1. a. A hospital shall adopt and maintain evidence-based discharge policies and procedures. At a minimum, the policies and procedures shall provide for an assessment of the patient‘s ability for self-care after discharge and, as part of the assessment, shall provide a patient, or if applicable the patient’s legal representative, with an opportunity to designate one lay caregiver prior to discharge of the patient.

 b. A legal representative who is an agent under a durable power of attorney for health care pursuant to chapter 144B shall be given the opportunity to designate a lay caregiver in lieu of the patient’s designation of a lay caregiver only if, consistent with chapter 144B, in the judgment of the attending physician or attending physician assistant, the patient is unable to make the health care decision. A legal representative who is a guardian shall be given the opportunity to designate a lay caregiver in lieu of the patient’s designation of a lay caregiver to the extent consistent with the powers and duties granted the guardian pursuant to sections 232D.401 and 232D.402 or section 633.635.

Terms Used In Iowa Code 144F.2

  • Aftercare assistance: means any assistance provided by a lay caregiver to a patient following discharge of the patient that involves tasks directly related to the patient's condition at the time of discharge, does not require a licensed professional, and is determined to be appropriate by the patient's discharging physician or other licensed health care professional. See Iowa Code 144F.1
  • Discharge: means the exit or release of a patient from inpatient care in a hospital to the residence of the patient. See Iowa Code 144F.1
  • following: when used by way of reference to a chapter or other part of a statute mean the next preceding or next following chapter or other part. See Iowa Code 4.1
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • Hospital: means a licensed hospital as defined in section 135B. See Iowa Code 144F.1
  • Lay caregiver: means an individual, eighteen years of age or older, who is designated as a lay caregiver under this chapter by a patient or the patient's legal representative, and who is willing and able to perform aftercare assistance for the patient at the patient's residence following discharge. See Iowa Code 144F.1
  • Legal representative: means , in order of priority, an attorney in fact under a durable power of attorney for health care pursuant to chapter 144B or, if no durable power of attorney for health care has been executed pursuant to chapter 144B or if the attorney in fact is unavailable, a legal guardian appointed pursuant to chapter 232D or 633. See Iowa Code 144F.1
  • Patient: means an individual who is receiving or who has received inpatient medical care in a hospital. See Iowa Code 144F.1
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • State: means a state, territory, or possession of the United States, the District of Columbia, or the Commonwealth of Puerto Rico. See Iowa Code 152E.3
 2. If a patient or the patient’s legal representative declines to designate a lay caregiver, the hospital shall document the declination in the patient’s medical record and the hospital shall be deemed to be in compliance with this section.
 3. If a patient or the patient’s legal representative designates a lay caregiver, the hospital shall do all of the following:

 a. Record in the patient’s medical record the designation of the lay caregiver, in accordance with the hospital’s policies and procedures, which may include information such as the relationship of the lay caregiver to the patient, and the name, telephone number, and address of the lay caregiver.
 b. (1) Request written consent from the patient or the patient’s legal representative to release medical information to the lay caregiver in accordance with the hospital’s established procedures for releasing a patient’s personal health information and in compliance with all applicable state and federal laws.

 (2) If a patient or the patient’s legal representative declines to consent to the release of medical information to the lay caregiver, the hospital is not required to provide notice to the lay caregiver under section 144F.3 or to consult with or provide information contained in the patient’s discharge plan to the lay caregiver under section 144F.4.
 4. A patient or the patient’s legal representative may change the designation of a lay caregiver if the lay caregiver becomes incapacitated.
 5. The designation of an individual as a lay caregiver under this section does not obligate the individual to perform any aftercare assistance for the patient.
 6. This section shall not be construed to require a patient or the patient’s legal representative to designate a lay caregiver.
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