Georgia Advance Directives in Nursing Homes and Hospice Care

If you're moving a parent into a nursing home or transitioning to hospice care in Georgia, an advance directive isn't optional — it's practically a prerequisite. Most facilities ask about advance directives during the admission process, and arriving without one triggers a scramble to get documents signed under time pressure with limited witness options.

Understanding how advance directives work inside these facilities prevents that scramble.

Nursing Home Admission and Advance Directives

Georgia nursing homes are required under federal law (the Patient Self-Determination Act) to ask patients about advance directives at admission. They must:

• Ask whether you have an existing advance directive
• Provide written information about your rights under Georgia law to create one
• Document your directive status in your medical record

They are not required to help you execute one, and they cannot condition admission on having one. But in practice, families that arrive without an advance directive face immediate pressure to establish one — often while dealing with the stress of a care transition.

The witness problem is amplified in nursing homes. Under O.C.G.A. § 31-32-5(c), people directly involved in your medical care are disqualified from witnessing. That eliminates most facility staff. Only one employee of the treating facility may serve as a witness, and some facilities maintain blanket policies prohibiting any staff involvement.

Hospice: Where the Advance Directive Meets POLST

Hospice care represents a shift from curative treatment to comfort care. For patients entering hospice in Georgia, the advance directive serves a different function than in a hospital setting:

The advance directive establishes your agent and general preferences. It names who makes decisions and outlines your broad wishes about life-sustaining treatment.

A POLST converts those wishes into physician orders. The Georgia Physician Orders for Life-Sustaining Treatment form — completed by the attending physician, not the patient — translates your preferences into clinical protocols that emergency responders and facility staff must follow immediately.

The distinction matters because EMTs responding to a crisis at a hospice facility or private home cannot legally interpret a standard advance directive. They need a physician-signed POLST, typically printed on bright-colored paper, to know whether to perform CPR, administer medications, or provide comfort measures only.

For home hospice patients, Georgia also requires a DNR bracelet or necklace (worn on the wrist or ankle) and a prominently posted DNR notice in the residence for EMS personnel to honor a do-not-resuscitate order.

Hospital Policies That Affect Your Directive

Georgia hospitals vary significantly in how they handle advance directives:

Witness restrictions. Major systems like Northside Hospital maintain internal policies that prohibit staff from witnessing patient directives, even though state law allows one facility employee to serve. If you're trying to sign in a hospital, verify the specific facility's policy before your signing day.

Electronic medical records. Most Georgia hospital systems can scan your advance directive into your patient record. Ask the admissions or patient services department to do this during any scheduled visit — having it pre-loaded means the ER team has access if you arrive unconscious.

Ethics committees. If a dispute arises between your healthcare agent and the medical team about your treatment preferences, Georgia hospitals typically refer the conflict to an internal ethics committee before any party pursues court intervention.

Practical Steps for Facility-Based Care

1. Complete your advance directive before admission — not during. The emotional and logistical pressure of a care transition makes poor conditions for careful decision-making.
2. Get a POLST if your physician agrees you're in your last year of life. This is especially important for hospice patients and nursing home residents with progressive conditions.
3. Provide the facility with a copy of your directive at admission. Ask for written confirmation it's been added to your chart.
4. Review and update your directive annually while in long-term care. Preferences and agents may change as your condition evolves.
5. Brief facility staff on your wishes. A quick conversation with the nursing director ensures the people providing daily care understand your preferences, not just the document in your file.

The Georgia Advance Directive & Living Will Kit walks you through the advance directive and POLST relationship, includes a facility admission checklist, and provides wallet cards for patients transitioning between care settings.

See more Georgia guides →