CMS: Nursing homes may not establish blanket no-CPR policies

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Mother, daughter dead after apparent murder-suicide at San Francisco nursing home
Mother, daughter dead after apparent murder-suicide at San Francisco nursing home
Nursing homes will face survey citations for facility-wide policies that prohibit cardiopulmonary resuscitation for residents, according to a recent Centers for Medicare & Medicaid Services memorandum.
 
Research has shown that CPR is not very effective in the elderly nursing home population, and some facilities have put in place general no-CPR policies, the memo states. However, this does not comply with federal regulations that guarantee the right of residents to formulate advance directives. Therefore, nursing homes are prohibited from establishing and implementing these blanket policies, according to CMS.
 
If an advance directive or do-not-resuscitate order is not in place for a particular resident, staff must provide CPR if that resident experiences cardiac arrest, the CMS document states.
 
“Any limits on how a facility may implement advance directives should be applied on a case-by-case basis, taking into consideration a resident's preferences, medical conditions, and cultural beliefs,” according to the memo, dated Oct. 1. 
 
The document also notes that nursing homes are seeing more short-stay and younger residents, for whom CPR is a more effective life-saving measure. Research published last week shows that strokes are increasingly common among people between the ages of 20 and 65, suggesting this trend of younger residents will continue.