Section 16.03.09.235 - PATIENT "ADVANCE DIRECTIVES."01.Provider Participation. Hospitals, nursing facilities, providers of home health care services (home health agencies, federally qualified health clinics, rural health clinics), hospice providers, and personal care RN supervisors must: a. Provide all adults receiving medical care written and oral information (the information provided must contain all material found in the Department's approved Advance Directive Registration Form) which defines their rights under state law to make decisions concerning their medical care.i. The provider must explain that the participant has the right to make decisions regarding their medical care which includes the right to accept or refuse treatment. If the participant has any questions regarding treatment, the facility or agency will notify the physician of those concerns. Their physician can answer any questions they may have about the treatment.ii. The provider will inform the participant of their rights to formulate advance directives, such as "Living Will" or "Durable Power of Attorney For Healthcare," or both.iii. The provider must comply with Subsection 235.02 of this rule.b. Provide all adults receiving medical care written information on the providers' policies concerning the implementation of the participant's rights regarding "Durable Power of Attorney for Healthcare," "Living Will," and the participant's right to accept or refuse medical and surgical treatment.c. Document in the participant's medical record whether the participant has executed an advance directive ("Living Will" or "Durable Power of Attorney for Healthcare," or both), or have a copy of the Department's approved Advance Directive Registration Form attached to the patient's medical record which has been completed acknowledging whether the patient/resident has executed an advance directive ("Living Will" or "Durable Power of Attorney for Healthcare," or both).d. The provider cannot condition the provision of care or otherwise discriminate against an individual based on whether that participant has executed an advance directive.e. If the provider cannot comply with the patient's "Living Will" or "Durable Power of Attorney for Healthcare," or both, as a matter of conscience, the provider will assist the participant in transferring to a facility or agency that can comply.f. Provide education to their staff and the community on issues concerning advance directives.02.When Advance Directives Must Be Given. Hospitals, nursing facilities, providers of home health care (home health agencies, federally qualified health centers, rural health clinics), hospice agencies, and personal care RN supervisors, must give information concerning "advance directives" to adult participants in the following situations:a. Hospitals must give the information at the time of the participant's admission as an inpatient unless Subsection 235.03 of this rule applies.b. Nursing facilities must give the information at the time of the participant's admission as a resident.c. Home health providers must give the information to the participant in advance of the participant coming under the care of the provider.d. The personal care RN supervisors will inform the participant when the RN completes the RN Assessment and Care Plan. The RN supervisor will inform the Qualified Intellectual Disabilities Professional (QIDP) and the personal care attendant of the participants decision regarding "advance directives."e. A hospice provider must give information at the time of initial receipt of hospice care by the participant.03.Information Concerning Advance Directives at the Time an Incapacitated Individual Is Admitted. An individual may be admitted to a facility in a comatose or otherwise incapacitated state and be unable to receive information or articulate whether they have executed an advance directive. In this case, to the extent that a facility issues materials about policies and procedures to the families or to the surrogates or other concerned persons of the incapacitated patient under state law, it must also include the information concerning advance directives. This does not relieve the facility from its obligation to provide this information to the patient once they are no longer incapacitated.04.Provider Agreement. A "Memorandum of Understanding Regarding Advance Directives" is incorporated within the provider agreement. By signing the Medicaid provider agreement, the provider is not excused from its obligation regarding advance directives under Section 1902(a) of the Social Security Act, as amended by Section 4751 of OBRA 1990.Idaho Admin. Code r. 16.03.09.235