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Nebraska Healthcare Power of Attorney Requirements

Nebraska's Power of Attorney for Health Care law bars not just family members but also your romantic or dating partner and any member of your mental health treatment team from serving as a witness or as your attorney in fact, a modern addition most states' health care power of attorney statutes don't include.

Introduction

Nebraska's Power of Attorney for Health Care law bars not just family members but also your romantic or dating partner and any member of your mental health treatment team from serving as a witness or as your attorney in fact, a modern addition most states' health care power of attorney statutes don't include. This document, created and governed by Nebraska Revised Statutes Sections 30-3401 through 30-3432, lets you name someone you trust, your attorney in fact, to make health care decisions for you if you are ever unable to make them yourself. This document is narrower than a general power of attorney, reaching only health care decisions. Your money, property, and bills fall outside what it covers. It also works differently than people often assume: signing it does not hand your attorney in fact immediate authority. Your attorney in fact can only start making decisions once your attending physician determines, in writing, that you are incapable of making your own health care decisions, and you may even require that a second physician confirm any future incapacity finding. Before that point, all health care decisions remain yours to make. Nebraska gives you two ways to make the document legally valid: sign it in front of two qualified witnesses, or sign it before a notary public. The Nebraska Department of Health and Human Services publishes a version of the statutory form, and there is no state registry to file it with. You simply keep the original and give copies to your physician, your attorney in fact, and any successor attorney in fact.

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Key Things to Know

  1. 1

    Nebraska's Power of Attorney for Health Care disqualifies not only close relatives but also romantic or dating partners and mental health treatment team members from witnessing the document, a modern addition to the traditional conflict-of-interest list; the document itself lets you (the principal) name a trusted adult (the attorney in fact) to make health care decisions for you if you become unable to make them yourself.

  2. 2

    Your attorney in fact's authority does not start the moment you sign. It begins only after your attending physician determines in writing that you are incapable of making your own decisions, and you can require that a second physician confirm any future determination (Neb. Rev. Stat. Section 30-3412).

  3. 3

    Unless you limit it in the document, your attorney in fact can make any and all health care decisions for you, guided by your wishes or, if unknown, your best interests and religious and moral beliefs.

  4. 4

    Your attorney in fact cannot be your attending physician, a member of your mental health treatment team, an unrelated employee of either, or an unrelated owner, operator, or employee of a facility where you are a patient or resident (Neb. Rev. Stat. Section 30-3406).

  5. 5

    You need two adult witnesses who both clear Nebraska's disqualification list (no spouse, parent, child, sibling, presumptive heir, attending physician, mental health treatment team member, or romantic partner), or you can sign before a notary instead. You do not need both.

  6. 6

    You can revoke the document at any time while you are competent, in any manner that communicates your intent, simply by telling your attorney in fact, your physician, or a health care provider.

  7. 7

    If you name your spouse as attorney in fact and later divorce, their authority ends automatically unless your document or the divorce decree states otherwise.

  8. 8

    Nebraska has no central state registry for Powers of Attorney for Health Care. Keep the signed original and give copies to your physician, your attorney in fact, and any successor attorney in fact.

  9. 9

    This is a different document from Nebraska's Durable Power of Attorney under the Nebraska Uniform Power of Attorney Act, which covers property and financial decisions, not health care.

Key decisions before you file

Before you file a Healthcare Power of Attorney in Nebraska, a few decisions shape the document: which option to choose and what each one means. The Healthcare Power of Attorney guide walks through them.

Open the Healthcare Power of Attorney guide

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NEBRASKA POWER OF ATTORNEY FOR HEALTH CARE. STATE EXECUTION TEMPLATE

NOTICE: Under Nebraska Revised Statutes Sections 30-3401 to 30-3432, this is a legal Power of Attorney for Health Care. Signing it lets you, the "principal," appoint a trusted adult, your "attorney in fact," to make health care decisions on your behalf once you are unable to make them yourself. Money, property, and other financial matters are outside its scope.

  1. Designation of Attorney in Fact I, [Principal Name], of [County], Nebraska, appoint [Attorney in Fact Name], of [Address and Phone], as my attorney in fact to make health care decisions for me as authorized in this document. If my attorney in fact is unable or unwilling to act, I appoint [Successor Attorney in Fact Name] as my successor attorney in fact.

  2. Grant of Authority Except as I state otherwise below, my attorney in fact may make any and all health care decisions for me, consistent with my wishes or, if my wishes are unknown, my best interests, with due regard for my religious and moral beliefs.

  3. When My Attorney in Fact's Authority Begins This document takes effect as soon as I sign it, but my attorney in fact may not actually make decisions for me until my attending physician determines in writing that I am incapable of making my own health care decisions. I may require that any future incapacity determination be confirmed by a second physician. My attorney in fact's authority ends automatically if I am later found capable again, unless I direct otherwise, and it recommences if I become incapable again.

  4. Attorney in Fact Restrictions My attorney in fact may not be my attending physician or a member of my mental health treatment team, an unrelated employee of either, an unrelated owner, operator, or employee of a facility where I am a patient or resident, or an unrelated person already serving as attorney in fact for ten or more other people.

  5. Life-Sustaining Treatment and Nutrition or Hydration My attorney in fact has no authority to withhold or withdraw routine comfort care or the usual provision of nutrition and hydration. My attorney in fact may consent to withholding or withdrawing a life-sustaining procedure or artificially administered nutrition or hydration only if I am in a terminal condition or persistent vegetative state, and only if I have explicitly granted that authority here or my wishes are shown by clear and convincing evidence.

  6. Revocation I may revoke this document at any time while I am competent, in any manner that communicates my intent, by telling my attorney in fact, my physician, or a health care provider.

EXECUTION (Nebraska Revised Statutes Section 30-3404). Choose ONE: (a) Sign in the presence of two adult witnesses. Neither witness may be my spouse, parent, child, grandchild, sibling, presumptive heir, known devisee, attending physician, a member of my mental health treatment team, my romantic or dating partner, my attorney in fact, or an employee of a life or health insurer for me. No more than one witness may be an administrator or employee of a health care provider caring for me. Both witnesses sign below. (b) Sign and have my signature acknowledged before a notary public, who may not be my attorney in fact or successor attorney in fact. No witnesses are required if I choose this option.

For decisions about money and property, see Nebraska's separate Durable Power of Attorney under the Nebraska Uniform Power of Attorney Act.

Nebraska Requirements for Healthcare Power of Attorney

Power of Attorney for Health Care Authority (Neb. Rev. Stat. Sections 30-3401 to 30-3432)

Establishes the legal framework letting a competent adult designate an attorney in fact to make health care decisions if the adult later becomes incapable (Section 30-3401).

Pregnancy Limitation on Attorney in Fact Authority (Neb. Rev. Stat. Section 30-3417)

Under Neb. Rev. Stat. Section 30-3417, an attorney in fact has no authority to make a health care decision that would result in the death of the principal's unborn child if it is probable the child would develop to live birth with continued care.

Immunity for Health Care Providers and Attorneys in Fact (Neb. Rev. Stat. Section 30-3423)

The Power of Attorney for Health Care has its own immunity provision protecting an attorney in fact who acts in good faith, and protecting a physician or health care provider who relies in good faith on a person's apparent status as attorney in fact, from criminal, civil, or professional-discipline liability.

Prohibition Against Suicide or Homicide Interpretation (Neb. Rev. Stat. Section 30-3401(3))

The Act states that it confers no new right regarding any specific medical treatment, does not alter existing homicide or suicide law, and does not condone, authorize, or approve homicide, suicide, or assisted suicide (Neb. Rev. Stat. Section 30-3401(3)).

Patient Self-Determination Act (42 U.S.C. Section 1395cc(f))

Facilities that participate in Medicare and Medicaid must inform patients of their rights under state law to make advance directives, including a Power of Attorney for Health Care.

HIPAA Authorization (45 C.F.R. Section 164.508)

Federal HIPAA regulations govern how the attorney in fact can be authorized to access the principal's protected health information once this document is in effect.

Anatomical Gift Authorization (Neb. Rev. Stat. Sections 71-4824 to 71-4843)

The Revised Uniform Anatomical Gift Act is codified at Sections 71-4824 to 71-4843. Under Section 71-4827, an agent of the donor, which includes an attorney in fact under a power of attorney for health care, may make an anatomical gift on the principal's behalf during the principal's life, unless the power of attorney for health care or another record prohibits it.

Advance Mental Health Care Directives Act Integration (Neb. Rev. Stat. Sections 30-4401 to 30-4415)

The Advance Mental Health Care Directives Act is a separate, distinctly executed instrument covering psychotropic medication, short-term facility admission, and electroconvulsive therapy preferences, with its own witness or notary and revocation rules. It is not automatically part of the Power of Attorney for Health Care. Current law (Neb. Rev. Stat. Section 30-3408(5)) allows a Power of Attorney for Health Care to include an advance mental health care directive, and the Power of Attorney for Health Care's own definitions (Section 30-3402) now expressly include mental health care within health care and cross-reference this Act.

Artificial Nutrition and Hydration Limits on Attorney in Fact Authority (Neb. Rev. Stat. Section 30-3418)

Neb. Rev. Stat. Section 30-3418 provides that: the attorney in fact has no authority to withhold or withdraw a life-sustaining procedure or artificially administered nutrition or hydration unless the principal is in a terminal condition or persistent vegetative state, and either the document explicitly grants that authority or the principal's intent is shown by clear and convincing evidence. In any case, the attorney in fact has no authority to withhold routine comfort care or the usual provision of nutrition and hydration.

Out-of-State Recognition (Neb. Rev. Stat. Section 30-3408(4))

Under Neb. Rev. Stat. Section 30-3408(4), a power of attorney for health care validly executed in another state is considered valid in Nebraska.

Health Care Surrogacy Act Fallback (Neb. Rev. Stat. Sections 30-601 to 30-619)

The Health Care Surrogacy Act establishes a hierarchy of default surrogate decision-makers, such as a spouse, adult child, parent, or adult sibling, for a patient who has not executed a valid Power of Attorney for Health Care.

Religious or Moral Objection by Health Care Provider (Neb. Rev. Stat. Section 30-3428)

Neb. Rev. Stat. Section 30-3428 provides that: a health care provider organization or an individual provider is not obligated to honor a decision by the attorney in fact that conflicts with the provider's formally adopted religious, ethical, or moral policy, but must promptly inform the attorney in fact and assist in transferring the principal to a provider willing to honor the decision.

Medicare/Medicaid Compliance (42 C.F.R. Section 489.102)

Medicare and Medicaid regulations require participating facilities to honor a patient's rights regarding advance directives, including the right to accept or refuse medical treatment.

Guardianship and Conservatorship Interaction (Neb. Rev. Stat. Sections 30-2601 to 30-2661 and Section 30-3420(5))

A valid Power of Attorney for Health Care supersedes guardianship and conservatorship proceedings regarding health care decisions, unless the document states otherwise (Section 30-3420(5)). Nebraska case law confirms this is not absolute: a court may still revoke or set aside a Power of Attorney for Health Care in favor of a guardianship when the ward's best interests support it (In re Guardianship and Conservatorship of Mueller, 23 Neb. App. 430 (2015)).

Electronic Signatures Validity (Neb. Rev. Stat. Sections 86-612 to 86-643)

Nebraska's Uniform Electronic Transactions Act generally allows electronic signatures for legal documents, but the Health Care Power of Attorney Act itself contains no declaration-specific electronic-signature rule of its own.

Frequently Asked Questions

A Power of Attorney for Health Care in Nebraska is a legal document, created under Neb. Rev. Stat. Sections 30-3401 to 30-3432, that lets you name a trusted adult (your attorney in fact) to make health care decisions for you if you ever become unable to make them yourself. It takes effect for decision-making purposes only after your attending physician determines in writing that you are incapable of deciding for yourself.

A Power of Attorney for Health Care covers only health care decisions. Nebraska's Durable Power of Attorney, created under the Nebraska Uniform Power of Attorney Act (Neb. Rev. Stat. Sections 30-4001 to 30-4045), covers property and financial matters instead, such as banking or real estate. The two documents also start differently. General powers of attorney under that Act are treated as durable by default, meaning they can take effect immediately and continue through any later incapacity. A Power of Attorney for Health Care never works that way. Your attorney in fact's authority always waits for your attending physician's written incapacity determination, with no immediate-effect option.

Nebraska law requires two adult witnesses, and both witnesses (not just one) must clear the same disqualification list. Neither witness may be your spouse, parent, child, grandchild, sibling, presumptive heir, known devisee, attending physician, a member of your mental health treatment team, your romantic or dating partner, your attorney in fact, or an employee of a life or health insurer for you (Neb. Rev. Stat. Section 30-3405). No more than one witness may be an administrator or employee of a health care provider caring for you. You can sign before a notary instead, and no witnesses are required in that case.

No. Nebraska law bars a person from acting as your attorney in fact while also serving as your attending physician or a member of your mental health treatment team, unless that person happens to be related to you by blood, marriage, or adoption (Neb. Rev. Stat. Section 30-3406).

No. Nebraska does not operate a central registry for Powers of Attorney for Health Care. The document simply becomes part of your medical record once a health care provider learns of it (Neb. Rev. Stat. Section 30-3409), so you should keep the signed original yourself and give copies to your physician, your attorney in fact, and any successor attorney in fact.

You can revoke it at any time while you are competent, in any manner that communicates your intent to revoke, such as telling your attorney in fact, your attending physician, or a health care provider. Simply writing new instructions or limitations does not revoke the document unless you say it does (Neb. Rev. Stat. Section 30-3420).

Only in limited circumstances. Your attorney in fact has no authority to withhold or withdraw routine comfort care or the usual provision of nutrition and hydration. Your attorney in fact may consent to withholding or withdrawing a life-sustaining procedure or artificially administered nutrition and hydration only if you are in a terminal condition or persistent vegetative state, and only if you explicitly granted that authority in the document or your wishes are shown by clear and convincing evidence (Neb. Rev. Stat. Section 30-3418).

No. Nebraska treats them as two separate documents. A Power of Attorney for Health Care appoints a person, your attorney in fact, to make decisions for you. A living will, created under Nebraska's separate Rights of the Terminally Ill Act (Neb. Rev. Stat. Sections 20-401 to 20-416), lets you write down your own instructions about life-sustaining treatment in a terminal condition or persistent vegetative state, without naming anyone to decide on your behalf. Nebraska law lets you use both.