The patient had a living will on the refrigerator at home. Nobody at the hospital knew about it.
Advance directives ensure patients receive the care they actually want - but only when healthcare workers know how to ask about them, document them properly, and honor them under pressure. EZBunny's course covers the Patient Self-Determination Act, the different types of directives, and your responsibilities as a healthcare worker.
Start 14-day free trialThe Patient Self-Determination Act requires Medicare/Medicaid-participating facilities to inform patients of their right to create advance directives.
Course Details
15 minutes
Patient Care
Federal / State
Online, self-paced
What your team will learn
- What advance directives are and why they matter
- The difference between a living will and a durable power of attorney for health care
- POLST and DNR: medical orders vs. advance planning documents
- What the Patient Self-Determination Act requires of providers
- Admission as a starting point for advance directive conversations
- Healthcare worker responsibilities for documenting and honoring directives
- Surrogate decision-making when no directive exists
Who needs this training?
Recommended for clinical staff in settings where patients may have or need advance directives. R = Required by regulation. S = Strongly recommended.
| Practice Type | Status | Authority |
|---|---|---|
| Home Health Agencies | Recommended | Common in home health patients |
| Behavioral Health & SUD Treatment | Recommended | Patient rights |
| Ambulatory Surgery Centers (ASCs) | Recommended | Pre/post-op nurses (pre-surgical planning) |
| All other verticals | Recommended | Applicable in settings with vulnerable or elderly populations |
Which roles must complete this training?
All clinical staff in inpatient, surgical, home health, and long-term care settings:
- Home Health Aides: Often first to encounter directive documents in the home
- Registered Nurses: Admission assessments include directive screening
- Pre/Post-Op Nurses: Pre-surgical advance care planning
- Case Managers & Social Workers: Facilitate advance care planning conversations
Common advance directives training questions
What's the difference between a living will and a DPAHC?
A living will specifies the types of medical treatment a person does or does not want if they become incapacitated. A durable power of attorney for health care (DPAHC) designates someone else to make healthcare decisions on the person's behalf. They serve different purposes and can work together - the living will states the patient's wishes while the DPAHC names someone to ensure those wishes are followed.
What is the Patient Self-Determination Act?
The PSDA (42 USC 1395cc(f)) requires all Medicare and Medicaid-participating facilities to address advance directives at admission. Specifically, they must ask patients whether they have an advance directive, provide written information about the state's advance directive laws, and document the patient's directive status in their medical record. This applies to hospitals, nursing homes, home health agencies, and hospices.
What happens when there is no advance directive and the patient can't decide?
When no directive exists, surrogate decision-making hierarchies set by state law determine who makes decisions. Typically the hierarchy is: court-appointed guardian, then spouse, then adult children, then parents, then siblings. The surrogate should decide based on what the patient would have wanted (substituted judgment), not what the surrogate personally wants. This is why advance care planning matters - it prevents difficult family disagreements.
Train your team to honor every patient's advance care planning
15 minutes per person. Certificate on completion. Start your 14-day free trial now.
Start 14-day free trialRegulatory Disclaimer
Training requirements vary by organization type, size, state, payer mix, and accreditation. This guide reflects common federal and state requirements as of April 2026 and is not legal advice. Consult your compliance officer or legal counsel for requirements specific to your organization. State-specific content currently covers CA, TX, FL, NY, and IL. Additional states may have requirements not listed here. Last reviewed: April 2026.