Cardiopulmonary Resuscitation (CPR) in Nursing Homes
***Revised to include information on CPR certification and Appendix PP draft guidance revisions at F155***
• Revisions to Guidance - The Centers for Medicare & Medicaid Services (CMS) have revised the guidance to surveyors in Appendix
PP under F155 to clarify a facility’s obligation to provide CPR.
• Initiation of CPR - 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. CPR-certified
staff must be available at all times.
• Facility CPR Policy - Some nursing homes have implemented facility-wide no CPR policies. Facilities must not establish
and implement facility-wide no CPR policies.
• Surveyor Implications - Surveyors should ascertain that facility policies related to emergency response require staff to
initiate CPR as appropriate and that records do not reflect instances where CPR was not initiated by staff even though the
resident requested CPR or had not formulated advance directives.
• CPR Certification - Staff must maintain current CPR certification for healthcare providers through CPR training that includes
hands-on practice and in-person skills assessment. Online-only certification is not acceptable.