Nursing homes ignorant of DNR purpose and policy
Lexington Herald-Leader had an article about nursing homes that caused at least 6 deaths due to their ignorance and negligence. Incredible. State investigators have cited 4 nursing homes for failing to perform lifesaving measures on residents who had requested that they be resuscitated.
The errors alleged by the state provide ammunition for those who are pushing for a new law or regulation that would mean all nursing homes would use a purple wristband to identify residents who had signed a do not resuscitate — or DNR — order.
Kentucky has no uniform regulations regarding how to inform staff members of DNR orders at the bedside at nursing homes or hospitals. Three different groups of nursing home and hospital officials are meeting in the next several weeks to determine whether Kentucky should join other states that have adopted a color-coded system.
Five of the six facilities sanctioned received Type A citations, the most serious the state can give. In all six cases, the individuals died.
■ Kenton Healthcare in Lexington was cited in September 2007 after the staff allegedly did not initiate lifesaving measures on a resident despite a doctor's orders that everything possible be done to save the patient.
■ Hillcrest Health Care Center in Owensboro was cited in December 2008 after cardiovascular pulmonary resuscitation was not performed on a resident who wanted to be resuscitated.
■ In April 2007, staff members at Christian Health Center in Bowling Green did not immediately resuscitate a resident, despite a doctor's orders that lifesaving measures should be used.
Staff members told state investigators that the facility did not have a system that allowed immediate access to the code status of a resident.
■ Woodland Oaks Nursing Home in Ashland is appealing a citation it received in January. Officials there deny failing to perform CPR on a dying patient who had requested lifesaving measures.
■ On the other end of the spectrum, Green Meadows Health Care in Mount Washington received a citation in March 2008 for trying to revive a resident who had signed a DNR order. Green Meadows officials did not return a telephone call seeking comment.
■ In March, Jefferson Manor in Louisville was cited after 95-year-old Eva Karem was resuscitated in February 2008 despite a DNR order. (It received a citation that was not as serious as a Type A.)
The Karem case prompted a series of meetings of lawmakers, nursing home officials and others who are looking at the use of wristbands.
"It is very important to accurately identify patients' preferences regarding resuscitation, while also protecting their privacy, which is a factor we will be taking into careful consideration when making our decision," she said.
Defendant nursing homes in litigation often attempt to confuse the jury regarding DNR orders. Nursing homes always claim that a DNR allows them to ignore and neglect residents because "the family signed the order and must have wanted him/her dead". Ridiculous.
