PRINTER'S NO. 1021
No. 909 Session of 1991
INTRODUCED BY SAURMAN, VROON, HECKLER, BUNT, FARGO AND
E. Z. TAYLOR, APRIL 2, 1991
REFERRED TO COMMITTEE ON HEALTH AND WELFARE, APRIL 2, 1991
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, aged, injured or sick persons
16 in their places of residence and other health services provided
17 to 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.
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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
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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, which
13 would require a coroner's investigation, the registered nurse
14 shall notify the county coroner, and the authority to release
15 the body of the deceased to the funeral director shall be that
16 of the coroner.
17 (c) Pronouncement of death.--This act allows the
18 pronouncement of death by registered nurses in accordance with
19 the act of December 17, 1982 (P.L.1401, No.323), known as the
20 Uniform Determination of Death Act, but in no way authorizes a
21 nurse to determine the cause of death. The responsibility for
22 determining the cause of death remains with the physician or the
23 coroner as provided in the act of June 29, 1953 (P.L.304,
24 No.66), known as the Vital Statistics Law of 1953.
25 Section 6. Liability.
26 (a) Immunity.--Registered nurses and employing agencies of
27 registered nurses acting in good faith and in compliance with
28 the guidelines established by this act and the State Board of
29 Nursing shall be immune from liability claims by reason of
30 pronouncing death.
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1 (b) No obligation.--Nothing contained in this act shall be
2 deemed to impose any obligation upon a registered nurse to carry
3 out the function authorized by this act.
4 (c) Other liability.--Nothing in this act is intended to
5 relieve a registered nurse of any civil or criminal liability
6 that might otherwise be incurred for failing to follow the rules
7 and regulations of the State Board of Nursing.
8 Section 7. Rules and Regulations.
9 The State Board of Nursing shall, within 90 days after the
10 effective date of this act, promulgate such rules and
11 regulations as may be necessary to carry out the provisions of
12 this act.
13 Section 8. Effective date.
14 This act shall take effect in 60 days.
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