Advance Directives: Ensuring Compliance with CMS and TJC in 2024 (W4033)-Advance Directives 2024 final presentation

Advance Directives 2024 final presentation

Pdf Summary

The document provides an in-depth overview of advance directives, their importance, legal considerations, and guidelines for healthcare facilities to ensure compliance with federal and state regulations and standards. It emphasizes the importance of advance directives—legal documents that specify a patient's healthcare preferences if they become incapacitated—and highlights various types such as Living Wills, Durable Power of Attorney, and Do-Not-Resuscitate (DNR) orders. The document also includes details on state and federal legislation, including the Patient Self Determination Act (PSDA), which mandates healthcare facilities to inform patients about their rights concerning advance directives upon admission.<br /><br />The document discusses significant legal cases such as those involving Karen Ann Quinlan, Nancy Cruzan, and Theresa Schiavo, which have contributed to establishing and understanding patients' rights to refuse life-sustaining treatment. It covers the role of the Centers for Medicare & Medicaid Services (CMS) and The Joint Commission (TJC) in upholding these rights within healthcare settings, detailing the regulatory framework, including CMS's Conditions of Participation, TJC standards, and surveyor duties in assessing compliance.<br /><br />Emphasizing education, the document outlines the need for community and staff education on advance directives and details methods for ensuring patient preferences are documented and honored, like using stickers or electronic health record flags to indicate the presence of an advance directive.<br /><br />The document also addresses the challenges in end-of-life planning, underscoring the physician’s responsibility to discuss with patients their medical interventions and documenting code statuses. Further, it touches on billing aspects for advance care planning, educating on the financial components of these discussions under Medicare.<br /><br />Lastly, the document reviews professional organizations’ positions on DNR orders during surgery and other procedures, encouraging respect for patient autonomy and decision-making in healthcare settings.

Keywords

advance directives

Living Wills

Durable Power of Attorney

Do-Not-Resuscitate

Patient Self Determination Act

Karen Ann Quinlan

Nancy Cruzan

Theresa Schiavo

Centers for Medicare & Medicaid Services

The Joint Commission