This bill has been amended

Bill S4894-2011

Relates to content of pre-admission reports for persons entering assisted living residences

Relates to pre-admission reports for persons entering assisted living residences; permits reports to be made by a physician assistant or a nurse practitioner.

Details

Actions

  • 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

Votes

VOTE: COMMITTEE VOTE: - Aging - May 23, 2011
Ayes (11): Ball, Farley, Golden, LaValle, Robach, Zeldin, Valesky, Diaz, Addabbo, Avella, Stavisky
Excused (1): Kruger

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.


Text

STATE OF NEW YORK ________________________________________________________________________ 4894 2011-2012 Regular Sessions IN 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
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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