POLST Form by State: What Families Need to Know (NJ, PA, WA, OR and More)

When your parent is seriously ill or aging with a life-limiting condition, a conversation about resuscitation and emergency treatment is unavoidable. The POLST form turns that conversation into a set of medical orders that go wherever your parent goes — home, nursing facility, or emergency room. But POLST is not a federal document. Every state runs its own version, and the name, format, and requirements differ depending on where your parent lives.

This guide walks through how POLST works across key states, what it covers that an advance directive does not, and why completing it is one of the most practical steps a family can take right now.

What Is a POLST Form?

POLST stands for Physician Orders for Life-Sustaining Treatment. Unlike a living will or advance directive — which expresses a person's wishes — a POLST is a set of actual medical orders signed by a physician, nurse practitioner, or physician assistant. That distinction matters enormously.

An advance directive tells the family and healthcare team what the patient would generally prefer. A POLST tells paramedics, ER staff, and nursing home nurses exactly what to do or not do in a specific emergency — without requiring anyone to dig through paperwork or make judgment calls.

POLST forms are designed for people who are:

• Elderly and frail, even without a specific terminal diagnosis
• Living with a serious chronic illness (heart failure, COPD, advanced dementia)
• In their last year or two of life based on a clinician's assessment
• Already receiving hospice or palliative care

For generally healthy adults, an advance directive is sufficient. POLST becomes relevant when the chance of a serious medical emergency is real and near-term.

What a POLST Covers

Most POLST forms address three core questions:

1. CPR (Cardiopulmonary Resuscitation) If the heart stops, should emergency responders attempt to restart it? The form gives a clear yes or no. Choosing "do not attempt resuscitation" (DNAR) does not affect any other care — it only applies to cardiac arrest.

2. Medical Interventions This section distinguishes between three levels of care:

• Full treatment — all interventions including ICU care, mechanical ventilation, and artificial nutrition
• Selective interventions — some hospital treatment but no prolonged mechanical ventilation or intensive measures
• Comfort-focused treatment — medication and care to relieve pain and symptoms, with transfer to hospital only if comfort cannot be achieved at home

3. Artificially Administered Nutrition Some versions include a separate section on tube feeding, allowing families to specify preferences for long-term artificial nutrition.

POLST by State: Key Differences

New Jersey (NJ POLST)

New Jersey uses a bright pink form — the color is intentional so emergency responders can spot it immediately. It is officially called the "New Jersey POLST" form and must be signed by the patient (or their healthcare representative if the patient lacks capacity) and a licensed physician, NP, or PA.

In New Jersey, the form must be reviewed at least every 12 months or whenever the patient's condition changes significantly. The form is registered in a state database, though the paper copy remains the primary document paramedics look for.

To get the NJ POLST form: New Jersey's Division of Consumer Affairs maintains the current version. Your parent's physician can also provide and complete the form during an office visit or through the hospital discharge process.

Pennsylvania (PA POLST)

Pennsylvania uses the same "POLST" name and a standardized form issued by the Pennsylvania POLST Program. It is bright pink, similar to New Jersey, and is legally recognized by emergency responders across the state.

A key Pennsylvania requirement: the form must be signed by a physician, certified registered nurse practitioner (CRNP), or physician assistant. Patient signature alone is not sufficient — this is a medical order, not just a patient declaration.

Pennsylvania hospitals and nursing facilities are required to document POLST status in a patient's records. If your parent is being discharged from a rehabilitation facility or hospital, ask the discharge coordinator explicitly whether a POLST has been completed or updated.

Washington State (WA POLST)

Washington State calls its form the "Physician Orders for Life-Sustaining Treatment" but also officially accepts the term "POLST." The form is one of the most detailed in the country, including specific checkboxes for artificial nutrition and fluid hydration in addition to the standard CPR and intervention level sections.

Washington State has a POLST registry — the "WA POLST Registry" — where completed forms can be stored electronically, which allows emergency responders to access the orders even if the paper form is not immediately available. Enrollment in the registry is voluntary but strongly recommended for anyone who relies on home health aides or lives alone.

Oregon

Oregon was the original state that developed the POLST concept in the 1990s, and its form is called the "POLST" as well. Oregon's version is printed on bright pink paper, is two-sided, and includes a section for additional patient or family notes.

Oregon has a robust POLST registry maintained by the state's Department of Human Services. If your parent is in Oregon, ask their physician whether the completed form has been submitted to the registry. This is particularly important for parents living at home who may encounter a different medical team in an emergency than their regular provider.

Other States: Different Names, Same Concept

POLST exists in some form in every state, but the name varies:

• California: POLST (California POLST Program)
• New York: MOLST (Medical Orders for Life-Sustaining Treatment)
• Florida: DNRO (Do Not Resuscitate Order) — Florida does not currently use the full POLST format and has a more limited form
• Texas: OOH-DNR (Out-of-Hospital DNR) for CPR decisions; some providers also use a MOST form
• Illinois: POLST Illinois
• Ohio: DNR Comfort Care

If you are not sure whether your parent's state has a POLST equivalent, their physician's office or the local hospital social worker can direct you to the correct form.

A Note on DPOA and POLST Working Together

A common source of confusion: the Durable Power of Attorney for Healthcare (DPOA-HC) and the POLST form are not the same thing and do not replace each other.

The DPOA-HC appoints a person — the healthcare agent — to make medical decisions when your parent cannot speak for themselves. The POLST form documents specific medical orders that are immediately actionable. Your parent needs both.

If your parent has a DPOA but no POLST, the healthcare agent will be asked to make decisions in real time during a crisis. If your parent has a POLST but no DPOA, there is no one formally designated to update those orders if the situation changes and your parent cannot speak.

How to Bring This Up with Your Parent

The conversation does not have to start with the form. It can start with a question:

"If something happened and your heart stopped, would you want paramedics to try to restart it? I want to make sure we have that written down so no one has to guess."

That single question, asked calmly over coffee, is the foundation of the POLST conversation. From there, their doctor can guide the form completion during a routine appointment.

What Happens at the Scene

Emergency medical technicians (EMTs) and paramedics are trained to look for a POLST form at the patient's home, typically posted on the refrigerator or kept in a visible location near the bed. In states with electronic registries, some responders can access the database from the field.

If the POLST is not visible and the family cannot produce it, EMTs in most states are legally required to begin full resuscitation. This is why having the completed form accessible — not locked in a filing cabinet — matters as much as having completed it at all.

Where POLST Fits in a Complete End-of-Life Plan

A POLST form is one piece of a larger puzzle. A complete end-of-life plan also includes:

• A will or trust to direct the disposition of assets
• A durable power of attorney for finances so someone can manage accounts if your parent is incapacitated
• A healthcare proxy or medical power of attorney designating a decision-maker
• An advance directive or living will documenting general treatment preferences
• A document locator so the family can find all of the above when it matters

If your family is working through these documents together for the first time, the End-of-Life Planning Workbook from Elder Safety Hub provides a step-by-step framework, conversation guides, and fillable worksheets that walk through every one of these documents — including a section specifically for organizing and storing POLST and advance directive information.

Get the End-of-Life Planning Workbook

The POLST form itself is free through your parent's physician or state health department. What takes effort is having the conversation clearly enough that the form actually reflects what your parent wants. That is where the real planning happens.