Staff members at a Rhode Island nursing home are facing allegations of forging a do-not-resuscitate (DNR) directive after a slow response to a resident’s medical emergency. According to a search warrant affidavit filed on October 29, police requested a judge’s permission to seize relevant medical records, video surveillance, and the identities of staff involved in the care of the 55-year-old resident, who died on October 2. The investigation began five days later, prompted by a report from the state Department of Human Services (DHS) detailing suspicions raised by first responders called to assist the resident.
Body-camera footage reportedly shows staff on the phone with someone claiming to be the facility manager, who appeared to instruct them on how to fill out the DNR form. An investigator noted that a report from the Minnesota DHS included statements from a paramedic present at the scene, suggesting that the nursing home staff suspected the resident was in distress but failed to check on her or call 911 promptly.
When emergency personnel arrived, staff claimed the resident had a DNR order, but they were unable to provide the documentation despite repeated requests. According to the warrant, responders observed staff members completing a DNR form, leading them to suspect forgery. The investigator’s warrant application also cites body-camera footage from a responding police officer, which recorded interactions between the paramedics and nursing home staff, including the phone conversation regarding the DNR form.
Compliance Perspective
Issue
Quality of care is a fundamental principle in nursing facilities, requiring adherence to comprehensive care plans and professional standards. Facilities must ensure adequate nursing staff with the necessary competencies to guarantee resident safety and well-being. Certified staff must be available at all times to provide cardiopulmonary resuscitation (CPR) when needed. If a resident requires CPR, it must be performed in accordance with their advance directives. In the absence of such directives, CPR should be initiated as necessary. Failure to provide CPR can be classified as neglect, potentially leading to criminal charges and disciplinary actions against staff. Nurses are expected to maintain honesty and integrity in care delivery, including accurate documentation and timely reporting of any changes or errors. Falsifying care documents or failing to provide necessary care undermines resident safety and compromises continuity of care.
Discussion Points
- Review your policies and procedures on CPR. Update as needed.
- Ensure staff receive comprehensive training on CPR and emergency protocols, maintaining current certifications. Document training and file signed records in each employee’s education file. Include training on ethical documentation practices and the serious consequences of forgery and falsification of records.
- Conduct periodic audits, including mock code drills, to assess CPR readiness among licensed staff. Regularly audit medical records for completeness, accuracy, and compliance with documentation standards. Ensure incident and accident reports are timely and complete, confirming that responsible parties and physicians are notified appropriately.
*This news alert has been prepared by Med-Net Concepts, Inc. for informational purposes only and is not intended to provide legal advice.*
