Advance Directives, POLST, and Do-Not-Resuscitate Orders
Sets the Agency’s written policies and procedures on advance directives (22 CCR §74743(c)(2)(B); 42 CFR §489.102): written information on California law (the Health Care Decisions Law, Probate Code Division 4.7) before care starts; asking about and recording advance health care directives, powers of attorney for health care, surrogates, POLST forms, and prehospital do-not-resuscitate forms; honoring them in the home; conscience objections; and never conditioning care on whether a patient has a directive.
About this policy
- Policy number
- CA-HH-PR-02
- Version
- 1.0
- Main rule
- 22 CCR §74743(c)(2)(B)
- Library
- California home health · 58 policies
- Category
- Client rights
- Sections
- 24
In short
- Give every adult patient the advance directive information before any care starts.
- Ask if the patient has an advance directive, a POLST form, or a DNR form. Record the answer and ask for a copy.
- Care never depends on whether the patient has a directive.
- In an emergency, look for the POLST form. If it does not say no CPR, call 911 and start CPR if trained.
- Never witness a patient’s advance directive and never pressure a patient to sign or change one.
- If a patient says they want to change or cancel a directive, write it down and tell the nurse supervisor the same day.
What's inside
24 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (22 CCR §74743(c)(2)(B))
- 5. Written Information Before Care Starts
- 6. California Law: What the Patient Is Told
- 7. Recording and Keeping Copies
- 8. Honoring Directives and POLST Forms in the Home
- 8.1 Advance health care directives and agents
- 8.2 POLST forms
- 8.3 Medical emergency during a visit
- 8.4 Good-faith reliance
- 9. Revocation and Changes
- 10. Staff Conduct
- 11. Conscience Objections
- 12. Staff and Community Education
- 13. Responsibilities
- 14. Records and Compliance Monitoring
- 15. Staff Training
- 16. References
- 17. Related Policies and Forms
- 18. Approval
- 19. Revision History
An inspector may ask
- Show me the written information on advance directives and California law that you gave this patient before care started.
- Where in the record do you show whether the patient has an advance directive or a POLST form?
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