Practice Management Alert

Question: Does a patient need a new MOLST form for every facility they receive treatment?

New York Subscriber

Answer: Different states have different rules, so check your state’s laws for specifics.

In New York, a Medical Orders for Life-Sustaining Treatment (MOLST) form is a standard form that allows individuals to list their preferences for medical intervention in certain circumstances. Theoretically, MOLST forms “follow” the patient, and may be accessed by providers in healthcare facilities, as well as emergency medical technicians (EMTs). There are other standardized forms that carry similar information, but in New York State, only the MOLST form can be used as evidence of a patient’s wishes for Do Not Resuscitate (DNR) or Do Not Intubate (DNI) orders in emergency situations, like where EMTs may be providing care. (Even if a patient has a living will, a MOLST form is the only directive an EMT can follow in New York.)

A MOLST form is valid as soon as it is signed. In New York, the MOLST form should be signed by a provider: a physician licensed in New York, a nurse practitioner, a physician assistant, or a physician licensed in a border state (with the state’s abbreviation listed along with the signature). It can be updated as a patient’s health condition or their wishes change.

“The signed MOLST form should be transported with patients as they travel to different health care settings. The medical orders on the form need not be re-issued by the patient’s new health care provider, but should be reviewed and may be revised by a physician, nurse practitioner, or physician assistant, when the patient transitions to a different setting and when the patient’s preferences and/or medical conditions change,” says the New York Department of Health (NYDOH).