Tennessee POST Form: What It Is and When You Need One

A Tennessee advance directive tells your family and doctors what you want. A POST form tells paramedics what to do right now. That distinction matters more than most people realize — because EMTs arriving at your home during a cardiac arrest cannot legally follow your advance directive. They need a POST form or an out-of-hospital DNR order.

The Physician Orders for Scope of Treatment (POST) form, governed by T.C.A. § 68-11-224, is Form PH-4193 issued by the Health Facilities Commission. It converts your treatment preferences into actionable medical orders that emergency responders, hospitals, and nursing facilities must follow.

Who Needs a POST Form

The POST form is specifically designed for individuals whose healthcare providers would not be surprised if they died within the next year. That includes people with:

• Advanced cancer or other terminal diagnoses
• Severe chronic conditions like end-stage COPD, heart failure, or kidney disease
• Advanced dementia or progressive neurological conditions
• Frailty requiring skilled nursing care

The POST is not intended for healthy adults doing routine advance care planning. If you're a generally healthy 55-year-old creating an advance directive, you don't need a POST form yet. You need an advance directive that names your healthcare agent and outlines your treatment preferences — the POST comes later, when your medical situation warrants it.

What the POST Form Covers

The POST addresses four categories of emergency medical decisions:

Section A — Cardiopulmonary Resuscitation (CPR). Do you want CPR attempted if your heart stops? Options range from full resuscitation attempts to DNR (do not attempt resuscitation).

Section B — Medical Interventions. What level of treatment do you want? Choices include full treatment (ICU, ventilators, intubation), limited additional interventions (IV fluids, cardiac monitoring, but no intubation), or comfort measures only (pain management and dignity-focused care).

Section C — Antibiotics. Do you want antibiotics used to treat infections, or only for comfort (such as treating a painful urinary tract infection)?

Section D — Artificially Administered Nutrition. Do you want feeding tubes or IV nutrition if you can no longer eat or drink? Options include long-term feeding tubes, a defined trial period, or no artificial nutrition.

How It Differs From an Advance Directive

The two documents complement each other. Your advance directive guides your healthcare agent and hospital physicians in making broader treatment decisions. Your POST form gives immediate, standing orders for emergency situations.

How to Get a POST Form Completed

1. Discuss your treatment preferences with your physician during a planned visit — not during an emergency
2. Your physician completes Form PH-4193 based on your stated wishes and clinical situation
3. Both you (or your surrogate) and the physician sign the form
4. Keep the original where emergency responders can find it — on the refrigerator door or near the front entrance
5. Faxes and photocopies carry the same legal force as the original

Once signed, a POST form is valid across all Tennessee healthcare settings: your home, ambulances, hospitals, nursing facilities, and hospice. If you transfer between facilities, the POST travels with you.

Families cannot legally override a POST form that the patient personally signed. If your medical condition changes and you want to update your orders, your physician can complete a new POST form — the most recent version supersedes all earlier ones.

The Tennessee Advance Directive & Living Will Kit includes a POST/DNR comparison guide that explains exactly when you need each form and how to coordinate them with your advance directive.

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