Do Not Resuscitate Orders (DNROs)
(1) POLICIES AND PROCEDURES. (a) Each assisted living facility must have written policies and procedures that explain its implementation of state laws and rules relative to Do Not Resuscitate Orders (DNROs). An assisted living facility may not require execution of a DNRO as a condition of admission or treatment. The assisted living facility must provide the following to each resident, or resident ‘ s representative, at the time of admission:
1. Form SCHS-4-2006, ” Health Care Advance Directives – The Patient ‘ s Right to Decide, ” April 2006, or with a copy of some other substantially similar document, which incorporates information regarding advance directives included in Chapter 765, F.S
(b) There must be documentation in the resident ‘ s record indicating whether a DH Form 1896 has been executed. If a DH Form 1896 has been executed, a yellow copy of that document must be made a part of the resident ‘ s record. If the assisted living facility does not receive a copy of a resident ‘ s executed DH Form 1896, the assisted living facility must document in the resident ‘ s record that it has requested a copy.
(c) The executed DH Form 1896 must be readily available to medical staff in the event of an emergency.
(2) LICENSE REVOCATION. An assisted living facility ‘ s license is subject to revocation pursuant to Section 408.815, F.S., if, as a condition of treatment or admission, the facility requires an individual to execute or waive DH Form 1896.
(3) DNRO PROCEDURES. Pursuant to Section 429.255, F.S., an assisted living facility must honor a properly executed DH Form 1896 as follows:
(a) In the event a resident experiences cardiac or pulmonary arrest, staff trained in cardiopulmonary resuscitation (CPR) or a health care provider present in the facility, may withhold cardiopulmonary resuscitation (artificial ventilation, cardiac compression, endotracheal intubation and defibrillation).
(b) In the event a resident is receiving hospice services and experiences cardiac or pulmonary arrest, facility staff must immediately contact hospice staff. The hospice procedures take precedence over those of the assisted living facility.
- Make sure that you have identified all of your resident’s with a DNR
- Make sure all of those identified have the yellow form on file
- Take a moment and Review your resident admission package and facility DNR Policy and Procedure and make sure it meets ACHA’s standards.
Here is a sample that you can use in your admission package to help you meet the AHCA requirement
Do Not Resuscitate Order—Form 1896
Important! In order to be legally valid, this form MUST be printed on yellow paper prior to being completed. EMS and medical personnel are only required to honor the form if it is printed on yellow paper.