PURPOSE: This rule establishes the policy and procedures to be followed by Missouri Rehabilitation Center to assure the rights of patients to participate in and direct health care decisions affecting them.

1. (1) Unless the context clearly indicates otherwise, the following definitions shall be used in the interpretation of this rule:

   1. (A) Advance health care directive means a written document executed by a competent individual which identifies his/her wishes regarding the withdrawing or withholding of life-sustaining treatment in the event s/he becomes incompetent; and
   2. (B) Attorney-in-fact means a person or corporation appointed by a patient’s written power of attorney for health care to act as an agent for the patient if s/he becomes incompetent.
2. (2) Any competent adult patient shall have the right to make decisions regarding his/her health care including the right to refuse or accept medical treatment and to execute an advance health care directive.
3. (3) During the admission process at Missouri Rehabilitation Center a patient or her/his guardian or attorney-in-fact shall be asked to provide to hospital staff a copy of the patient’s advance health care directive if one exists. The center’s staff shall provide the patient or guardian or attorney-in-fact a copy of the center’s policy on the carrying out of advance health care directives. If an advance health care directive is produced, it shall be included in the patient’s medical record. No patient shall be refused admission because s/he does not have an advance health care directive. An Exhibit A form shall be completed for each person admitted to Missouri Rehabilitation Center.
4. (4) Missouri Rehabilitation Center shall accept and honor the lawful advance health care directive of each patient.
5. (5) Individual employees of Missouri Rehabilitation Center shall not be required to assist in carrying out a health care decision of an attorney-in-fact if that decision is contrary to the employee’s religious beliefs or moral convictions. At the employee’s request, s/he shall not be required to provide care to the patient.

AUTHORITY: section 192.005.2., RSMo 1986.* Original rule filed Jan. 15, 1993, effective July 8, 1993. *Original authority: 192.005, RSMo 1985. and Local Health Service SENIOR SERVICES