Long-Term Care Survey Alert

Know when you need specific consent for treatments.

Question: When does a specific treatment fall outside the parameters of a consent form that a resident/decision-maker signs upon admission for routine care? Should physicians and the facility obtain special consent for antipsychotic medications?

Answer: Nursing facilities typically obtain a signed informed consent document upon admission that authorizes the facility and staff to render routine treatments and care to the resident during the course of her stay, notes John Lessner, an attorney with Ober/Kaler in Baltimore.

"But some specific treatments fall outside the definition of routine treatment -- for example, surgical insertion of a feeding tube," says Lessner. The nursing facility and physician in many ways share a joint obligation for obtaining consent documents for special treatments, he adds.

Attorney Joseph Bianculli notes that many facilities do require special consents for antipsychotic medications "simply because the [meds] are so regulated." The consent form might "recite" that the facility had advised the decision-maker about the risks and benefits of the medication, he says.