HF 252 (LSB 2233YH (2) 86)

HOUSE FILE 252

BY  FORBES

A BILL FOR

An Act relating to improved transitions from hospital discharge to a nursing facility.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 135C.14, Code 2015, is amended by adding the following new subsection:
   NEW SUBSECTION.  9.  Requirements for readmissions of residents to a nursing facility following an inpatient hospital stay. The rules shall require that if a resident is discharged from a nursing facility for an inpatient hospital stay, upon return to the nursing facility, the nursing facility staff shall do all of the following:
   a.  Obtain signed copies of the hospital history and physical discharge summary, which may consist of the hospital transfer summary, and verify the content of the summary with the discharging hospital.
   b.  Contact the resident’s attending physician to review and reconcile the resident’s hospital orders with the resident’s previous orders including those relating to medications, therapy, and dietary needs and requirements. Following such review, the resident’s attending physician shall sign and authorize current physician orders for the resident and the nursing facility shall administer the orders as directed.
   c.  Include a descriptive assessment of the resident’s condition in the resident’s clinical record.
   d.  Include any changes in diagnoses in the resident’s clinical record.
   e.  Complete a new resident assessment instrument. Additionally, if the evaluation of the resident indicates a significant change which appears to be permanent, the nursing facility staff shall update the resident’s comprehensive care plan.
EXPLANATION
The inclusion of this explanation does not constitute agreement with

the explanation’s substance by the members of the general assembly.
   This bill directs the department of inspections and appeals to adopt rules for nursing facilities relating to requirements for readmission of residents to a nursing facility following an inpatient hospital stay. The rules are to require that if a resident is discharged from a nursing facility for an inpatient hospital stay, upon return to the nursing facility, the nursing facility staff shall: obtain signed copies of the hospital history and physical discharge summary, which may consist of the hospital transfer summary, and verify the content of the summary with the discharging hospital; contact the resident’s attending physician to review and reconcile the resident’s hospital orders with the resident’s previous orders including those relating to medications, therapy, and dietary needs and requirements; include a descriptive assessment of the resident’s condition in the resident’s clinical record and include any changes in diagnoses in such record; and complete a new resident assessment instrument. Additionally, if the evaluation of the resident indicates a significant change which appears to be permanent, the nursing facility staff shall update the resident’s comprehensive care plan.