{"ref":"TX-HH-PR-02","title":"Advance Directives","category":"Patient rights","summary":"Sets out how the Agency tells every adult patient about the right to make health care decisions and advance directives, when the notice is given (including to someone else when the patient is incapacitated), how directives are recorded and shared with the care team, what the Agency can and cannot carry out, and how staff respond to an out-of-hospital do-not-resuscitate order.","inShort":["Give every patient the advance directive notice before care starts, and ask whether they have a directive, medical power of attorney, or out-of-hospital DNR order.","Record the answer on the face sheet, keep a copy of any directive, and note where the original is kept in the home.","If the patient cannot receive the notice, give it to the guardian, health care decision maker, spouse, adult child, parent, or admitting person, in that order. Give it to the patient later when able.","No pulse or not breathing and no valid OOH-DNR you can see: call 911 and start CPR if trained. With a valid OOH-DNR: do not start CPR and call the supervising nurse.","Care never depends on whether a patient has an advance directive."],"primaryCitation":"26 TAC §558.283","citations":["26 TAC §558.283","26 TAC §558.292","26 TAC §558.301","Tex. Health & Safety Code ch. 166","Tex. Hum. Res. Code ch. 102"],"federalCitations":["42 CFR §489.102","42 CFR §484.60(a)(2)(xv)"],"surveyorAsks":["Show me the advance directive notice in this record and the date it was given. Was it before care was furnished?","Where in the record do you document whether the patient has an advance directive?"],"forms":[{"ref":"TX-HH-PR-02-A","title":"Advance Directive Information and Acknowledgment"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (26 TAC §558.283)","5. Giving the Notice","6. When the Patient Is Incapacitated at Admission","7. Recording and Sharing an Advance Directive","8. Statement of Limitation","9. Response to Cardiac or Respiratory Arrest","10. Complaints, Staff Education, and Community Education","11. Responsibilities","12. Records and Compliance Monitoring","13. Staff Training","14. References","15. Related Policies and Forms","16. Approval","17. Revision History"],"version":"1.0","sample":false,"pack":"tx-lhhs","state":"Texas","service":"Home health","guides":[{"path":"/guides/home-health-agency-policies/","h1":"What policies and procedures are required for home health agencies?"},{"path":"/guides/home-health-conditions-of-participation/","h1":"Home health Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Home Health Agency","legalName":"Sample Home Health Agency, LLC","logo":null}}