POLST Completion and Continuity in California Nursing Homes

Published in: Journal of the American Geriatrics Society (2021). doi: 10.1111/jgs.17610

Posted on RAND.org on March 16, 2022

by David Zingmond, David Powell, Lee A. Jennings, Jose J. Escarce, Li-Jung Liang, Punam Parikh, Neil S. Wenger

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Physician Orders for Life-Sustaining Treatment (POLST) can effectively transmit decisions about aggressiveness of care for nursing home (NH) residents across time and settings. However, POLST requires valid completion, continuity, and availability to ensure care consistent with goals. These aspects of POLST use have been studied only in narrow samples over brief periods or through registries. California implemented POLST in 2009 and since 2011 California NHs were required to report POLST completion and content in a supplemental section of the Minimum Data Set (MDS). We used MDS 2011–2016 linked to California Section S to describe POLST completion, cardiopulmonary resuscitation (CPR) and do not resuscitate (DNR) orders, invalid POLST documents, and switches in POLST content across the population of California NH residents.

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