Nursing Homes Must Not Implement Blanket No-CPR Policies, Says CMS

​Nursing homes must not have facility-wide policies to not provide cardiopulmonary resuscitation (CPR) to residents, states an October 18, 2013, Centers for Medicare and Medicaid Services (CMS) memorandum to state survey agency directors. According to CMS, blanket no-CPR policies prevent full implementation of advance directives and do not promote person-centered care. Specifically, federal regulations at 42 CFR § 483.10 provide that a resident of a skilled nursing facility or nursing facility has the “right to a dignified existence” and “self-determination,” including the right “to formulate an advance directive.” While recognizing that research generally shows that CPR is ineffective in the elderly nursing home population, CMS noted that the nursing home population increasingly comprises younger residents requiring medical care and residents needing short-term rehabilitation. It is also growing more culturally diverse, and cultural issues may have a significant impact on a resident’s beliefs regarding end-of-life issues.