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

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.