Do Florida Nurse Registries Need Advance Directives or a DNR Form?

By Scott Strachan, RN BSN. Last reviewed September 2026. Statutes cited are from the 2026 Florida Statutes.

No. Florida law does not require a nurse registry to collect advance directives or keep a DNR form in the client file. The nurse registry statute and AHCA’s nurse registry rules don’t mention either one. Asking about them is still a good practice, and the Florida DNRO only works if it’s the official yellow form and someone can find it.

This post is for registry owners and applicants who have been asked about advance directives during a survey, or who want a sensible way to handle DNR orders without taking on responsibilities the law doesn’t give them. It covers what’s required, what isn’t, how Florida’s DNRO works, and what we do at Abby Services.

Why this question comes up in surveys

A client of mine was recently told by a surveyor during an initial licensure survey that they needed advance directives in their client forms. That isn’t in the nurse registry statute or rules. The surveyor went off script, and that’s exactly why surveyors have a script.

The confusion is understandable. The same surveyors inspect other provider types, and some of those providers do have advance directive and DNR requirements. Home health agencies are one. Nurse registries are not.

From the registry office: A surveyor once asked me whether I thought advance directives were a good idea. I said sure, but is it required? A registry can’t be expected to guess what else a surveyor might want. If something is a good idea for every registry, the place to make it a requirement is the Legislature.

What the law says

What the law says. Section 400.506, F.S., the nurse registry statute, and Chapter 59A-18, F.A.C., AHCA’s nurse registry rules, don’t mention advance directives, living wills, or do not resuscitate orders.

The advance directive notice requirement in Section 765.110, F.S. applies to health care facilities under the federal Patient Self-Determination Act. That law covers Medicare and Medicaid providers such as hospitals, nursing homes, hospices, and home health agencies.

Home health agencies also have a DNR provision of their own. Section 400.487(7), F.S. says home health agency personnel may withhold or withdraw CPR when presented with a valid order not to resuscitate. The nurse registry statute has no matching provision.

What that doesn’t mean. It doesn’t mean advance directives don’t matter, or that a registry should ignore them. It means you aren’t required to collect them, file them, or put them in your policies.

The rule I give every client: Anything you put in your policies and procedures that the law doesn’t require still gets held against you in a survey.

What we see in practice. Surveyors sometimes carry expectations over from other provider types. Know what’s required, be polite, and ask to be shown where it is in statute or rule.

How Florida’s DNRO works

Florida has its own do not resuscitate order, DH Form 1896, published by the Department of Health and governed by Rule 64J-2.018, F.A.C. The details matter:

• It must be yellow. EMS is only required to honor the form if it’s printed on yellow paper, any shade. A copy counts if it’s on yellow paper and the signatures are legible. A white photocopy does not.
• Two signatures. The patient or the patient’s representative, and a Florida-licensed physician, advanced practice registered nurse, or physician assistant. No notary is needed.
• It’s directed to EMS. Under Section 401.45, F.S., it tells Florida paramedics and EMTs they may withhold resuscitation. Hospitals and hospices may honor it too.
• It comes with a wallet card. A reduced-size copy is attached so the client can carry it.
• It’s Florida-specific. The Florida DNRO is directed to Florida-certified EMS, and a DNR from another state isn’t the same thing.

That last point catches a lot of people. Many of our clients come to Florida from other states, and they believe their paperwork is in order when it isn’t. A living will or an out-of-state DNR doesn’t replace the Florida yellow form.

A DNRO in a drawer does nothing

The form only works if it’s in front of EMS when they walk in. In an emergency, no one has the time or the presence of mind to go looking for it. I encourage clients and families to post it where it can’t be missed. The refrigerator is the classic spot, and the wallet card should stay with the client.

It also matters that people make their wishes known. Years ago, Florida’s Terri Schiavo case made national news. She had no written advance directive, and her family spent years in court over what she would have wanted. If your wishes aren’t written down, they may not be honored.

When a client stops breathing

There is no good answer here that covers every situation. This is what I tell caregivers:

1. No valid DNRO: call 911 and start CPR.
2. A valid yellow DNRO: call 911 and hand EMS the form. EMS makes the resuscitation decision under the law that authorizes them to.
3. Hospice is involved: follow the hospice plan and call the hospice. Hospice is another authoritative source, and these decisions are part of what they manage every day.

Because the nurse registry statute doesn’t give referred caregivers the same express authority home health agency personnel have, have an attorney review whatever you tell caregivers before you put it in writing.

What we do at Abby Services

We keep it simple, and we stay in our lane as a registry:

• At intake, we ask whether the client has a DNRO or other advance directives.
• We note the answer on the client’s demographic face sheet and in our software.
• We communicate it to the client’s caregiver so they know it exists and where it is.
• We don’t collect or manage the DNRO. That stays with the client, the family, and the physician. We can offer input and guidance, like pointing them to the Florida form and suggesting they post it.

From the registry office: I’ve worked hospice through Abby and in inpatient settings, so this one is close to my heart. A DNRO is pointless if it’s filed away.

What to tell a surveyor

If you’re asked about advance directives, you don’t need to argue. A short, accurate answer works:

“Advance directives aren’t required for nurse registries under 400.506 or 59A-18. We ask about them at intake, note them on the face sheet and in our software, and let the caregiver know. We encourage clients to use the Florida yellow DNRO and keep it posted.”

If the surveyor still wants to cite it, ask where the requirement is. For more on handling a disagreement before the surveyor leaves, see AHCA Omission Letters and Citations.

Frequently asked questions

Are Florida nurse registries required to have advance directives in client files?

No. Section 400.506, F.S. and Chapter 59A-18, F.A.C. don’t require nurse registries to collect or keep advance directives. It’s a good practice to ask about them and note the answer.

What is the Florida DNRO form?

It’s DH Form 1896, the Department of Health’s do not resuscitate order. It must be on yellow paper and signed by the patient or representative and a Florida-licensed physician, APRN, or PA.

Is a photocopy of a Florida DNRO valid?

Yes, if it’s on yellow paper or has a full yellow background and the signatures are legible. A white photocopy is not.

Does a DNR from another state work in Florida?

Don’t count on it. The Florida DNRO is directed to Florida-certified paramedics and EMTs. Clients moving from other states should complete the Florida yellow form with their physician.

Can a nurse registry caregiver honor a DNRO?

Florida law gives that express authority to EMS and to home health agency personnel, not to nurse registry caregivers. Our practice is to call 911 and hand EMS the form, or follow the hospice plan when hospice is involved.

Where should a client keep a DNRO?

Somewhere EMS will see it right away, such as on the refrigerator, with the wallet card on the client. A DNRO filed in a drawer won’t help in an emergency.

Getting ready for your survey?

Book a free 15-minute consultation. We’ll talk through what surveyors ask, what’s actually required, and how to answer both. Call 239-766-8238, or see the Path to Licensure.

This article provides general regulatory information. It is not legal, tax, or insurance advice.