Long-Term Care Survey Alert

2 key guidelines give your facility wiggle room.

In developing effective cardiopulmonary resuscitation  policies and procedures, follow these rules to avoid trouble down the line.

Rule No. 1: Make the policies and procedure realistic and achievable. The time frames for CPR spelled out by the facility's policies and procedures can "shoot [it] in the foot," cautions attorney Matthew Murer, an attorney with Foley & Lardner in Chicago. "It may sound reasonable when people are sitting around a conference table to say we will do this in x minutes and y in a certain number of hours." But  in an emergency, you may not be able to hit those goals, he says.

Rule No. 2: Individualize the CPR policies and procedures to fit the facility. For example, take a look at your staff's expertise and the facility's case-mix."A subacute facility with higher than average acuity will have a different expectation for managing cardiopulmonary arrest ...," says Christopher Puri, an attorney with Boult Cummings Conners & Berry in Nashville, TN.

Taking the no-code road: Some nursing facilities are setting themselves up as "no code" facilities where they don't do CPR -- much like a non-smoking facility, says Barbara Miltenberger, JD, with Husch & Eppenberger in Jefferson City, MO.  Residents agree to the no-code policy at admission. The no-code strategy doesn't work well if the facility admits a lot of rehab patients, she adds.