PRINTER'S NO. 2955
No. 2217 Session of 1990
INTRODUCED BY SAURMAN, J. H. CLARK, ARGALL, FOX, FAIRCHILD, JOSEPHS, TIGUE, STISH, E. Z. TAYLOR, CIVERA AND NOYE, JANUARY 2, 1990
REFERRED TO COMMITTEE ON HEALTH AND WELFARE, JANUARY 2, 1990
AN ACT 1 Providing authority for pronouncement of death by registered 2 professional nurses when an anticipated death occurs from 3 natural causes in the home or place of residence of the 4 deceased, in hospice care, or in a long-term care facility. 5 The General Assembly of the Commonwealth of Pennsylvania 6 hereby enacts as follows: 7 Section 1. Short title. 8 This act shall be known and may be cited as the Death 9 Pronouncement by Registered Nurses Act. 10 Section 2. Legislative intent. 11 It is the intent of the General Assembly and the purpose of 12 this act to establish uniform guidelines for pronouncement of an 13 anticipated death from natural causes by certain registered 14 nurses outside a hospital setting. The General Assembly further 15 intends to facilitate the release of the dead body, as defined 16 in the act of June 29, 1953 (P.L.304, No.66), known as the Vital 17 Statistics Law of 1953, to the funeral director when the 18 pronouncement of death by the registered nurse has been made.
1 Section 3. Definitions. 2 The following words and phrases when used in this act shall 3 have the meanings given to them in this section unless the 4 context clearly indicates otherwise: 5 "Attending physician." A licensed physician, selected by or 6 assigned to the patient, who has primary responsibility for the 7 treatment and care of the patient. 8 "Death." Death as determined under the act of December 17, 9 1982 (P.L.1401, No.323), known as the Uniform Determination of 10 Death Act. 11 "Funeral director." A licensed funeral director as defined 12 in the act of January 14, 1952 (1951 P.L.1898, No.522), known as 13 the Funeral Director Law. 14 "Home health care." The provision of nursing and other 15 therapeutic services to disabled, injured or sick persons in 16 their places of residence and other health services provided to 17 protect and maintain persons in their own homes. 18 "Home health care agency." An organization or part thereof 19 staffed and equipped to provide nursing and at least one 20 therapeutic service to disabled, aged, injured or sick persons 21 in their places of residence. The agency may also provide other 22 health-related services to protect and maintain persons in their 23 own homes. 24 "Hospice care." A program of care for terminally ill 25 patients whose life expectancy is limited to a maximum of six 26 months and which offers supportive rather than curative care 27 chosen by the patient, family and physician. The program is 28 implemented by an interdisciplinary group of professionals 29 utilizing a coordinated team approach to deliver continuity of 30 care and counsel. 19900H2217B2955 - 2 -
1 "Hospital." An institution licensed or approved as a 2 hospital by the Department of Health under the act of July 19, 3 1979 (P.L.130, No.48), known as the Health Care Facilities Act. 4 "Long-term care facility." A facility that provides either 5 skilled or intermediate nursing care or both levels of care to 6 two or more patients, unrelated to the nursing home 7 administrator, for a period exceeding 24 hours. 8 "Pronouncement of death." Assessment by a registered nurse 9 that death has occurred. 10 "Registered nurse." An individual licensed under the act of 11 May 22, 1951 (P.L.317, No.69), known as The Professional Nursing 12 Law. 13 Section 4. Pronouncement of death. 14 (a) Required circumstances.--Registered nurses who, as part 15 of their employment, are involved in direct care of a patient 16 shall have the authority to pronounce death under the following 17 circumstances: 18 (1) In the case of death from natural causes that occurs 19 in the home or place of residence of a patient who is under 20 the care of a physician when the physician is unable to be 21 present within a reasonable period of time to certify the 22 cause of death. 23 (2) In the case of death from natural causes that occurs 24 in a long-term care facility when the attending physician is 25 unable to be present within a reasonable period of time to 26 certify the cause of death. 27 (b) Release of body.--Registered nurses shall have the 28 authority to release the body of the deceased to a funeral 29 director after notice has been given to the attending physician, 30 when the deceased has an attending physician, and to a family 19900H2217B2955 - 3 -
1 member. 2 Section 5. Restrictions. 3 (a) Authorized nurses.--The authority provided in this act 4 shall be limited to the following: 5 (1) Currently practicing registered nurses employed in 6 home health care through a home health care agency. 7 (2) Currently practicing registered nurses who are 8 employed or involved in hospice care. 9 (3) Currently practicing registered nurses employed in a 10 long-term care facility. 11 (b) Suspicious death.--In the event that circumstances 12 surrounding the nature of the death are not anticipated, the 13 registered nurse shall notify the county coroner, and the 14 authority to release the body of the deceased to the funeral 15 director shall be that of the coroner. 16 (c) Pronouncement of death.--This act allows the 17 pronouncement of death by registered nurses but in no way 18 authorizes a nurse to determine the cause of death. The 19 responsibility for determining the cause of death remains with 20 the physician or the coroner as provided in the act of June 29, 21 1953 (P.L.304, No.66), known as the Vital Statistics Law of 22 1953. 23 Section 6. Liability. 24 (a) Immunity.--Registered nurses and employing agencies of 25 registered nurses acting in good faith and in compliance with 26 the guidelines established by this act and the State Board of 27 Nursing shall be immune from liability claims by reason of 28 pronouncing death. 29 (b) No obligation.--Nothing contained in this act shall be 30 deemed to impose any obligation upon a registered nurse to carry 19900H2217B2955 - 4 -
1 out the function authorized by this act. 2 (c) Other liability.--Nothing in this act is intended to 3 relieve a registered nurse of any civil or criminal liability 4 that might otherwise be incurred for failing to follow the rules 5 and regulations of the State Board of Nursing. 6 Section 7. Rules and Regulations. 7 The State Board of Nursing shall, within 90 days after the 8 effective date of this act, promulgate such rules and 9 regulations as may be necessary to carry out the provisions of 10 this act. 11 Section 8. Effective date. 12 This act shall take effect in 60 days. K27L35WMB/19900H2217B2955 - 5 -