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Originally published Monday, March 4, 2013 at 9:39 PM

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‘We always start CPR,’ Washington medical official says after Calif. facility refuses

Retirement-community officials in Washington are shocked at a nurse’s failure to attempt resuscitation on a resident of a California senior-living facility. The resident, 87, later died.

Seattle Times health reporter

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When news reports surfaced that a nurse in a California retirement home refused to perform CPR on a dying 87-year-old resident — despite the pleading of a 911 dispatcher to help her — local senior-living-facility leaders girded themselves for the questions.

“No, no, no! Nothing like that happens here!” exclaimed Rich Miller, president and CEO of the Washington Health Care Association, which represents assisted-living and skilled-nursing facilities in Washington.

At Merrill Gardens, which operates 24 independent, assisted and memory-care facilities in Washington, all the workers — even the dining-room staff — are required to get CPR training, said Wendy Gardner, vice president of quality services for the company, which operates 56 communities in nine states.

“We always start CPR,” Gardner said, “regardless of whether they’re in assisted living or not.”

Dr. Mickey Eisenberg, longtime medical director of King County Emergency Medical Services, which includes medical dispatch services for 911, said he’s never heard of a similar case in King County in the three decades he’s been involved in emergency-medical services and CPR training.

There was no indication the resident had a do-not-resuscitate order on file with the facility.

One issue that may have arisen in California, retirement-community leaders here said, is the distinction between a resident in an independent-living facility and one in a licensed assisted-living or nursing-home facility.

The resident was in an independent-living unit, which is essentially an apartment with added services such as housekeeping and meals — but not the ongoing medical care that could be offered in a licensed facility such as an assisted-living residence or nursing home.

Washington laws, however, make it clear that intermittent emergency assistance can be provided to a resident in an independent-living unit of a larger facility without fear of the facility having to acquire a higher-level license, said Deb Murphy, CEO of LeadingAge Washington, an association of long-term care providers.

And operators of local facilities that include both independent and assisted or nursing units say they’re very clear about what they should do if a resident of any part of the facility needed help.

The 87-year-old California woman, a resident of the Glenwood Gardens in
Bakersfield, collapsed in the dining room last Tuesday.

A woman from the facility who identified herself as a nurse called 911 but told the dispatcher she was not allowed to perform CPR.

The 911 dispatcher pleads with her to find someone who can perform CPR until the ambulance arrives, and offers to instruct someone else.

“Is there a gardener, any staff?” the dispatcher asks the nurse. “Anybody who doesn’t work for you anywhere? Can we flag someone down in the street and get them to help this lady? ... Can we flag a stranger down? I bet a stranger will help her ...”

No CPR was performed until medics arrived. Battalion Chief Anthony Galagaza of the Bakersfield Fire Department, the first on the scene, said the resident, Loraine Bayless, did not have a do-not-resuscitate order on file, according to reports by The Associated Press.

Firefighters began CPR, and continued until they transported Bayless to the hospital, where she later died.

“If we had that issue, we would provide resuscitation,” said Kevin McFeely, chief operating officer of The Hearthstone at Green Lake, which has independent-living, assisted-living and memory-care units.

“When you have somebody residing in your community, you err on the side of caution,” he said. “I’d be surprised if you talked to anyone who didn’t do that.”

McFeely said he wondered whether the nurse in California understood the policy clearly.

However, management of Glenwood Gardens, in a written statement, said the nurse did follow the facility’s policy.

While each state’s nursing board has its own standards of practice, McFeely said he believed such a refusal to act could put the nurse’s license in jeopardy.

“Good Samaritan” laws would protect someone from liability acting on behalf of a patient in an emergency situation, McFeely said. “There are a whole lot of protections there.”

Emeritus Senior Living, a national company with 28 communities in Washington, said the policy is that any individual certified in CPR can administer it as long as they have called 911 or arranged for someone else to do so, said Budgie Amparo, executive vice president of quality and risk management.

“It is our policy to do the right thing in all circumstances, and we will stand behind any employee who does so,” Amparo said in a statement.

Material from The Associated Press was included in this report.

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com.

On Twitter #costrom

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