LCO No. 3486 1 of 7
General Assembly Raised Bill No. 956
January Session, 2023
LCO No. 3486
Referred to Committee on PUBLIC HEALTH
Introduced by:
(PH)
AN ACT REQUIRING DISCHARGE STANDARDS REGARDING
FOLLOW-UP APPOINTMENTS AND PRESCRIPTION MEDICATIONS
FOR PATIENTS BEING DISCHARGED FROM A HOSPITAL OR
NURSING HOME FACILITY.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 19a-504c of the general statutes is repealed and the 1
following is substituted in lieu thereof (Effective October 1, 2023): 2
(a) For purposes of this section and section 19a-504e: 3
(1) "Caregiver" means any individual who a patient designates as a 4
caregiver to provide post-discharge assistance to the patient in the 5
patient's home in the community. The term "caregiver" includes, but is 6
not limited to, a relative, spouse, partner, friend or neighbor who has a 7
significant relationship with the patient. For the purposes of this section 8
and section 19a-504e, the term caregiver shall not include any individual 9
who receives compensation for providing post-discharge assistance to 10
the patient. 11
(2) "Home" means the dwelling that the patient considers to be the 12 Raised Bill No. 956
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patient's home in the community. The term "home" shall not include, 13
and the provisions of this section and section 19a-504e shall not apply 14
to, a discharge to any rehabilitation facility, hospital, nursing home, 15
assisted living facility, group home or any other setting that was not the 16
patient's home in the community immediately preceding the patient's 17
inpatient admission. 18
(3) "Hospital" has the same meaning as provided in section 19a-490. 19
(4) "Post-discharge assistance" means nonprofessional care provided 20
by a designated caregiver to a patient following the patient's discharge 21
from an inpatient admission to a hospital in accordance with the written 22
discharge plan of care signed by the patient or the patient's 23
representative, including, but not limited to, assisting with basic 24
activities of daily living, instrumental activities of daily living and 25
carrying out support tasks, such as assisting with wound care, 26
administration of medications and use of medical equipment. 27
(b) The Department of Public Health shall adopt regulations, in 28
accordance with the provisions of chapter 54, to set minimum standards 29
for hospital discharge planning services. Such standards shall include, 30
but [not necessarily] need not be limited to, requirements for (1) a 31
written discharge plan prepared in consultation with the patient, or the 32
patient's family or representative, and the patient's physician, including, 33
but not limited to, the date and location of each follow-up medical 34
appointment scheduled prior to the patient's discharge and a list of all 35
medications the patient is currently taking and will continue to take 36
after the patient's discharge, and (2) a procedure for advance notice to 37
the patient of the patient's discharge and provision of a copy of the 38
discharge plan to the patient prior to discharge. 39
(c) Whenever a hospital refers a patient's name to a nursing home as 40
part of the hospital's discharge planning process, or when a hospital 41
patient requests such a referral, the hospital shall make a copy of the 42
patient's hospital record available to the nursing home and shall allow 43
the nursing home access to the patient for purposes of care planning and 44 Raised Bill No. 956
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consultation. 45
(d) Whenever a hospital's discharge planning indicates that an 46
inpatient will be discharged to the patient's home, the hospital shall (1) 47
allow the patient to designate a caregiver at, or prior to, the time that a 48
written copy of the discharge plan is provided to the patient, and (2) 49
transmit in an oral, written or electronic manner to the patient's 50
pharmacy each prescription ordered for the patient prior to discharge 51
that the patient will need after discharge. A patient is not required to 52
designate any individual as a caregiver and any individual designated 53
as a caregiver under this section is not obligated to perform any post-54
discharge assistance for the patient. 55
(e) If an inpatient designates a caregiver pursuant to subsection (d) of 56
this section prior to receiving written discharge instructions, the 57
hospital shall: 58
(1) Record the patient's designation of caregiver, the relationship of 59
the designated caregiver to the patient, and the name, telephone number 60
and address of the patient's designated caregiver in the discharge plan. 61
(2) Make reasonable attempts to notify the patient's designated 62
caregiver of the patient's discharge to the patient's home as soon as 63
practicable. In the event the hospital is unable to contact the designated 64
caregiver, the lack of contact shall not interfere with, delay, or otherwise 65
affect the medical care provided to the patient or an appropriate 66
discharge of the patient. 67
(3) Prior to discharge, provide caregivers with instructions in all post-68
discharge assistance tasks described in the discharge plan. Training and 69
instructions for caregivers may be conducted in person or through video 70
technology, as determined by the hospital to effectively provide the 71
necessary instruction. Any training or instructions provided to a 72
caregiver shall be provided in nontechnical language, to the extent 73
possible. At a minimum, this instruction shall include: (A) A live or 74
recorded demonstration of the tasks performed by an individual 75
designated by the hospital who is authorized to perform the post-76 Raised Bill No. 956
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discharge assistance task and is able to perform the demonstration in a 77
culturally competent manner and in accordance with the hospital's 78
requirements to provide language access services under state and 79
federal law; (B) an opportunity for the caregiver to ask questions about 80
the post-discharge assistance tasks; and (C) answers to the caregiver's 81
questions provided in a culturally competent manner and in accordance 82
with the hospital's requirements to provide language access services 83
under state and federal law. 84
(4) Document in the patient's medical record any training for initial 85
implementation of the discharge plan provided to the patient, the 86
patient's representative or the designated caregiver. Any instruction 87
required under subdivision (3) of this subsection shall be documented 88
in the patient's medical record, including, at a minimum, the date, time 89
and contents of the instruction. 90
(f) If the patient agrees, the written discharge materials referenced in 91
this section may include electronic-only versions, and acknowledgment 92
of any such written discharge materials may be documented through 93
electronic means. 94
Sec. 2. Section 19a-535c of the general statutes is repealed and the 95
following is substituted in lieu thereof (Effective October 1, 2023): 96
(a) For purposes of this section and section 19a-535d: 97
(1) "Caregiver" means any individual who a resident designates to 98
provide post-discharge assistance to the resident in the resident's home 99
in the community. The term "caregiver" includes, but is not limited to, a 100
relative, spouse, partner, friend or neighbor who has a significant 101
relationship with the resident. For the purposes of this section and 102
section 19a-535d, the term "caregiver" shall not include any individual 103
who receives compensation for providing post-discharge assistance to 104
the resident. 105
(2) "Home" means the dwelling that the resident considers to be the 106
resident's home in the community. The term "home" shall not include, 107 Raised Bill No. 956
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and the provisions of this section and section 19a-535d, shall not apply 108
to, a discharge to any rehabilitation facility, hospital, assisted living 109
facility, group home or any other setting that was not the resident's 110
home in the community immediately preceding the resident's 111
admission. 112
(3) "Resident" means a resident of a nursing home facility or the 113
resident's representative. 114
(4) "Nursing home facility" has the same meaning as provided in 115
section 19a-521. 116
(5) "Post-discharge assistance" means nonprofessional tasks provided 117
by a designated caregiver to a resident following the resident's 118
discharge from a nursing home facility in accordance with the written 119
discharge plan of care signed by the resident or the resident's 120
representative, which involves assisting with basic activities of daily 121
living, instrumental activities of daily living and carrying out support 122
tasks, such as assisting with wound care, administration of medications 123
and use of medical equipment. 124
(b) The Department of Public Health may adopt regulations, in 125
accordance with the provisions of chapter 54, to set minimum standards 126
for nursing home facility discharge planning services. Any such 127
standards shall include, but need not be limited to, requirements for (1) 128
a written discharge plan prepared in consultation with the resident, or 129
the resident's family or representative, and the resident's physician, 130
including, but not limited to, the date and location of each follow-up 131
medical appointment scheduled prior to the resident's discharge and a 132
list of all medications the resident is currently taking and will continue 133
to take after the resident's discharge, and (2) a procedure for advance 134
notice to the resident of the resident's discharge and provision of a copy 135
of the discharge plan to the resident prior to discharge. 136
(c) Whenever a discharge plan from a nursing home facility indicates 137
that a resident shall be discharged to the resident's home, the nursing 138
home facility shall (1) allow the resident to designate a caregiver at, or 139 Raised Bill No. 956
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prior to, the time that a written copy of the discharge plan is provided 140
to the resident, and (2) transmit in an oral, written or electronic manner 141
to the resident's pharmacy each prescription ordered for the resident 142
prior to discharge that the resident will need after discharge. A resident 143
is not required to designate any individual as a caregiver and any 144
individual designated as a caregiver under this section is not obligated 145
to perform any post-discharge assistance for the resident or agree to 146
receive any instruction required under this section. 147
(d) If a resident designates a caregiver pursuant to subsection (c) of 148
this section prior to receiving written discharge instructions, the nursing 149
home facility shall: 150
(1) Record the resident's designation of caregiver, the relationship of 151
the designated caregiver to the resident and, if known, the name, 152
telephone number and address of the resident's designated caregiver in 153
the discharge plan. 154
(2) Make more than one reasonable attempt to notify the resident's 155
designated caregiver of the resident's discharge to the resident's home 156
as soon as practicable. In the event the nursing home facility is unable 157
to contact the designated caregiver, the lack of contact shall not interfere 158
with, delay, or otherwise affect the medical care provided to the resident 159
or an appropriate discharge of the resident. 160
(3) Prior to discharge, provide caregivers with instructions in all post-161
discharge assistance tasks described in the discharge plan. Training and 162
instructions for caregivers may be provided in writing or conducted in 163
person or through video technology, as determined by the nursing 164
home facility to effectively provide the necessary instruction. Any 165
training or instructions provided to a caregiver shall be provided in 166
nontechnical language, to the extent possible. At a minimum, this 167
instruction shall include: (A) A written, live or recorded demonstration 168
of the tasks performed by an individual designated by the nursing home 169
facility who is authorized to perform the post-discharge assistance task 170
and is able to perform the demonstration in a culturally competent 171 Raised Bill No. 956
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manner and in accordance with the requirements of the nursing home 172
facility to provide language access services under state and federal law; 173
(B) an opportunity for the caregiver to ask questions about the post-174
discharge assistance tasks; and (C) answers to the caregiver's questions 175
provided in a culturally competent manner and in accordance with the 176
requirements of the nursing home facility to provide language access 177
services under state and federal law. 178
(4) Document in the resident's medical record any training for initial 179
implementation of the discharge plan provided to the resident, the 180
resident's representative or the designated caregiver. Any instruction 181
required under subdivision (3) of this subsection shall be documented 182
in the resident's medical record, including, at a minimum, the date, time 183
and subject of the instruction. 184
This act shall take effect as follows and shall amend the following
sections:
Section 1 October 1, 2023 19a-504c
Sec. 2 October 1, 2023 19a-535c
Statement of Purpose:
To require discharge standards regarding follow-up appointments and
prescription medications for patients being discharged from a hospital
or nursing home facility.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
underlined.]