Minnesota POLST Form: How It Works and When You Need One
A POLST — Provider Orders for Life-Sustaining Treatment — is the document that EMS crews, hospital staff, and nursing home nurses follow when a patient is actively dying or in a medical crisis. It is not something you fill out at your kitchen table. A physician, advanced practice registered nurse (APRN), or physician assistant must complete and sign it with you.
This distinction matters because many Minnesotans confuse a POLST with an advance directive. They serve different purposes, activate at different times, and carry different legal weight.
POLST vs. Health Care Directive
| Feature | Health Care Directive | POLST |
|---|---|---|
| Who completes it | You (the individual) | Your healthcare provider, with you |
| Who signs it | You + notary or two witnesses | Physician, APRN, or PA |
| When it activates | When you lose decision-making capacity | Immediately — it is an active medical order |
| Portability | Depends on provider having a copy | Travels with you across all clinical settings |
| Primary use | Future planning for any medical scenario | Directing treatment right now for serious illness |
A Health Care Directive is a planning document. You create it while healthy, and it sits dormant until you lose the ability to make your own decisions.
A POLST is a medical order that takes effect immediately. It tells paramedics whether to attempt CPR, tells the ER whether to intubate, and tells the nursing home whether to transfer you to a hospital or keep you comfortable in place.
DNR vs. POLST in Minnesota
A Do Not Resuscitate (DNR) order is one specific instruction: do not attempt cardiopulmonary resuscitation if my heart stops. A POLST is broader — it covers CPR, but also addresses mechanical ventilation, hospital transfers, IV fluids, and antibiotics.
In practice, a DNR in Minnesota is typically embedded within a POLST rather than existing as a separate order. The POLST form has a section for CPR preferences (attempt resuscitation or do not attempt), and a separate section for other interventions.
If you only have a DNR but no POLST, paramedics will honor the no-CPR instruction but may still intubate you, start IV medications, or transport you to a hospital for aggressive treatment. A POLST provides the full picture.
Who Should Have a POLST
Not everyone needs one. POLST forms are designed for people who:
- Have a serious, life-limiting illness
- Are in the advanced stages of a chronic condition
- Are frail and elderly with declining health
- Have been hospitalized multiple times in the past year
- Are transitioning to hospice or palliative care
If you are generally healthy and planning for the future, a Health Care Directive is the right document. If you are facing an active medical situation where treatment decisions need to be communicated across providers right now, a POLST translates your wishes into binding orders.
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How a POLST Works in Minnesota
Your physician (or APRN or PA) initiates the conversation, reviews your medical condition, and completes the POLST form based on your stated preferences. The provider signs the order. Your signature is optional — the form is legally valid without it.
Once signed, the POLST is a medical order that binds every provider who treats you:
- Emergency medical services (EMS): Paramedics follow the POLST. If it says "Do Not Resuscitate," they do not begin CPR.
- Hospitals: The ER team follows the POLST on admission. It overrides default protocols.
- Nursing homes and assisted living: Staff follow the POLST for in-facility events.
- Hospice: The POLST aligns with the hospice care plan.
Photocopied, faxed, and electronic versions of a POLST are legally valid in Minnesota. Healthcare providers who follow a POLST in good faith have complete statutory immunity from civil and criminal liability.
The POLST should be reviewed whenever you are transferred between care settings, discharged from a hospital, or experience a significant change in your medical condition. It is not a set-it-and-forget-it document.
Getting a POLST in Minnesota
You cannot download a POLST and fill it out yourself. Contact your primary care provider, specialist, or hospital care team to initiate the conversation. If you are in a nursing home, ask the medical director.
Honoring Choices Minnesota — a statewide organization embedded in major health systems like Allina, Fairview, and HealthPartners — provides training for facilitators who guide these conversations, but the form itself must be completed by a licensed provider.
What to Do First
If you do not yet have a Health Care Directive, start there. The directive handles the broader planning — who makes decisions, what your general preferences are, and what instructions apply across future scenarios. The POLST is a targeted, provider-driven order for a specific clinical situation.
The Minnesota Advance Directive & Living Will Kit covers the Health Care Directive process, explains how it coordinates with a POLST, and includes a treatment preferences worksheet you can bring to the POLST conversation with your provider.
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