Regulatory Updates

ACHE of Western PA seeks to keep it’s members up to date on state and federal legislation that might impact it’s members.  Alexi Jurewicz, JD, LL.M, and current University of Pittsburgh, MHA candidate will be providing occasional reviews and summaries for members.  Please read below to learn more.

The Pennsylvania CARE Act

The Pennsylvania Caregiver Advise, Record, Enable (CARE) Act was signed into law on April 20, 2016 and it will take effect in April 2017. The Pennsylvania CARE Act is based on model legislation developed by AARP. The legislation was approved unanimously in both the State Senate and House. The Pennsylvania Hospital Association was a key supporter of this new law. Pennsylvania becomes the 25th state to enact a version of the Act.

The Care Act uses the term “lay caregiver” to describe an individual who is chosen by a hospital in-patient and who accepts the role of providing post-discharge after-care assistance in the patient’s home.

Key provisions imposing duties on hospitals

The new law requires hospitals to take the following actions:

  • Provide each patient, or if applicable, the patient’s legal guardian with the opportunity to designate at least one lay caregiver following the patient’s entry into a hospital and prior to the patient’s discharge to the residence [Section 3(a)];
  • If the patient or the patient’s legal guardian declines to designate a lay caregiver, the hospital shall promptly document the decision on the patient’s medical record [Section 3(c)];
  • If the patient designates a lay caregiver, the hospital must record the designation and related information (relationship, name, telephone number and address) in the patient’s medical record [Section 3(d)(3)];
  • With the patient’s written consent, the hospital may release medical information to the designated lay caregiver in compliance with all Federal and State laws (Section 3(d)(1)];
  • Notify the designated lay caregiver of the patients pending discharge to a residence or transfer to another facility [Section 4 (a)];
  • Promptly document the notification in the patient’s medical record [Section 4(b)];
  • Consult with the lay caregiver prior to the patient’s discharge to a residence and issue a discharge plan that describes the patient’s after-care assistance needs at the residence. [Section 5(a)]. The discharge plan shall include at a minimum:
  • the name and contact information of the lay caregiver,
  • a description of all after-care assistance tasks necessary to maintain the patient’s ability to reside at home,
  • contact information for any health care, community resources, long-term care services and support services necessary to successfully carry out the patient’s discharge plan, and
  • contact information for a hospital employee who can respond to questions about the discharge plan [Section 5(a)(4).
  • Provide lay caregivers with instructions in all after-care tasks described in the discharge plan [Section 5(b)]. Training and instructions may be conducted in person or through video technology at the discretion of the lay caregiver. The instruction must include:
  • a live or recorded demonstration of the tasks,
  • an opportunity for the lay caregiver and patient to ask questions, and
  • answers to those questions in an understandable language.

CARE Act Limitations and Exclusions

The CARE Act is focused on hospitals and the discharge or transfer of hospital patients regardless of their age. [See the definition of “Discharge” in Section 2]. The Act only applies where there has been “an inpatient admission.”

The CARE Act may not apply to care-recipients who:

  • were not hospitalized,
  • are being discharged from non-hospital facilities,
  • receive hospital services that were provided on an outpatient basis.

“After-care assistance” is defined as assistance relating to the patient’s condition at the time of hospital discharge. So the Act does not address situations where a once hospitalized care-recipient’s needs have changed but there has been no new inpatient hospitalization.

Even if a patient is hospitalized, the law does not include any enforcement provisions or penalties in the event that a hospital fails to comply.

To read a copy of the Act – please visit here