In December 2016, Gov. Charlie Baker signed the CARE Act into Massachusetts State Law in hopes of easing the transition for patients who are leaving the hospital and being discharged into the care of a designated caregiver. Taking effect in November 2017, this law means changes for the MGH. Martin Lantieri, RN, of MGH Clinical Compliance, answered five questions to help staff better understand exactly what this law means for MGH employees, patients and caregivers.

What is the Massachusetts CARE act?
CARE stands for: Caregiver Advise, Record, Enable. This new Massachusetts law requires inpatient facilities to provide patients with an opportunity to designate a caregiver – any individual 18 years of age or older whom a patient designates to receive access to his or her health information and to assist the patient after discharge at home. However, patients are not required to pick a caregiver.

Why is it needed?
Many older Americans prefer to live independently, with many seniors relying solely on their loved ones and family members to provide a variety of caregiving duties at home. The CARE Act recognizes the critical role these family caregivers play in keeping their loved ones safe after discharge and out of costly institutions.

What information can be shared with a caregiver?
The type of information shared is based on what the patient has authorized the hospital to release to their caregiver. For example, if the patient chooses to share aftercare information, the caregiver is notified when the patient is going to be discharged to another facility or back home. The hospital must also provide an explanation and, if needed, a demonstration of the medical tasks the patient should follow at home. If authorized, the caregiver may also receive a copy of the patient’s discharge instructions.

Are there any documentation requirements?
Yes. The hospital must document that the patient has been notified of their ability to designate a caregiver. Once designated, the caregiver needs to be identified in the patient’s medical record. The patient’s consent to share personal health information and the authorization to notify the caregiver at the time of discharge must also be documented. One important thing to note is that the patient’s discharge should not be delayed if the hospital is not reasonably able to contact the caregiver.

How is it documented?
Caregiver identification and notification are shared responsibilities. In Epic, Caregiver Navigator sections have been added to the Nursing Admission & Discharge Navigators, Case Manager Navigator, Social Work Navigator and Provider Discharge Navigator. The admitting office also may document the name of the identified caregiver.

For more information, including Epic tip sheets, contact your local unit or departmental leadership, or email Lantieri at

This article was originally published in the 02/23/18 Hotline issue.