Florida Regulations 59A-38.015: Advance Directives and Do Not Resuscitate Orders (DNRO)
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(1) The administrator must ensure the development, documentation and implementation of policies and procedures which delineate the hospice’s compliance with the state law and rules relative to advance directives. The hospice must not base or condition treatment or admission upon whether or not the patient has executed or waived an advance directive. In the event of a conflict between the hospice’s policies and procedures and the patient’s advance directive, resolution must be made in accordance with chapter 765, F.S.
(2) The hospice’s policies and procedures must include:
(a) At the time of admission, providing each patient, or the patient’s surrogate, proxy or other legal reprensentative, with a copy of Form SCHS-4-2006, “”Health Care Advance Directives – The Patient’s Right to Decide,”” effective April 2006, or with a copy of some other substantially similar document which incorporates information regarding advance directives included in chapter 765, F.S. The form is hereby incorporated by reference and is available from the Agency for Health Care Administration, 2727 Mahan Drive, Mail Stop 34, Tallahassee, FL 32308, or the agency’s website at: http://ahca.myflorida.com/MCHQ/Health_Facility_Regulation/HC_Advance_Directives /docs/adv_dir.pdf.
(b) At the time of admission, providing each patient, or the patient’s surrogate, proxy or other legal representative, with written information concerning the hospice’s policies regarding resuscitation and advance directives, including information concerning DH Form 1896, Florida Do Not Resuscitate Order Form, incorporated by reference in Fl. Admin. Code R. 64J-2.018
(c) Requiring documentation of the existence of an advance directive in the patient’s medical record. A hospice which is provided with a patient’s advance directive shall make the advance directive or a copy thereof a part of the patient’s interdisciplinary care record and the patient’s medical record.
(3) Pursuant to Florida Statutes § 400.6095(8), a hospice may withhold or withdraw cardiopulmonary resuscitation from a patient if a valid Do Not Resuscitate Order (DNRO) is presented and executed pursuant to Florida Statutes § 401.45
(a) An absence of an order not to resuscitate, executed pursuant to Florida Statutes § 401.45, does not preclude a physician from withholding or withdrawing cardiopulmonary resuscitation as otherwise permitted by law.
(b) Hospice personnel shall not be subject to criminal prosecution or civil liability, nor be considered to have engaged in negligent or unprofessional conduct for withholding or withdrawing cardiopulmonary resuscitation pursuant to such a DNRO and rules adopted by the department, pursuant to Florida Statutes § 400.6095(8) Any licensed professional hospice personnel, who, in good faith, obeys the directives of an existing DNRO, executed pursuant to Florida Statutes § 401.45, will not be subject to prosecution or civil liability for his or her performance regarding patient care.
(4) Pursuant to Florida Statutes § 765.110, a hospice health care provider or facility shall be subject to discipline if the healthcare provider or facility requires an individual to execute or waive an advance directive as a condition of treatment or admission.
Rulemaking Authority 765.110, 400.605, 400.6095(8) FS. Law Implemented 400.605, 400.6095(8), 765.109, 765.110 FS. History-New 1-11-93, Formerly 59A-2.025, Amended 4-27-94, Formerly 59A-2.0232, Amended 6-5-97, 8-11-08, Formerly 58A-2.0232, 7-1-19.
(a) At the time of admission, providing each patient, or the patient’s surrogate, proxy or other legal reprensentative, with a copy of Form SCHS-4-2006, “”Health Care Advance Directives – The Patient’s Right to Decide,”” effective April 2006, or with a copy of some other substantially similar document which incorporates information regarding advance directives included in chapter 765, F.S. The form is hereby incorporated by reference and is available from the Agency for Health Care Administration, 2727 Mahan Drive, Mail Stop 34, Tallahassee, FL 32308, or the agency’s website at: http://ahca.myflorida.com/MCHQ/Health_Facility_Regulation/HC_Advance_Directives /docs/adv_dir.pdf.
(b) At the time of admission, providing each patient, or the patient’s surrogate, proxy or other legal representative, with written information concerning the hospice’s policies regarding resuscitation and advance directives, including information concerning DH Form 1896, Florida Do Not Resuscitate Order Form, incorporated by reference in Fl. Admin. Code R. 64J-2.018
(c) Requiring documentation of the existence of an advance directive in the patient’s medical record. A hospice which is provided with a patient’s advance directive shall make the advance directive or a copy thereof a part of the patient’s interdisciplinary care record and the patient’s medical record.
(3) Pursuant to Florida Statutes § 400.6095(8), a hospice may withhold or withdraw cardiopulmonary resuscitation from a patient if a valid Do Not Resuscitate Order (DNRO) is presented and executed pursuant to Florida Statutes § 401.45
(a) An absence of an order not to resuscitate, executed pursuant to Florida Statutes § 401.45, does not preclude a physician from withholding or withdrawing cardiopulmonary resuscitation as otherwise permitted by law.
(b) Hospice personnel shall not be subject to criminal prosecution or civil liability, nor be considered to have engaged in negligent or unprofessional conduct for withholding or withdrawing cardiopulmonary resuscitation pursuant to such a DNRO and rules adopted by the department, pursuant to Florida Statutes § 400.6095(8) Any licensed professional hospice personnel, who, in good faith, obeys the directives of an existing DNRO, executed pursuant to Florida Statutes § 401.45, will not be subject to prosecution or civil liability for his or her performance regarding patient care.
(4) Pursuant to Florida Statutes § 765.110, a hospice health care provider or facility shall be subject to discipline if the healthcare provider or facility requires an individual to execute or waive an advance directive as a condition of treatment or admission.
Rulemaking Authority 765.110, 400.605, 400.6095(8) FS. Law Implemented 400.605, 400.6095(8), 765.109, 765.110 FS. History-New 1-11-93, Formerly 59A-2.025, Amended 4-27-94, Formerly 59A-2.0232, Amended 6-5-97, 8-11-08, Formerly 58A-2.0232, 7-1-19.