on Current Life-Sustaining Treatment Options
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.
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:
homes are to offer the form to new residents or their
proxies (health care agents and surrogates).
a resident already has a Patient’s Plan of Care form,
there is no requirement to do a new LST Options form. A future
in preferences, however, should be documented on the LST
health care facilities and providers may, but are not
required to, use the form as a tool for finding out patient
A letter about the positive
effect of the form during a JCAHO survey is available
using the form should be sure to copy it two-sided. As
the regulations say, the LST Options form is to be only one
of paper, to avoid the problem on pages accidently separated.
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
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.
here to download
a presentation that summarizes the objectives and contents
of the LST Options form.