10.07.01.35

.35 Designation of Lay Caregivers.

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 hospitalís 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 patientís 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 patientís 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 hospitalís 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, ß19-383, 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 patientís 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 patientís lay caregiver to prepare the lay caregiver for the patientís 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 patientís 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 hospitalís 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.