Current through Register Vol. 30, No. 38, September 20, 2024
A. Except as
provided in
R9-10-315(E) or
(F), an administrator shall ensure that a
discharge plan for a patient is:
1. Developed
that:
a. Identifies any specific needs of the
patient after discharge;
b. If the
discharge date has been determined, includes the discharge date;
c. Is completed before discharge occurs;
and
d. Includes a description of
the level of care that may meet the patient's assessed and anticipated needs
after discharge;
2.
Documented in the patient's medical record within 48 hours after the discharge
plan is completed; and
3. Provided
to the patient or the patient's representative before the discharge
occurs.
B. For a patient
who was admitted after a suicide attempt or who exhibits suicidal ideation, in
addition to the discharge planning requirements in subsection (A), an
administrator shall ensure that:
1. The
patient receives a suicide assessment; and
2. The patient or the patient's
representative receives:
a. The results of the
suicide assessment;
b. Information
about the availability of age-appropriate, suicide crisis services, including
contact information; and
c.
Information about and instructions on how to access the Department of Insurance
and Financial Institution's website, available through difi.az.gov, developed
in compliance with A.R.S. §
20-3503(B),
including how to file an appeal of an insurance determination.
C. An administrator
shall ensure that:
1. A request for
participation in developing a patient's discharge plan is made to the patient
or the patient's representative,
2.
An opportunity for participation in developing the patient's discharge plan is
provided to the patient or the patient's representative, and
3. The request in subsection (C)(1) and the
opportunity in subsection (C)(2) are documented in the patient's medical
record.
D. An administrator
shall ensure that a patient is discharged from a behavioral health inpatient
facility when the patient's treatment needs are not consistent with the
services that the behavioral health inpatient facility is authorized and able
to provide.
E. An administrator
shall ensure that there is a documented discharge order by a medical
practitioner or behavioral health professional before a patient is discharged
unless the patient leaves the behavioral health inpatient facility against a
medical practitioner's or behavioral health professional's advice.
F. An
administrator shall ensure that, at the time of discharge, a patient receives:
1. A referral for treatment or ancillary
services that the patient may need after discharge, if applicable;
and
2. For a patient who was
admitted after a suicide attempt or who exhibits suicidal ideation, specific
information about or a referral to one of the following for ongoing or
follow-up treatment related to suicide, including scheduling an appointment for
the patient when practicable:
a. Another
health care institution;
b. A
medical practitioner or, for a patient going to another state after discharge,
a similarly licensed individual in the other state; or
c. A behavioral health professional certified
or licensed under A.R.S. Title 32 to provide treatment related to suicide or,
for a patient going to another state after discharge, a similarly certified or
licensed individual in the other state.
G. If
a patient is discharged to any location other than a health care institution,
an administrator shall ensure that:
1.
Discharge instructions are documented, and
2. The patient or the patient's
representative is provided with a copy of the discharge instructions.
H. An administrator shall ensure that a discharge
summary:
1. Is entered into the patient's
medical record within 10 working days after a patient's discharge;
and
2. Includes:
a. The following information authenticated by
a medical practitioner or behavioral health professional:
i. The patient's presenting issue and other
physical health and behavioral health issues identified in the patient's
nursing assessment, behavioral health assessment, or treatment plan;
ii. A summary of the treatment provided to
the patient;
iii. The patient's
progress in meeting treatment goals, including treatment goals that were and
were not achieved; and
iv. The
name, dosage, and frequency of each medication ordered for the patient by a
medical practitioner at the behavioral health inpatient facility at the time of
the patient's discharge;
b. For a patient who was admitted after a
suicide attempt or who exhibits suicidal ideation, the following information:
i. A description of the specific information
about ongoing or follow-up treatment related to suicide provided to the patient
or the patient's representative;
ii. Whether a referral was made for the
patient according to subsection (F)(2) for ongoing or follow-up treatment
related to suicide and, if so, information about the referral; and
iii. Whether an appointment was scheduled for
the patient according to subsection (F)(2) for ongoing or follow-up treatment
related to suicide and, if so, the date and time of the appointment;
and
c. A description of the disposition of the patient's
possessions, funds, or medications brought to the behavioral health inpatient
facility by the patient.
I. An administrator
shall ensure that a patient who is dependent upon a prescribed medication is
offered detoxification services, opioid treatment, or a written referral to
detoxification services or opioid treatment before the patient is discharged
from the behavioral health inpatient facility if a medical practitioner for the
behavioral health inpatient facility will not be prescribing the medication for
the patient at or after discharge.
