The Medical Orders for Scope of Treatment (MOST) document is a standardized form that patients can use to designate treatment preferences which can be used as medical orders across healthcare facilities. The legislation (2007) that authorized the creation the MOST form also requested that the NCIOM study the implementation of the form. This report summarizes the finding of the study, and includes key informant interviews and a web-based survey of hospital-based care managers and administrators of nursing homes, adult care comes, and assisted living facilities.