CHA News Article

Governor Signs Law Expanding Authorization to Sign POLST Forms
Nurse practitioners, physician assistants may now sign under certain circumstances

Governor Brown has signed AB 637 (Campos, D – San Jose), which will allow a nurse practitioner or a physician assistant acting under the supervision of a physician and within the scope of practice authorized by law to sign a Physician Orders for Life Sustaining Treatment (POLST) form. The POLST form is a document signed by the patient and health care provider that helps providers understand and honor a patient’s wishes regarding resuscitative and life-sustaining treatment. The bill becomes effective Jan. 1, 2016. Currently, a POLST form must be signed by a physician. POLST forms may be found at www.capolst.org.

Hospitals are reminded that the Centers for Medicare & Medicaid Services (CMS) interprets the Medicare Conditions of Participation to require that all inpatient care be ordered by a physician on the medical staff of the hospital. Therefore, hospitals should ensure that a physician on the medical staff reviews all POLST forms signed by non-medical staff members (whether physicians, nurse practitioners or physician assistants) as soon as possible, and enter appropriate orders in the patient’s medical record.

This procedure will also ensure that the hospital does not inadvertently provide inpatient care on the orders of a person not licensed in California or excluded from participation in the Medicare or Medi-Cal programs.

Details about the POLST form may be found in chapter 5 of CHA’s Consent Manual – A Reference for Consent and Related Health Care Law. Details about the Consent Manual and ordering information may be found at www.calhospital.org/consent.

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