42 CFR 489.12 – Federal Patient Self-Determination Act

(3) Not condition the provision of care or otherwise discriminate against an individual based on whether or not the individual has executed an advance directive.

(4) Ensure compliance with requirements of State law (whether statutory- or recognized by the courts of the State) regarding advance directives. The provider must inform individuals that complaints concerning the advance directive requirements may be filed with the State survey and certification agency.

(5) Provide education for staff concerning its policies and procedures on advance directive; and,

(6) Provide for community education regarding issues concerning advance directives that may include material required in paragraph (a)(1) of this section, either directly or in concert with other providers and organizations. Separate community education materials may be developed and used, at the discretion of providers. The same written materials do not have to be provided in all settings, but the material should define what constitutes an advance directive, emphasizing that an advance directive is designed to enhance an incapacitated individual’s control over medical treatment, and describe applicable State law concerning advance directives. A provider must be able to document its community education efforts.

(b) The information specified in paragraph (a) of this section is furnished:

(1) In the case of a hospital, at the time of the individual’s admission as an inpatient.

(2) In the case of a skilled nursing facility at the time of the individual’s admission as a resident.

(3)

(i) In the case of a home health agency, in advance of the individual coming under the care of the agency. HHA may furnish advancer directives information to a patient at the time of the first home visit, as long as the information is furnished before care is provided.

(ii) In the case of personal care services, in advance of the individual coming under the care of the personal care services provider. The personal care provider may furnish advance directives information to a patient at the time of the first home visit, as long as the information is furnished before care is provided.

(4) In the case of a hospice program, at the time of initial receipt of hospice care by the individual in the program.

(c) The providers listed in paragraph (a)of this section

(1) Are not required to provide care that conflicts with an advance directive.