In a recent revision to an S&C letter Ref: 14-01-NH which mandated that nursing homes may not establish or implement facility-wide no CPR policies, CMS has revised Guidance to Surveyors in Appendix PP at F-155 to clarify information on this policy. Facility-wide no CPR policies violate the rights of residents to formulate an Advance Directive under this F-tag.
Facilities must have a policy in place to ensure that staff, at a minimum, initiate CPR when cardiac arrest occurs for:
- Residents who have requested CPR in their Advance Directives
- Residents who do not have a valid DNR order in place
- Residents who do not show obvious signs of Clinical Death
Additionally, facility policies can not only require that staff call 911. Initial basic life support must be performed until emergency services arrive, including initiating CPR. As such, CPR-certified staff must be available at all times. Certified staff must have engaged in training that requires hands-on practice and in-person skills assessments, not just online-only certification courses.
Read the January 23, 2015 revision to S&C Letter 14-01-NH and the Appendix PP draft Guidance revisions at F-155.