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Tenn. Comp. R. & Regs. 0720-27-.13 — Policies and Procedures for Health Care Decision-Making

TennesseeregulationTennessee Health Facilities Commission· effective 2022-07-01

What this rule requires your agency to do

  • 1For patients lacking capacity, identify and document the surrogate in the current clinical record, applying the eligibility, best-qualified, and priority criteria and honoring the limits on artificial nutrition/hydration withdrawal (two-physician certification) (0720-27-.13(16)(c),(d),(g),(k)).(Tenn. Comp. R. & Regs. 0720-27-.13 — Policies and Procedures for Health Care Decision-Making)
  • 2Issue POST only under the informed-consent conditions specified; upon discharge of a patient with a DNR complete a POST, and on transfer communicate and provide a copy of the POST to EMS and the receiving facility, which shall make it part of the patient's record (0720-27-.13(30)(a),(f)).(Tenn. Comp. R. & Regs. 0720-27-.13 — Policies and Procedures for Health Care Decision-Making)
  • 3Do not require the execution or revocation of an advance directive as a condition for being insured for or receiving health care (0720-27-.13(10)).(Tenn. Comp. R. & Regs. 0720-27-.13 — Policies and Procedures for Health Care Decision-Making)
  • 4Ensure advance directives are in writing, signed by the patient, and either notarized or witnessed by two competent adult witnesses (neither the agent; at least one unrelated and not entitled to the estate), with an attestation clause (0720-27-.13(3)).(Tenn. Comp. R. & Regs. 0720-27-.13 — Policies and Procedures for Health Care Decision-Making)
  • 5If declining to comply for reasons of conscience or medical inappropriateness, promptly inform the patient/decision-maker, continue care until transfer, and make all reasonable efforts to assist transfer to a willing provider (0720-27-.13(20),(21),(22),(23)).(Tenn. Comp. R. & Regs. 0720-27-.13 — Policies and Procedures for Health Care Decision-Making)
  • 6Comply with a patient's individual instructions and with health care decisions of a person then authorized to make them, to the same extent as if made by the patient with capacity (0720-27-.13(19)).(Tenn. Comp. R. & Regs. 0720-27-.13 — Policies and Procedures for Health Care Decision-Making)
  • 7Maintain and establish policies and procedures governing the designation of a health care decision-maker for a patient who is incompetent or lacks capacity, including withholding of CPR measures (0720-27-.13(1)).(Tenn. Comp. R. & Regs. 0720-27-.13 — Policies and Procedures for Health Care Decision-Making)
  • 8Have a determination that a patient lacks or has recovered capacity made by the designated physician, who shall promptly record it in the current clinical record and communicate it to the patient (if possible) and any authorized decision-maker (0720-27-.13(6),(18)).(Tenn. Comp. R. & Regs. 0720-27-.13 — Policies and Procedures for Health Care Decision-Making)

Applies to: personal care

Requires home health agencies to establish policies for designating health care decision-makers for patients lacking capacity, and codifies the Tennessee Health Care Decisions Act framework — advance directives (execution/witness requirements), surrogate selection and priority, guardian precedence, provider compliance and conscience-based refusal with mandatory transfer assistance, and Physician Orders for Scope of Treatment (POST). Framework topic: Advance Directives / Health Care Decision-Making.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.