Beware: Texas law does not require CPR in senior living facilities
Earlier this month, the news reported on a 911 call that was taken by a nurse in California who refused to give emergency CPR assistance to a dying senior in her care. The refusal of this nurse to assist a dying resident is nothing less than shocking, however, the facility was within its rights to refuse care.
In Texas, facilities, even licenses facilities such as those regulated by Adult Protective Services, have the option of not providing CPR. However, they are required to notify individuals during the admissions policy process that they will not administer CPR.
The question is whether notifying people upon admissions is reasonable. It is likely that facilities around the state have a form that is signed during admissions stating they are aware of the policy of the facility. However, during the admissions process, there are tons of documents to sign and many people do not even read them. Does this constitute notice?
Does the nurses refusal to administer aid constitute a criminal case in Texas? Failure to stop and render aid (FSRA) is governed by Chapter 550 of the Texas Transportation Code. The penal code typically governs criminal offenses resulting in possible confinement and a conviction for FSRA can result in jail time, probation and a fine. However the Texas nurse is not likely guilty of FSRA because the rules are pretty clear that the facility is not required to provide CPR. If this were you or me, we would be required if we knew CPR. Funny! So beware of the facilities policy before you place your love one in a senior living facility!
Texas Law Today 
March 9, 2013 at 5:27 pm
It does make an interesting case study, but much was misunderstood in the reporting of this case.
1. It was an Independent Living building, so although the caller happened coincidentally to be some sort of nurse or nurse-delegate, the facility was not licensed for any sort of medical staff, equipment or care. If she had acted and injured the woman further, Good Samaritan laws would not have covered her, since they only apply to untrained bystanders.
2. The 911 dispatcher misdiagnosed the need for CPR by hyper-focusing on the initial symptom (breathing) and not moving on to assess pulse, skin pallor or other signs. Instead, dispatch engaged in a time-wasting argument with the caller over CPR.
3. Post-mortem diagnosis states she died of a massive stroke. CPR would have increased the violence of her death, through probable rib fracture, lung puncture, abdominal hemorrhage or aspiration. Instead, she died peacefully and naturally.
4. The facility did not require DNRs, but instead had the policy spelled out in Residence Contracts that no care could be provided and there was no staff or equipment on hand. The surviving family stated the woman desired no medical intervention. Prompt use of an AED and oxygen (unavailable – Independent Living) might have kept her alive, but it would have been against her wishes, and she would only have survived in a state of severe brain injury.
What this case illustrates best is the individual’s need to have evidence of a DNR or POLST form on file. It could have been in her purse, or an alert worn as a bracelet. Having the victim’s wishes known immediately would have clarified the correct course of action for all parties.