New Jersey CARE Act: Your Caregiver Rights at Hospital Discharge

Your parent is being discharged from a New Jersey hospital and you're supposed to manage wound care, medication injections, and catheter maintenance at home — but nobody at the hospital has actually shown you how to do any of it. You're not a nurse. You shouldn't have to figure this out from a printout. New Jersey law agrees with you.

What the CARE Act Requires

The Caregiver Advise, Record, Enable Act, codified at N.J.S.A. 26:2H-5.24 through 26:2H-5.32, is a New Jersey state law that gives family caregivers specific, enforceable rights during a hospital stay. It was designed to reduce hospital readmissions by making sure the person who's actually going to provide care at home — usually an adult child — is formally involved in the discharge process.

The law has three core mandates:

Designate a caregiver. Within 24 hours of admission (or recovery of consciousness), the hospital must give the patient or their legal guardian a formal opportunity to designate a primary caregiver. The hospital records the caregiver's name, relationship, and contact information directly in the patient's electronic medical record. The patient must provide written consent for the hospital to share medical information with the designated caregiver.

Notify the caregiver before discharge. The hospital must notify the designated caregiver of the patient's impending discharge or transfer as soon as possible — at minimum, when the attending physician actually issues the discharge order. This notification requirement means the hospital cannot discharge your parent without making reasonable efforts to reach you first.

Train the caregiver on after-care tasks. At least 24 hours before discharge, the clinical team must consult with the designated caregiver, assess their physical capabilities and limitations, and provide a customized discharge plan detailing every medical after-care task required at home. The hospital must provide live or recorded demonstrations of these tasks — wound care, injections, catheter maintenance, feeding tube management — in non-technical language and in a culturally competent manner. The caregiver must be given an active opportunity to ask questions, and the complete contents, date, and time of these instructions must be documented in the patient's medical record.

How to Invoke Your CARE Act Rights

The CARE Act doesn't activate automatically. You need to take specific steps:

1. Ask for the caregiver designation form within the first 24 hours of your parent's admission. If the hospital doesn't offer it proactively, request it from the admissions nurse or the case management department.

2. Document your designation in writing. Once you're designated, confirm that your name and contact information are entered into the patient's electronic medical record. Ask for a copy of the signed consent form.

3. Request the discharge training meeting. Don't wait for the hospital to schedule it. As soon as you learn discharge is being discussed, tell the case manager that you're the designated caregiver under the CARE Act and that you need the mandated consultation and demonstration session before your parent leaves.

4. Ask specific questions during training. The law requires the hospital to answer your questions. Ask about medication schedules, signs of complications to watch for, when to call the doctor versus when to go to the emergency room, and exactly how to perform any clinical tasks you'll be responsible for at home.

What to Do If the Hospital Ignores the CARE Act

N.J.S.A. 26:2H-5.30 states that the CARE Act does not create a private right of action against a hospital, so you cannot sue the hospital solely for violating the statute. However, document a failure to comply with CARE Act requirements and use the available complaint and appeal processes:

File a complaint with the NJ Department of Health. Report the hospital's failure to provide caregiver training or discharge notification to the Division of Health Facility Survey and Field Operations.

Use it in a discharge appeal. If you believe the discharge is unsafe because the hospital hasn't trained you on required after-care tasks, document the failure in writing and submit it as part of your expedited discharge appeal with Commence Health (1-866-815-5440). A "Beneficiary Perspective" letter that details the hospital's failure to consult, train, or establish a safe discharge plan becomes a permanent part of the clinical file and strengthens the appeal.

Request a supplemental medical record entry. Under federal Office of Civil Rights regulations, the patient has the right to supplement the medical record. If the CARE Act training never happened, submit a written statement documenting that fact. This creates evidence if problems arise after discharge.

Why This Matters for Your Parent's Safety

Hospital readmission rates for elderly patients within 30 days of discharge are stubbornly high, and inadequate caregiver preparation is a leading contributor. The CARE Act exists because the state legislature recognized that family caregivers — not paid professionals — are the ones performing complex medical tasks at home, often with zero training.

When you assert your CARE Act rights, you're not being difficult. You're using a law that was specifically written to prevent your parent from being sent home to a caregiver who hasn't been taught what to do.

The New Jersey Hospital-to-Home Transition Planner includes a CARE Act checklist with the specific language to use when requesting your designation, a discharge training agenda you can hand to the case manager, and a log for documenting each training session.

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