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Instruction on Current Life-Sustaining Treatment Options

Instructions on Current Life-Sustaining Treatment Options (formerly Patient's Plan of Care) Form

The effective date for use of the Instructions on Current Life-Sustaining Treatment Options (LST Options) form is April 1, 2008.

The Life Sustaining Treatment options form has been released in Spanish - A version of the form in Spanish is available here.

Regulations concerning the form are available here.

Points to remember:

  • Nursing homes are to offer the form to new residents or their proxies (health care agents and surrogates).
  • If a resident already has a Patient's Plan of Care form, there is no requirement to do a new LST Options form. A future change in preferences, however, should be documented on the LST Options form.
  • Other health care facilities and providers may, but are not required to, use the form as a tool for finding out patient wishes. A letter about the positive effect of the form during a JCAHO survey is available here.
  • Those using the form should be sure to copy it two-sided. As the regulations say, the LST Options form is to be only one sheet of paper, to avoid the problem on pages accidently separated.
  • Do not alter the contents or format of the form, except for spacing needs related to patient identification. Contact Kathleen Todd at 410-767-1864 if you want a word processing version of the form, so you can modify the form's spacing for this purpose. (But be aware that the original word processor is WordPerfect, not Word; converting it might foul up the formatting.)

Three Explanatory Guides about the LST Options form are available for download:

Two advice letters have also been issued about the Patient's Plan of Care form:

1. Letter to Herbert Hubbard (2005): Decisions on Patient's Plan of Care form. The letter confirms that a surrogate's decision-making authority about life-sustaining treatments has not been expanded by the Patient's Plan of Care form.

2. Letter to Dr. Harold Bob (2005): Patient's Plan of Care form and surrogate authority. The letter analyzes how the Act's requirement on certification of condition affects a surrogate's completion of the form and the entry of physician orders to implement surrogate decisions about feeding tube use.

Click here to download a presentation that summarizes the objectives and contents of the LST Options form.



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