Long-term care facilities cannot institute “no CPR” policies according to a memorandum issued by the Centers for Medicare & Medicaid (CMS). The memo notes that such policies are contrary to federal regulations that ensure the resident’s right to have an advance directive or “do not resuscitate (DNR)” order on file.
According to the memo, if a resident without an advance directive or DNR on file experiences cardiac arrest, CPR and basic life support must begin before emergency services arrive. Individuals with advance directives or DNR orders, however, should have CPR and basic life support provided according to the wishes expressed in those documents. CPR-trained personnel should be available at all times.
CMS notes that facility-wide “no CPR” policies disregard residents’ right to create their own advance directives. The memo states: “The right to formulate an advance directive applies to each and every individual resident and facilities must inform residents of their option to formulate advance directives.”
An article in the National Review Online notes: “This memo doesn’t prevent Futile Care Theory from being imposed in individual cases.” However, nursing homes cannot ignore their residents in a crisis situation.
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