Revised Ftag of the Week – F678 CPR

Happy New Year! We first posted an “Ftag of the Week” for F678 Cardio-Pulmonary Resuscitation (CPR) back in 2017. Now it’s time for a little update to reflect the CMS QSO Memo from November 2024 which includes revised guidance for surveyors effective February 24, 2025 effective March 25, 2025 per the updated QSO Memo from January 13, 2025. The revised guidance for F678 thankfully provides more, rather than less, flexibility to providers. Let’s look at what’s changed.

The current State Operations Manual (8/16/2024) specifically states that there must be hands-on practice and in-person skills assessment, and that online-only certification was not acceptable. Barring any additional surprise changes/ tweaks to the draft Interpretive Guidance (IG) in the QSO Memo, the IG will now state that staff must have current CPR certification for healthcare providers which has been provided by a trainer where the training includes either physical or virtual instruction. The language regarding hands-on, in-person assessments has been removed. Specifically, F678 will read:

CPR Certification

Staff must maintain current CPR certification for Healthcare Providers through a CPR provider whose training includes a hands-on session either in a physical or virtual instructor-led setting in accordance with accepted national standards. For concerns related to CPR certification that meets accepted professional standards the survey team should consider §483.21(b)(3)(ii), Services Provided by Qualified Persons, F659 and/or §483.70(b) Compliance with Federal, State, and Local Laws and Professional Standards. F836.

What Else to Know about F678

In case you didn’t read the first go-round of the CMSCG Ftag of the Week for F678, here are some important reminders:

  • Residents have the right to formulate an advance directive. If the resident has a valid advance directive, the care provided must match this directive. Supportive and other pertinent care that is not prohibited by the advance directives must be provided as well.
  • Facilities should have procedures in place to document each resident’s choices regarding issues such as CPR. This includes verifying the presence of advance directives or the resident’s wishes related to CPR on admission.
  • Facility-wide “no CPR” directives are prohibited, as these conflict with the resident’s right to formulate an advance directive.
  • The facility must have an adequate number of appropriately trained staff present at all times to provide CPR when needed until emergency medical services arrive.
  • Facilities are required to ensure availability of staff to provide basic life support, including CPR, prior to the arrival of EMS if a resident experiences cardiac or respiratory arrest and the resident does not show obvious signs of irreversible death.

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