PLACEMENT IN A HOSPITAL OR RESIDENTIAL
 HEALTH CARE FACILITY; AND
 (III) THAT THE RESIDENT IS NOT OTHERWISE MEDICALLY OR MENTALLY UNSUIT
 ABLE FOR CARE IN THE FACILITY.
 (B) FOR THE PURPOSE OF CREATING AN ACCESSIBLE AND AVAILABLE RECORD AND
 ASSURING THAT A RESIDENT IS PROPERLY PLACED  IN  SUCH  A  FACILITY,  THE
 REPORT  SHALL  CONTAIN  THE  RESIDENT'S  SIGNIFICANT MEDICAL HISTORY AND
 CURRENT CONDITIONS, THE PRESCRIBED MEDICATION  REGIMEN,  RECOMMENDATIONS
 FOR  DIET,  THE ASSISTANCE NEEDED IN THE ACTIVITIES OF DAILY LIVING, AND
 WHERE APPROPRIATE, RECOMMENDATIONS FOR EXERCISE, RECREATION AND FREQUEN
 CY OF MEDICAL EXAMINATIONS.
 (C) SUCH RESIDENT SHALL THEREAFTER  BE  EXAMINED  BY  A  PHYSICIAN,  A
 PHYSICIAN'S  ASSISTANT  OR  A  NURSE PRACTITIONER AT LEAST ANNUALLY, AND
 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD11099-01-1
 
       S. 4894                             2
 SHALL SUBMIT AN ANNUAL WRITTEN REPORT IN CONFORMITY WITH THE  PROVISIONS
 OF THIS SUBDIVISION.
 (D)  FOLLOWING  A  RESIDENT'S STAY IN A HOSPITAL OR RESIDENTIAL HEALTH
 CARE FACILITY,  UPON  RETURN  TO  THE  ASSISTED  LIVING  RESIDENCE,  THE
 ASSISTED  LIVING RESIDENCE SHALL NOT BE REQUIRED TO OBTAIN THE REPORT IN
 PARAGRAPH (A) OF THIS SUBDIVISION, AND INSTEAD SHALL OBTAIN A  STATEMENT
 FROM THE DISCHARGING FACILITY WHICH SHALL:

 (I) STATE THAT THE RESIDENT IS APPROPRIATE TO RETURN TO THE RESIDENCE;
 AND
 (II)  INCLUDE  THE  REASON  FOR  THE  STAY,  THE  TREATMENT PLAN TO BE
 FOLLOWED, AND ANY NEW OR CHANGED ORDERS, INCLUDING MEDICATIONS.
 THE STATEMENT SHALL BE COMPLETED BY A PHYSICIAN, A PHYSICIAN'S ASSIST
 ANT OR A NURSE PRACTITIONER.
 (E) NOTHING REQUIRED IN THIS SUBDIVISION SHALL REQUIRE THE USE  OF  AN
 IDENTICAL  FORM IN ADULT CARE FACILITIES AND ASSISTED LIVING RESIDENCES,
 EITHER UPON ADMISSION OR RETURN.
 

S 2. Subdivision 7 of section 461-c of the  social  services  law,  as
 added by chapter 601 of the laws of 1981, is amended to read as follows:

 7.  (a)  At the time of the admission to an adult care facility, other
 than a shelter for adults, a resident shall submit  to  the  facility  a
 written  report  from  a  physician,  A PHYSICIAN'S ASSISTANT OR A NURSE
 PRACTITIONER, which report shall state:

 (i) that the physician, PHYSICIAN'S ASSISTANT  OR  NURSE  PRACTITIONER
 has  physically  examined  the resident within one month and the date of
 such examination;
 (ii) that the resident is not in need of acute or long term medical or
 nursing care which would require placement in a hospital or  residential
 health care facility; and
 (iii)  that  the  resident  is  not  otherwise  medically  or mentally
 unsuited for care in the facility.
 (b) For the purpose of creating an accessible and available record and
 assuring that a resident is properly placed  in  such  a  facility,  the
 [physician's]  report  shall  also  contain  the  resident's significant
 medical history and current conditions, the prescribed medication  regi
 men,  and  recommendations for diet, the assistance needed in the activ
 ities of daily living and where appropriate, recommendations  for  exer
 cise, recreation and frequency of medical examinations.
 (c)  Such  resident  shall  thereafter  be  examined by a physician, A
 PHYSICIAN'S ASSISTANT OR A NURSE PRACTITIONER,  at  least  annually  and
 shall submit an annual written report [from his physician] in conformity
 with the provisions of this subdivision.
 (D)  FOLLOWING  A  RESIDENT'S STAY IN A HOSPITAL OR RESIDENTIAL HEALTH
 CARE FACILITY, UPON RETURN TO THE ADULT CARE FACILITY,  THE  ADULT  CARE
 FACILITY  SHALL NOT BE REQUIRED TO OBTAIN THE REPORT IN PARAGRAPH (A) OF
 THIS  SUBDIVISION,  AND  INSTEAD  SHALL  OBTAIN  A  STATEMENT  FROM  THE
 DISCHARGING FACILITY WHICH SHALL:

 (I)  STATE THAT THE RESIDENT IS APPROPRIATE TO RETURN TO THE FACILITY;
 AND
 (II) INCLUDE THE REASON FOR THE RESIDENT'S STAY, THE TREATMENT PLAN TO
 BE FOLLOWED, AND ANY NEW OR CHANGED ORDERS, INCLUDING MEDICATIONS.
 THE STATEMENT SHALL BE COMPLETED BY A PHYSICIAN, A PHYSICIAN'S ASSIST
 ANT OR A NURSE PRACTITIONER.
 (E) NOTHING REQUIRED IN THIS SECTION SHALL REQUIRE THE USE OF AN IDEN
 TICAL FORM IN ADULT CARE  FACILITIES  AND  ASSISTED  LIVING  RESIDENCES,
 EITHER UPON ADMISSION OR RETURN.
 

S 3. This act shall take effect immediately.

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