NYS DOH issues Dear Administrator Letter regarding MOLST

The New York State Department of Health has issued DAL 22-13, Medical Orders for Life-Sustaining Treatment (MOLST) – Clarification for Adult Care Facilities which strongly encourages Case Managers  to discuss MOLST with existing and prospective ACF residents and their families.

For existing or prospective ACF residents with a MOLST, the ACF must determine if it can provide care and services to the individual within the ACF’s existing licensure and certification. Admission and retention decisions made by the ACF must be based on the ACF’s existing licensure and certification, applicable regulatory constructs, and the resident’s medical orders on the MOLST, taking into consideration current operational factors (e.g., staffing).

The MOLST does not dictate actions ACF staff take in the event of an emergency. Instead, in an emergency, pursuant to 18 NYCRR §§487.7(d)(6) and 488.7(b)(4), ACFs must secure necessary medical assistance which may include outreach to EMS. Existence of a MOLST does not prohibit the ACF from contacting EMS in the event of an emergency. In this circumstance, if EMS honors the MOLST and/or the qualified resident refuses treatment and the MOLST lacks specific instructions, the ACF must notify the resident’s primary care physician.

Attached is a copy of the Dear Administrator Letter.