{"ref":"NC-HC-CR-03","title":"Responsible Parties, Informed Consent, and Advance Directives","category":"Client rights","summary":"Identifies and records who may act for each client, obtains the informed agreement of the client (or of the responsible party when the client has been found not competent) before services start and before any change, respects the client's right to refuse any service, and records whether the client has an advance directive, a portable do-not-resuscitate order or a MOST form so that staff know where to find it.","inShort":["Know who the client's responsible party is.","Ask before each task. A client may refuse any task.","Record a refusal and tell your supervisor before the end of the shift, or at once if it puts the client at risk.","Know where the client's DNR order or MOST form is kept.","Never witness, sign or draft legal papers for a client."],"primaryCitation":"G.S. 131E-144.3(1), (9)","citations":["G.S. 131E-144.3(1), (9)","10A NCAC 13J .1107(a)","10A NCAC 13J .1101(7)","10A NCAC 13J .1402(a)(1)(C), (a)(2)(B)","G.S. 32A-15 et seq.","G.S. 90-320 et seq.","G.S. 90-21.17","G.S. Chapter 35A","G.S. 108A-102","NC Medicaid Clinical Coverage Policy 3L, §6.1.4(g), (j)","DHSR Home Care Frequently Asked Questions, Q49, Q51"],"federalCitations":[],"surveyorAsks":["Who is this client's responsible party, and what document shows that person's authority?","Show me the client's or responsible party's approval of the services and the signed plan of care. Was it signed before services started?"],"forms":[{"ref":"NC-HC-CR-03-A","title":"Responsible Party and Advance Directive Information"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (G.S. 131E-144.3(1), (9))","5. Identifying the Responsible Party","6. Informed Agreement to Services","7. Clients Who May Lack Capacity","8. Refusal of Services or Tasks","9. Advance Directives","10. Responsibilities","11. Records and Compliance Monitoring","12. Staff Training","13. References","14. Related Policies and Forms","15. Approval","16. Revision History"],"version":"1.0","sample":false,"pack":"nc-hca","state":"North Carolina","service":"Home care","guides":[{"path":"/guides/home-care-agency-policies/","h1":"What policies does a home care agency need?"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}