senate Bill S4894A

Signed By Governor
2011-2012 Legislative Session

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

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Sponsored By

Archive: Last Bill Status Via A7439 - Signed by Governor


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed by Governor

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Actions

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jul 20, 2011 signed chap.168
Jul 08, 2011 delivered to governor
Jun 17, 2011 returned to assembly
passed senate
3rd reading cal.794
substituted for s4894a
Jun 17, 2011 substituted by a7439a
Jun 01, 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

Votes

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Bill Amendments

Original
A (Active)
Original
A (Active)

S4894 - Bill Details

See Assembly Version of this Bill:
A7439A
Law Section:
Public Health Law
Laws Affected:
Amd §4657, Pub Health L; amd §461-c, Soc Serv L

S4894 - Bill Texts

view summary

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

view sponsor 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.

view full text
download pdf
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  4894

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             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.

S4894A (ACTIVE) - Bill Details

See Assembly Version of this Bill:
A7439A
Law Section:
Public Health Law
Laws Affected:
Amd §4657, Pub Health L; amd §461-c, Soc Serv L

S4894A (ACTIVE) - Bill Texts

view summary

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

view sponsor memo
BILL NUMBER:S4894A

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 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 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 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 2). Since nurse
practitioners and many physician 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 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 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 effect immediately after becoming law.

view full text
download pdf
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 4894--A
    Cal. No. 794

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             April 28, 2011
                               ___________

Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
  printed to be committed to the Committee on Aging -- reported  favora-
  bly  from  said committee, ordered to first and second report, ordered
  to a third reading, amended and ordered reprinted, retaining its place
  in the order of third reading

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 ASSISTANT OR A NURSE PRACTITIONER, WHICH REPORT SHALL STATE:
  (I) THAT THE PHYSICIAN, PHYSICIAN 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.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD11099-03-1

S. 4894--A                          2

  (C)  SUCH  RESIDENT  SHALL  THEREAFTER  BE  EXAMINED BY A PHYSICIAN, A
PHYSICIAN 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 ASSISTANT
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 ASSISTANT OR A NURSE PRAC-
TITIONER, which report shall state:
  (i) that the physician, PHYSICIAN 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 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 ASSISTANT
OR A NURSE PRACTITIONER.

S. 4894--A                          3

  (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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