Thomas A. Eaton

Implementation of the Patient Self-Determination Act: A Comparison of Nursing Homes to Hospitals

The Patient Self-Determination Act (PSDA) requires all health care facilities receiving Medicare or Medicaid funds to provide information about advance directives and the right of patients to refuse medical treatment. Administrators of 155 nursing homes in the state of Georgia completed surveys to assess implementation practices employed to comply with the PSDA mandates, knowledge of the law, and perceived effects of the passage of the PSDA. Responses from nursing home administrators were summarized, reported, and compared to results obtained from Georgia hospitals. Important differences were discovered. Nursing homes routinely provide more types of information to residents and spend more time with residents explaining relevant information than do hospitals, but hospital administrators demonstrated better knowledge of the PSDA and state law than nursing home counterparts. The implications of findings regarding the implementation of the PSDA and its overall effectiveness are discussed.