Penn. Nursing Home Ends No-CPR Policy
July 05--A federal directive is requiring the York County-operated nursing home to do away with its with no-CPR policy.
But officials at Pleasant Acres Nursing & Rehabilitation Center were a few steps ahead of the federal government and were in the process of putting a new CPR policy into place when a representative from the state Department of Health visited the facility to conduct an implementation survey in May.
"We had already begun the plans before the federal government changed the rules on us," said Marlin Peck, the center's administrator. "They (state health officials) said we had to have it (the policy) in place, and we had it in place within two hours after they left."
New rules: That means Pleasant Acres, in Springettsbury Township, is no longer a "no-CPR facility" and its staff are trained to administer the potentially life-saving emergency procedure to residents who wish to receive it.
Nursing homes in the country are no longer allowed to have the blanket policy of being no-CPR facilities, according to a directive by the federal Centers for Medicare & Medicaid Services issued in October.
A memo from the federal agency, a division of the Department of Health & Human Services, says nursing homes must provide basic life support, such as CPR, to residents who experience cardiac arrest. As such, nursing homes must have CPR-certified staff on hand at all times.
However, nursing home care providers must continue to honor resident's wishes such as "do not resuscitate" orders, the memo says.
Younger residents: Part of the rule change comes as nursing homes are seeing an increase in the number of younger patients, most of whom are short-stay residents, who are there for medical care or rehabilitation and could benefit from CPR, according to the memo.
When a resident of Pleasant Acres suffered a cardiac arrest event in the past, staff had to call 911 and await the arrival of trained medics, who then preformed CPR.
In order to comply with the new rules, 375-bed Pleasant Acres, which also has 32 independent living units, certified its staff on how to preform CPR, Peck said.
The staff were trained in-house by a staff member certified in CPR and were also trained to use automated external defibrillators (AED), cutting the cost incurred by the county. All told, the changeover cost less than $5,000, he said.
Respiratory services staff and about two dozen nurses were already certified to preform CPR.
The center's auxiliary, which raises money through fundraising efforts, bought the AEDs, further cutting the cost, Peck said.
Potentially harmful: Though the center is now equipped to perform CPR, some studies show the outcome is rarely a success on elderly nursing home residents.
A 2012 study published in the Journal of the American Medical Directors Association found that the post-CPR survival rate among elderly nursing home residents stands at between 2 percent and 11 percent.
"The way it's offered, the chest compressions can cause serious injuries," Peck said.
-- Reach Greg Gross at ggross@yorkdispatch.com.
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