{"ref":"TX-HSP-PR-03","title":"Advance Directives and Out-of-Hospital Do-Not-Resuscitate Orders","category":"Patient rights","summary":"Sets out how the Agency tells every patient about its advance directive policy and the patient’s rights under Texas law, when that notice is due and to whom it goes if the patient is incapacitated, how directives and out-of-hospital do-not-resuscitate orders are recorded and honored, and what the Agency is unable to provide or withhold.","inShort":["At the admission visit, before care, give the advance directive notice and get it signed.","If the patient cannot understand, give it to the guardian or the next person on the list, and give it to the patient later when they can.","Ask about directives and out-of-hospital DNR orders. Note clearly in the record whether the patient has one and file a copy.","Follow the patient’s directives. If you are unsure, call the RN coordinator or on-call nurse straight away.","Never treat a patient differently because they have, or do not have, an advance directive."],"primaryCitation":"26 TAC §558.283","citations":["26 TAC §558.283","26 TAC §558.292(a)(2)","26 TAC §558.301(a)(9)(O)","Tex. Health & Safety Code ch. 166","Tex. Hum. Res. Code §102.003(t)"],"federalCitations":["42 CFR §418.52(a)(2)","42 CFR Part 489 Subpart I","42 CFR §489.102","42 CFR §418.104(a)(6)"],"surveyorAsks":["Show me the advance directive notice given to this patient and when it was given.","Where in the record is it shown whether the patient has an advance directive?"],"forms":[{"ref":"TX-HSP-PR-03-A","title":"Advance Directive Notice and Acknowledgment"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (26 TAC §558.283; 42 CFR §418.52(a)(2))","5. When and How the Notice Is Given","5.1 If the patient is incapacitated","6. Recording Directives","7. Honoring Directives","7.1 Out-of-hospital do-not-resuscitate orders","8. Statement of Limitation","9. Complaints, Updates and Education","10. Administrative Penalty","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-hospice","state":"Texas","service":"Hospice","guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Hospice","legalName":"Sample Hospice, LLC","logo":null}}