Fig. 1.

POLST use in California nursing homes in 2011. (a) First MDS Section S completed in 2011: POLST Sections A, B, and C and signatures. (b) Last MDS Section S completed in 2011: POLST Sections A, B, and C and signatures Completed POLSTs are defined as those with Section A (resuscitation status) completed and signed by the resident/proxy and physician. POLST Section A contains preferences regarding resuscitation status, POLST Section B contains preferences regarding level of intervention, and POLST Section C contains preferences regarding artificial nutrition (2011 California POLST form provided in Online Appendix Figure 1). Denominator for all percentages is N = 289,753 (beyond the first branch in the tree). *Compared using the chi-square test, p < 0.0001