A little good news out of the federal bureaucracy for a change.
Apparently some nursing homes have instituted “no CPR” policies for all residents — regardless of what the patient or family might want — even if against an advance directive. Now, the Center for Medicare and Medicaid Services has issued an opinion informing nursing homes that such blanket policies violate the law. From the memo (Ref: S&C: 14-01-NH):
Prior to the arrival of emergency medical services (EMS), nursing homes must provide basic life support, including initiation of CPR, to a resident who experiences cardiac arrest (cessation of respirations and/or pulse) in accordance with that resident’s advance directives or in the absence of advance directives or a Do Not Resuscitate (DNR) order.
What about the “no CPR” policies?
Facilities must not establish and implement facility-wide no CPR policies for their residents as this does not comply with the resident’s right to formulate an advance directive . . . 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. Therefore, a facility-wide no CPR policy violates the right of residents to formulate an advance directive.
This memo doesn’t prevent Futile Care Theory from being imposed in individual cases. But at least it provides clarity that nursing homes can’t impose a duty to die and get out of the way on their residents.