2021 HCPR16: Physician’s Orders for Life-Sustaining Treatment (POLST) Form

Measure Description

Percentage of Patients Aged 65 Years and Older with Physician’s Orders for Life-Sustaining Treatment (POLST) Forms Completed

Denominator

• Adult patients aged ≥ 65 years evaluated by the Eligible Professional (E/M Codes 99221-99223, 99231-99233, 99238-99239, 99291-99292, 99304-99310, 99315, 99316)

Numerator

Patients with a completed Physician’s Orders for Life-Sustaining Treatment (POLST) form

Definitions:

• Physician’s Orders for Life-Sustaining Treatment (POLST) form is defined as a legally recognized, transportable and actionable medical order – intended for seriously ill patients at high risk for mortality – that remains with the patient whether at home, in the hospital, or in a care facility; the form indicates patient-specified medical treatment preferences and is signed by the authorizing physician, physician assistant (PA), or nurse practitioner (NP)
• The following elements must be present and completed in the Physician’s Orders for Life-Sustaining Treatment (POLST) form:
  • Legally recognized decision maker verification
  • Cardiopulmonary Resuscitation (CPR) preferences (e.g., attempt CPR, DNR)
  • Medical Intervention (e.g., full code, comfort measures, limited/selective treatments)
  • Signed by eligible healthcare provider (e.g., physician, PA, or NP)
• NOTE: The approved version and title of the Physician’s Orders for Life-Sustaining Treatment (POLST) form may differ slightly from state to state; variations in forms are acceptable as long as the elements listed above are present

Numerator Options

• Performance Met:
  • Existing Physician’s Orders for Life-Sustaining Treatment (POLST) form was acknowledged and documented in the medical record OR
  • Physician’s Orders for Life-Sustaining Treatment (POLST) form was completed or updated and documented in the medical record OR
  • Documented reason for not acknowledging, completing or updating Physician’s Orders for Life-Sustaining Treatment (POLST) form (e.g., patient refuses, patient is unresponsive or does not have capacity to complete, legally recognized decision maker is not present)
• Performance Not Met: Physician’s Orders for Life-Sustaining Treatment (POLST) form was not acknowledged, completed or updated, reason not specified

Numerator Exclusions

None

NQF ID Number

N/A

NQS Domain

Communication and Care Coordination

High Priority Measure

Yes

Includes Telehealth?

Yes

Inverse Measure

No

Proportional Measure

Yes

Continuous Variable Measure

No

Ratio Measure

No

Number of performance rates to be calculated and submitted

1

Risk-Adjusted Status?

No