Helpful Information


Advance Directive

Advance Directive

Advance Directive for Eagle Rock Outpatient Center and Eagle Rock Ambulatory Surgery Center

Download Advance Directive Information in PDF Format


  • To provide an atmosphere of respect, caring and preservation of dignity related to a patient’s medical care decision making, and to ensure that each patient's ability and right to participate in the self determination of care is maximized and respected and not compromised as a result of admission for care while at Eagle Rock ASC/OPC.
  • Additionally, to assure compliance with the Patient Self-Determination Act (PSDA) in such a manner as to expand the patient, staff and community knowledge base regarding advance directives and the process by which patient participation in medical decision making is carried out at this facility.


  • Eagle Rock ASC/OPC will respect and encourage patient self-determination.  Patients will be encouraged and assisted to be active participants in the decision-making process regarding their care through education, inquiry and assistance as requested.
  • Patients will be encouraged to communicate their desires in regard to advance directives to their significant others, to allow for guidance by significant others and healthcare providers in following the patient's wishes should the patient become incapacitated, rendering them unable to make decisions.
  • Eagle Rock ASC/OPC will inform all patients/patient representatives of any limitations if the facility cannot honor an advance directive on the basis of conscience.
    • A statement of limitation shall include, at a minimum:
      • Clarification of any difference between facility wide conscience objectives and those that may be raised by physicians
      • Identification of state legal authority permitting such an objection
      • Description of medical conditions or procedures affected by conscience objection
  • The existence of an advance directive, or lack thereof, will not determine the patient’s access to care, treatment and services.
  • Eagle Rock ASC/OPC will ensure compliance with state law regarding advance directives.
  • In an advance directive (or medical power of attorney), the patient may provide guidance as to his/her wishes in certain situations, or may delegate decision making to another individual as permitted by state law. 
    • If such an individual has been selected by the patient, or if a person willing and able under applicable state law is available to make treatment decisions, relevant information should be provided to the representative so that informed healthcare decisions can be made for the patient.
    • However, as soon as the patient is able to be informed of his/her rights, this facility will provide that information to the patient.
  • The advance directive will be maintained in the patient’s medical record.
  • Eagle Rock ASC/OPC will educate appropriate staff regarding advance directives.
  • Eagle Rock ASC will always attempt to resuscitate a patient and transfer that patient to a hospital in the event of deterioration. 


  • An inquiry will be made by the Registration staff during the admissions process of the patient, or if the patient is incapacitated, to the patient's significant other, as to whether or not the patient has completed an advance directive.  Eagle Rock ASC/OPC will not condition the provision of care or otherwise discriminate against any individual based on whether or not the individual has executed an advance directive.
  • A request of the patient/significant other to provide a copy of the advance directive for medical record entry will be made by the Registration staff during the admission process.
  • As part of the admission process the patient/significant other will be provided with an information packet outlining the individual's rights to make decisions concerning medical care.  The information packet provided will include:
    • The right to accept or refuse medical or surgical treatment, even if the treatment is life sustaining
    • Information concerning the Patient Self-Determination Act
    • That the existence of an advance directive, or lack thereof, will not determine the patient’s right to care, treatment or services
    • Definitions of pertinent healthcare terminology as they apply to the Patient Self Determination Act
    • Policy regarding the patient's right to voice a complaint related to advance directive requirements to the State Department of Health Services
    • Contact staff available to assist those interested in pursuing or making changes to the advance directive issue
    • Applicable State health and safety law
  • Registration staff will document in the medical record whether the patient has completed an advance directive and that information concerning advance directives has been given to the patient/significant other during the admission process.

Outpatient Facility Settings

  • Eagle Rock ASC/OPC will provide information regarding advance directives to outpatients/families upon request and when warranted by the care, treatment or service provided by the facility.
  • For those outpatients who request information regarding advance directives, staff will information to the patient and the family.
  • Patients will be made aware that advance directives , Do Not Resuscitate and Do Not Intubate will not be followed while in the care at Eagle Rock Surgery Center.


  • Protection and Advocacy System (Idaho)