Purpose

To establish guidelines for identifying individuals who are legally authorized to make healthcare decisions on behalf of a patient and to access healthcare information as the patient's representative.

Policy

LifeCare recognizes the authority of legally authorized Personal Representatives and will provide such individuals access to information and decision-making authority as permitted by law.

Staff shall verify authority before relying upon an individual's representation that they may act on behalf of a patient.

Definitions

Personal Representative

An individual legally authorized to make healthcare decisions for a patient and exercise the patient's rights regarding healthcare information.

Categories of Personal Representatives

A. Healthcare Power of Attorney

A Healthcare Power of Attorney or similar Advance Directive may designate an agent to make healthcare decisions on behalf of the patient.

Staff must:

• Review documentation when available.

• Verify whether the document is currently effective.

• Confirm the scope of authority granted.

B. Surrogate Decision-Maker

When a patient lacks decision-making capacity and no Healthcare Power of Attorney exists, state law may authorize a surrogate decision-maker.

Examples may include:

• Spouse

• Adult child

• Parent

• Adult sibling

• Other authorized relatives

Staff shall follow applicable state law when determining surrogate authority.

C. Court-Appointed Guardian

A guardian appointed by a court may possess authority over healthcare decisions.  Staff shall determine the guardian's authority by reviewing the court order.

Guardians may have:

• Full authority;

• Limited authority; or

• Authority restricted to specific matters.

D. Verification Requirements

Before relying on a Personal Representative's decisions, staff should review available documentation whenever possible.  Documentation may include:

• Power of Attorney documents

• Advance Directives

• Guardianship Orders

• Court Orders

 

When authority is unclear, do not disclose additional PHI until you obtain guidance.