On January 23, 2015, the Centers for Medicare and Medicaid Services (CMS) revised surveyor guidance regarding Cardiopulmonary Resuscitation (CPR) in nursing homes. The guidance clarifies a facility’s obligation to provide CPR. CMS requires that nursing home staff maintain current CPR certification through a CPR provider whose training includes hands-on practice and in-person skills assessment. Online-only certification is not sufficient. However, the program may have an on-line knowledge component if it also requires an in-person demonstration or skills assessment to obtain certification or recertification.

The revised surveyor guidance also incorporates CMS’ prohibition against a facility-wide “no CPR” policy because this may prevent implementation of a resident’s advance directives and does not meet the quality standards found in 42 C.F.R. § 483.20(k). If a resident experiences a cardiac arrest and does not show obvious signs of clinical death, facility staff must provide basic life support, including CPR, prior to the arrival of emergency medical services in accordance with the resident’s advance directives or in the absence of any advance directives or a Do Not Resuscitate Order. Finally, the guidance reiterates CMS’ requirement that CPR certified staff must be available at all times.