Current through Register Vol. 51, No. 19, September 20, 2024
A.
A hospital shall provide a patient or legal guardian of a patient with an
opportunity to designate one lay caregiver before the discharge of the patient
to their residence.
B. The
hospital's discharge planning shall include the designation of the lay
caregiver as soon as practicable in the discharge planning process.
C. If a patient or legal guardian of a
patient declines to designate a lay caregiver, the hospital shall:
(1) Document the decision in the patient's
medical record; and
(2) Be deemed
to be in compliance with this regulation.
D. If a patient or legal guardian of a
patient designates a lay caregiver the hospital shall record in the patient's
medical record:
(1) The designation of the
lay caregiver;
(2) The relationship
of the lay caregiver to the patient; and
(3) The name, telephone number, and address
of the lay caregiver.
E.
Release of Medical Information.
(1) If the
patient designates a lay caregiver, the hospital shall request the patient or
legal guardian to consent in writing to release medical information to the lay
caregiver. The release of records shall be in accordance with:
(a) The hospital's procedures for releasing
personal health information; and
(b) All applicable federal and State
laws.
(2) If a patient
or legal guardian of a patient declines to consent to the release of medical
information to the lay caregiver, the hospital is not required to:
(a) Provide to the lay caregiver the notice
required under Health-General Article, §19-382, Annotated Code of
Maryland; or
(b) Consult with the
lay caregiver or provide to the lay caregiver information contained in the
discharge plan issued under Health-General Article, §19-383, Annotated
Code of Maryland.
F. A patient or a legal guardian of the
patient may change the designation of a lay caregiver in the event the lay
caregiver becomes incapacitated.
G
Regardless of the desire of the patient or legal guardian of the patient, the
designated lay caregiver is not obligated to perform any aftercare for the
patient.
H. A patient or legal
guardian is not required to designate a lay caregiver.
I. Hospital Obligations.
(1) If a patient or legal guardian of a
patient designates a lay caregiver, the hospital shall notify the lay caregiver
as soon as practicable of the discharge of the patient or the patient's
transfer to another hospital, licensed health care facility or other
residential facility.
(2) As soon
as practicable before the discharge of a patient, the hospital shall attempt
to:
(a) Consult with the patient's lay
caregiver to prepare the lay caregiver for the patient's aftercare;
and
(b) Issue a discharge plan that
describes the aftercare needs of the patient.
(3) The hospital shall make reasonable
attempts to consult with the lay caregiver.
(4) The inability of the hospital to consult
with a lay caregiver may not interfere with, delay, or otherwise affect the
medical care provided to the patient or the patient's planned
discharge.
(5) The hospital shall
document successful or unsuccessful attempts to contact the lay
caregiver.
J. Discharge
Planning Requirements. Regardless of the request for the designation of a lay
caregiver, the hospital shall comply with all discharge planning requirements
in:
(1) Regulation .27 of this
chapter;
(2) The standards imposed
under the hospital's accreditation by a State-approved accreditation
organization; and
(3)42 CFR § 482.43.
K. The designation of a lay caregiver may
not:
(1) Interfere with the rights of an
agent to make health care decisions under Health-General Article, Title 5,
Subtitle 6, Annotated Code of Maryland; or
(2) Create a private right of action against
a hospital, a hospital employee, or a duly authorized agent of a hospital or
otherwise supersede or replace existing rights or remedies under any other
State or federal law.
