Glenwood Gardens
350 Calloway Drive, Bakersfield, CA 93312
(855) 204-3103
========================
911: "We need to get CPR started. That's not enough. OK?"
Nurse: "Yeah, we can't do CPR."
911: "Okay, then hand the phone to a passerby. If you can't do it, hand it to the passerby and I'll have her do it. Or if you've got any sitting citizens there, I'll have them do it.”
Nurse: "No. No."
911: "Anybody there can do CPR. Give them the phone please. I understand if your facility is not willing to do that. Give the phone to that passerby, then, that stranger. This woman is not breathing enough. She's going to die if we don't get this started. Do you understand?"
Nurse: "I understand.”
911: "Okay."
Nurse: "I am a nurse, but I cannot have our other senior citizens who don't know CPR--"
911: "I will instruct them in it."
Nurse: "--to do this. We're in a dining room."
911: "I will instruct them. Is there anyone there who is willing...?"
Nurse: "I cannot do that."
911: "I don't understand why you're not willing to help this patient."
===================
BAKERSFIELD, Calif. — A nurse's refusal to give CPR to a dying 87-year-old woman at a California independent living home despite desperate pleas from a 911 dispatcher has prompted outrage and spawned a criminal investigation.
The harrowing 7-minute, 16-second call also raised concerns that policies at senior living facilities could prevent staff from intervening in medical emergencies. It prompted calls for legislation Monday to prevent a repeat of what happened Feb. 26 at the Glenwood Gardens in Bakersfield.
Lorraine Bayless collapsed in the dining room of the retirement home that offers many levels of care. She lived in the independent living building, which state officials said is like a senior apartment complex and doesn't operate under licensing oversight.
"This is a wakeup call," said Assemblywoman Mariko Yamada, chair of the California Assembly Aging and Long-term Care Committee. "I'm sorry it took a tragedy like this to bring it to our attention."
Yamada cautioned that while it's not yet known whether intervention would have saved the woman's life, "we want to investigate because it has caused a lot of concern and alarm."
Independent living facilities "should not have a policy that says you can stand there and watch somebody die," said Pat McGinnis, founder of California Advocates for Nursing Home Reform, a consumer advocacy group. "How a nurse can do that is beyond comprehension."
In all her years of advocating for the elderly, McGinnis said: "This was so horrifying. I've never seen this happen before."
State officials did not know Monday whether the woman who talked to the 911 dispatcher actually was a nurse, or just identified herself as one during the call. She said one of the home's policies prevented her from doing CPR, according to an audio recording of the call.
"The consensus is if they are a nurse and if they are at work as a nurse, then they should be offering the appropriate medical care," said Russ Heimerich, spokesman for the California Board of Registered Nursing, the agency that licenses health care providers.
The executive director of Glenwood Gardens, Jeffrey Toomer, defended the nurse in a written statement, saying she followed the facility's policy.
"In the event of a health emergency at this independent living community, our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives," Toomer said. "That is the protocol we followed."
Toomer offered condolences to the woman's family and said a thorough internal review would be conducted. He told KGET-TV that residents of the facility are informed of the policy and agree to it when they move in. He said the policy does not apply at the adjacent assisted living and skilled nursing facilities.
Multiple calls to the facility and its parent company seeking more information were not returned.
Unlike nursing homes, which provide medical care, independent living facilities generally do not.
"These are like apartments for seniors. You're basically living on your own. They may have some services provided by basic nursing staff, but it's not their responsibility to care for the individual," said Dr. Susan Leonard, a geriatrics expert at the University of California, Los Angeles.
Residents of independent living communities can still take care of themselves, but may need help getting to doctor's appointments. In skilled nursing facilities and nursing homes, many residents require around-the-clock care.
Staff members are "required to perform and provide CPR" unless there's a do-not-resuscitate order, said Greg Crist, a senior vice president at the American Health Care Association.
Bayless did not have such an order on file at the facility, said Battalion Chief Anthony Galagaza of the Bakersfield Fire Department, which was the first on the scene. That's when firefighters immediately began CPR, continuing until she reached the hospital.
Dr. Patricia Harris, who heads the University of Southern California's geriatrics division, said the survival odds are slim among elderly who receive CPR. Even if they survive, they are never the same. She said she would override the home's policy and risk getting fired "rather than watch somebody die in front of me."
During the call, an unidentified woman called from her cellphone, and asked for paramedics to be sent to help the woman. Later, a woman who identified herself as the nurse got on the phone and told dispatcher Tracey Halvorson she was not permitted to do CPR on the woman.
Halvorson urged the nurse to start CPR, warning the consequences could be dire if no one tried to revive the woman, who had been laid out on the floor on her instructions.
"I understand if your boss is telling you, you can't do it," the dispatcher said. "But ... as a human being ... you know, is there anybody that's willing to help this lady and not let her die?"
"Not at this time," the nurse answered.
Halvorson assured the nurse that Glenwood couldn't be sued if anything went wrong in attempts to resuscitate the resident, saying the local emergency medical system "takes the liability for this call."
Later in the call, Halvorson asked, "Is there a gardener? Any staff, anyone 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 would help her."
"I understand if your facility is not willing to do that. Give the phone to a passer-by. This woman is not breathing enough. She is going to die if we don't get this started, do you understand?"
The woman had no pulse and wasn't breathing when fire crews reached her, Galagaza said.
Sgt. Jason Matson of the Bakersfield Police Department said its investigation so far had not revealed criminal wrongdoing, but the probe is continuing.
First responders say often it's hard to find someone willing to provide CPR in an emergency.
"It's not uncommon to have someone refuse to provide CPR if they physically can't do it, or they're so upset they just can't function," Kern County Fire Department Deputy Chief Michael Miller said. "What made this one unique was the way the conversation on the phone went. It was just very frustrating to anyone listening to it, like, why wasn't anyone helping this poor woman, since CPR today is much simpler than it was in the past?"
===========================
A 911 dispatcher pleaded with a nurse at a Bakersfield, Calif., senior living facility to save the life of an elderly woman by giving her CPR, but the nurse said policy did not allow her to, according to a newly released audiotape of the call.
“Is there anybody there that’s willing to help this lady and not let her die?” the dispatcher asked in a recording of the 911 call released by the Bakersfield Fire Department.
“Not at this time,” the nurse said.
The incident unfolded on Tuesday when 87-year-old Lorraine Bayless collapsed at Glenwood Gardens, a senior living facility in Bakersfield.
In the seven-minute, 16-second recording, the nurse told the dispatcher it was against the facility’s policy for employees to perform CPR on residents.
With every passing second, Bayless’ chances of survival were diminishing. The dispatcher’s tone turned desperate.
“Anybody there can do CPR. Give them the phone please. I understand if your facility is not willing to do that. Give the phone to that passerby,” the dispatcher said. ”This woman is not breathing enough. She is going to die if we don’t get this started.”
After several minutes, an ambulance arrived and took Bayless to Mercy Southwest Hospital, where she died.
Glenwood Gardens released a statement confirming its policy prohibiting employees from performing CPR.
“In the event of a health emergency at this independent living community, our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives. That is the protocol we followed,” the statement said.
Despite protocol being followed, the nursing home said it would launch an internal investigation into the matter.
=============================
The “no CPR” policy that has embroiled Brentwood-based Brookdale Senior Living Inc. in controversy is fairly common among independent living facilities but not always fully understood by residents, senior housing experts say.
Independent living facilities, such as the one in California where an employee said company policy prevented her from performing CPR on an elderly resident who subsequently died, are not required and usually are not equipped to perform CPR or other emergency medical care, they say.
“Independent living does not provide care,” said Paul J. Williams, senior government relations director for the Assisted Living Federation of America, whose members also operate independent centers. “It’s like renting a senior apartment, with meals and social activities included. There is no care provided.”
The controversy erupted after authorities released a taped 911 call surrounding the Feb. 26 death of 87-year-old Lorraine Bayless in Glenwood Gardens, a Brookdale-owned facility in Bakersfield, Calif.
In the call, an unidentified employee who said she was a nurse refused to perform CPR — despite the 911 operator’s pleas — on Bayless because it was against the facility’s policy. The local police department is now investigating the episode, the Los Angeles Times reported.
Parent company Brookdale Senior Living said in a statement Tuesday that the incident “resulted from a complete misunderstanding of our practice” regarding emergency care. Brookdale says that employee is on voluntary leave while the company investigates.
“Glenwood Gardens is an independent living facility, which by law is not licensed to provide medical care to any of its residents,” according to a separate statement from the facility. “We are conducting an internal review to determine all of the facts about what occurred while waiting for the paramedics, who arrived moments later. Our associate who was involved was serving in the capacity of a resident services director, not as a nurse.”
The publicly traded company, the nation’s largest owner and operator of senior living communities, operates more than 645 assisted living and retirement communities with nearly 60,000 residents in 33 states, according to its website.
Independent facilities essentially are senior-housing complexes in which residents pay rent in exchange for living quarters and other services, such as prepared meals and home maintenance. As such, they’re not regulated by Tennessee or any other state.
“Living in an independent living facility is just like having a landlord-tenant relationship,” said Jerry Blasingame, Tennessee’s long-term care ombudsman. “They’re not required to have any medical staff or provide any medical care.”
That differs from assisted living facilities and nursing homes, which are regulated and licensed. All but nine states require those facilities to have at least one employee who is certified in first aid and CPR on duty at all times, Williams said.
The only time they can refuse to perform CPR is when the resident has a “do not resuscitate” order or other pre-existing directives against such attempts, he said.
It’s a distinction that residents and their families need to understand, an AARP of Tennessee spokeswoman said.
“This heartbreaking situation in California absolutely points to the need to get as much information as possible about facilities and what their policies are,” Karin Miller said.
But those policies can differ, even among the same type of facility.
Five Star Quality Care Inc. has a policy similar to Brookdale’s for its more than 260 facilities nationwide, including a dozen in Tennessee, said Lisa Cooney, associate general counsel for the Newton, Mass.-based company.
“Our response to incidents and issues involving our independent residents is dictated based on the specific circumstances of each incident,” she wrote in an email. “In the event of an emergency, staff immediately call 911, remain with the resident, follow all reasonable instructions, and provide whatever assistance is needed to emergency responders upon arrival at the scene.”
She declined to elaborate on whether “following all reasonable instructions” includes performing CPR as directed by a 911 operator.
Elmcroft Senior Living, though, has a different policy for its 103 facilities in 19 states, including those offering independent living, said an official of the Louisville, Ky.-based company.
In the event a resident suffers cardiac or respiratory arrest, to the extent allowed under state law, our policy is to call 911 and perform CPR unless the resident has a do-not-resuscitate order,” said Bob Goyette, Elmcroft’s senior operations vice president. “That is a standard practice in the assisted living industry. Performing CPR at independent facilities — it’s up to the facility.”
=========================
NASHVILLE, Tenn. — The "no CPR" policy that has embroiled a California independent living facility in controversy is fairly common but not always fully understood by residents, senior housing experts say.
Facilities, such as the one in Bakersfield, Calif., where an employee said company policy prevented her from performing CPR on an elderly resident who subsequently died, are not required and usually are not equipped to perform CPR or other emergency medical care, they say.
"Independent living does not provide care," said Paul J. Williams, senior government relations director for the Assisted Living Federation of America, whose members also operate independent centers. "It's like renting a senior apartment, with meals and social activities included. There is no care provided."
The controversy erupted after authorities released a taped 911 call surrounding the Feb. 26 death of 87-year-old Lorraine Bayless in Glenwood Gardens, a facility owned by Brentwood, Tenn.-based Brookdale Senior Living Inc. in Bakersfield.
In the call, an unidentified employee who said she was a nurse refused to perform CPR — despite the 911 operator's pleas — on Bayless because it was against the facility's policy. The local police department is now investigating the episode, the Los Angeles Times reported.
So is Brookfield, the company said in a statement.
"Glenwood Gardens is an independent living facility, which by law is not licensed to provide medical care to any of its residents," the statement said. "We are conducting an internal review to determine all of the facts about what occurred while waiting for the paramedics, who arrived moments later. Our associate who was involved was serving in the capacity of a resident services director, not as a nurse."
Brookdale did not respond to repeated requests for further comment Tuesday. The publicly traded company, the largest owner and operator of senior living communities in the country, operates more than 645 assisted living and retirement communities with nearly 60,000 residents in 33 states, according to its website.
Independent facilities essentially are senior housing complexes in which residents pay rent in exchange for living quarters and other services, such as prepared meals and home maintenance. As such, they're not regulated by Tennessee or any other state.
"Living in an independent living facility is just like having a landlord-tenant relationship," said Jerry Blasingame, Tennessee's long-term-care ombudsman. "They're not required to have any medical staff or provide any medical care."
That differs from assisted living facilities and nursing homes, which are regulated and licensed. All but nine states require those facilities to have at least one employee who is certified in first aid and CPR on duty at all times, Williams said.
The only time they can refuse to perform CPR is when the resident has a "do not resuscitate" order or other pre-existing directives against such attempts, he said.
It's a distinction that residents and their families need to understand, an AARP of Tennessee spokeswoman said.
"This heartbreaking situation in California absolutely points to the need to get as much information as possible about facilities and what their policies are," Karin Miller said.
But those policies can differ, even among the same type of facility.
Five Star Quality Care Inc. has a policy similar to Brookdale's for its more than 260 facilities nationwide, said Lisa Cooney, associate general counsel for the Newton, Mass.-based company.
"Our response to incidents and issues involving our independent residents is dictated based on the specific circumstances of each incident," she wrote in an email. "In the event of an emergency, staff immediately call 911, remain with the resident, follow all reasonable instructions, and provide whatever assistance is needed to emergency responders upon arrival at the scene."
She declined to elaborate on whether "following all reasonable instructions" includes performing CPR as directed by a 911 operator.
Elmcroft Senior Living, though, has a different policy for its 103 facilities in 19 states, including those offering independent living, said an official of the Louisville, Ky.-based company.
"In the event a resident suffers cardiac or respiratory arrest, to the extent allowed under state law, our policy is to call 911 and perform CPR unless the resident has a do-not-resuscitate order," said Bob Goyette, Elmcroft's senior operations vice president. "That is a standard practice in the assisted living industry. Performing CPR at independent facilities — it's up to the facility."
============================
BAKERSFIELD, Calif. (AP) — A nurse's refusal to give CPR to a dying 87-year-old woman at a California independent living home despite desperate pleas from a 911 dispatcher has prompted outrage and spawned a criminal investigation.
The harrowing 7-minute, 16-second call also raised concerns that policies at senior living facilities could prevent staff from intervening in medical emergencies. It prompted calls for legislation Monday to prevent a repeat of what happened Feb. 26 at the Glenwood Gardens in Bakersfield.
Lorraine Bayless collapsed in the dining room of the retirement home that offers many levels of care. She lived in the independent living building, which state officials said is like a senior apartment complex and doesn't operate under licensing oversight.
"This is a wakeup call," said Assemblywoman Mariko Yamada, chair of the California Assembly Aging and Long-term Care Committee. "I'm sorry it took a tragedy like this to bring it to our attention."
Yamada cautioned that while it's not yet known whether intervention would have saved the woman's life, "we want to investigate because it has caused a lot of concern and alarm."
Independent living facilities "should not have a policy that says you can stand there and watch somebody die," said Pat McGinnis, founder of California Advocates for Nursing Home Reform, a consumer advocacy group. "How a nurse can do that is beyond comprehension."
In all her years of advocating for the elderly, McGinnis said: "This was so horrifying. I've never seen this happen before."
State officials did not know Monday whether the woman who talked to the 911 dispatcher actually was a nurse, or just identified herself as one during the call. She said one of the home's policies prevented her from doing CPR, according to an audio recording of the call.
"The consensus is if they are a nurse and if they are at work as a nurse, then they should be offering the appropriate medical care," said Russ Heimerich, spokesman for the California Board of Registered Nursing, the agency that licenses health care providers.
The executive director of Glenwood Gardens, Jeffrey Toomer, defended the nurse in a written statement, saying she followed the facility's policy.
"In the event of a health emergency at this independent living community, our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives," Toomer said. "That is the protocol we followed."
Toomer offered condolences to the woman's family and said a thorough internal review would be conducted. He told KGET-TV that residents of the facility are informed of the policy and agree to it when they move in. He said the policy does not apply at the adjacent assisted living and skilled nursing facilities.
Multiple calls to the facility and its parent company seeking more information were not returned.
Unlike nursing homes, which provide medical care, independent living facilities generally do not.
"These are like apartments for seniors. You're basically living on your own. They may have some services provided by basic nursing staff, but it's not their responsibility to care for the individual," said Dr. Susan Leonard, a geriatrics expert at the University of California, Los Angeles.
Residents of independent living communities can still take care of themselves, but may need help getting to doctor's appointments. In skilled nursing facilities and nursing homes, many residents require around-the-clock care.
Staff members are "required to perform and provide CPR" unless there's a do-not-resuscitate order, said Greg Crist, a senior vice president at the American Health Care Association.
Bayless did not have such an order on file at the facility, said Battalion Chief Anthony Galagaza of the Bakersfield Fire Department, which was the first on the scene. That's when firefighters immediately began CPR, continuing until she reached the hospital.
Dr. Patricia Harris, who heads the University of Southern California's geriatrics division, said the survival odds are slim among elderly who receive CPR. Even if they survive, they are never the same. She said she would override the home's policy and risk getting fired "rather than watch somebody die in front of me."
During the call, an unidentified woman called from her cellphone, and asked for paramedics to be sent to help the woman. Later, a woman who identified herself as the nurse got on the phone and told dispatcher Tracey Halvorson she was not permitted to do CPR on the woman.
Halvorson urged the nurse to start CPR, warning the consequences could be dire if no one tried to revive the woman, who had been laid out on the floor on her instructions.
"I understand if your boss is telling you, you can't do it," the dispatcher said. "But ... as a human being ... you know, is there anybody that's willing to help this lady and not let her die?"
"Not at this time," the nurse answered.
Halvorson assured the nurse that Glenwood couldn't be sued if anything went wrong in attempts to resuscitate the resident, saying the local emergency medical system "takes the liability for this call."
Later in the call, Halvorson asked, "Is there a gardener? Any staff, anyone 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 would help her."
"I understand if your facility is not willing to do that. Give the phone to a passer-by. This woman is not breathing enough. She is going to die if we don't get this started, do you understand?"
The woman had no pulse and wasn't breathing when fire crews reached her, Galagaza said.
Sgt. Jason Matson of the Bakersfield Police Department said its investigation so far had not revealed criminal wrongdoing, but the probe is continuing.
First responders say often it's hard to find someone willing to provide CPR in an emergency.
"It's not uncommon to have someone refuse to provide CPR if they physically can't do it, or they're so upset they just can't function," Kern County Fire Department Deputy Chief Michael Miller said. "What made this one unique was the way the conversation on the phone went. It was just very frustrating to anyone listening to it, like, why wasn't anyone helping this poor woman, since CPR today is much simpler than it was in the past?"
911: "Anybody there can do CPR. Give them the phone please. I understand if your facility is not willing to do that. Give the phone to that passerby, then, that stranger. This woman is not breathing enough. She's going to die if we don't get this started. Do you understand?"
Nurse: "I understand.”
911: "Okay."
Nurse: "I am a nurse, but I cannot have our other senior citizens who don't know CPR--"
911: "I will instruct them in it."
Nurse: "--to do this. We're in a dining room."
911: "I will instruct them. Is there anyone there who is willing...?"
Nurse: "I cannot do that."
911: "I don't understand why you're not willing to help this patient."
===================
BAKERSFIELD, Calif. — A nurse's refusal to give CPR to a dying 87-year-old woman at a California independent living home despite desperate pleas from a 911 dispatcher has prompted outrage and spawned a criminal investigation.
The harrowing 7-minute, 16-second call also raised concerns that policies at senior living facilities could prevent staff from intervening in medical emergencies. It prompted calls for legislation Monday to prevent a repeat of what happened Feb. 26 at the Glenwood Gardens in Bakersfield.
Lorraine Bayless collapsed in the dining room of the retirement home that offers many levels of care. She lived in the independent living building, which state officials said is like a senior apartment complex and doesn't operate under licensing oversight.
"This is a wakeup call," said Assemblywoman Mariko Yamada, chair of the California Assembly Aging and Long-term Care Committee. "I'm sorry it took a tragedy like this to bring it to our attention."
Yamada cautioned that while it's not yet known whether intervention would have saved the woman's life, "we want to investigate because it has caused a lot of concern and alarm."
Independent living facilities "should not have a policy that says you can stand there and watch somebody die," said Pat McGinnis, founder of California Advocates for Nursing Home Reform, a consumer advocacy group. "How a nurse can do that is beyond comprehension."
In all her years of advocating for the elderly, McGinnis said: "This was so horrifying. I've never seen this happen before."
State officials did not know Monday whether the woman who talked to the 911 dispatcher actually was a nurse, or just identified herself as one during the call. She said one of the home's policies prevented her from doing CPR, according to an audio recording of the call.
"The consensus is if they are a nurse and if they are at work as a nurse, then they should be offering the appropriate medical care," said Russ Heimerich, spokesman for the California Board of Registered Nursing, the agency that licenses health care providers.
The executive director of Glenwood Gardens, Jeffrey Toomer, defended the nurse in a written statement, saying she followed the facility's policy.
"In the event of a health emergency at this independent living community, our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives," Toomer said. "That is the protocol we followed."
Toomer offered condolences to the woman's family and said a thorough internal review would be conducted. He told KGET-TV that residents of the facility are informed of the policy and agree to it when they move in. He said the policy does not apply at the adjacent assisted living and skilled nursing facilities.
Multiple calls to the facility and its parent company seeking more information were not returned.
Unlike nursing homes, which provide medical care, independent living facilities generally do not.
"These are like apartments for seniors. You're basically living on your own. They may have some services provided by basic nursing staff, but it's not their responsibility to care for the individual," said Dr. Susan Leonard, a geriatrics expert at the University of California, Los Angeles.
Residents of independent living communities can still take care of themselves, but may need help getting to doctor's appointments. In skilled nursing facilities and nursing homes, many residents require around-the-clock care.
Staff members are "required to perform and provide CPR" unless there's a do-not-resuscitate order, said Greg Crist, a senior vice president at the American Health Care Association.
Bayless did not have such an order on file at the facility, said Battalion Chief Anthony Galagaza of the Bakersfield Fire Department, which was the first on the scene. That's when firefighters immediately began CPR, continuing until she reached the hospital.
Dr. Patricia Harris, who heads the University of Southern California's geriatrics division, said the survival odds are slim among elderly who receive CPR. Even if they survive, they are never the same. She said she would override the home's policy and risk getting fired "rather than watch somebody die in front of me."
During the call, an unidentified woman called from her cellphone, and asked for paramedics to be sent to help the woman. Later, a woman who identified herself as the nurse got on the phone and told dispatcher Tracey Halvorson she was not permitted to do CPR on the woman.
Halvorson urged the nurse to start CPR, warning the consequences could be dire if no one tried to revive the woman, who had been laid out on the floor on her instructions.
"I understand if your boss is telling you, you can't do it," the dispatcher said. "But ... as a human being ... you know, is there anybody that's willing to help this lady and not let her die?"
"Not at this time," the nurse answered.
Halvorson assured the nurse that Glenwood couldn't be sued if anything went wrong in attempts to resuscitate the resident, saying the local emergency medical system "takes the liability for this call."
Later in the call, Halvorson asked, "Is there a gardener? Any staff, anyone 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 would help her."
"I understand if your facility is not willing to do that. Give the phone to a passer-by. This woman is not breathing enough. She is going to die if we don't get this started, do you understand?"
The woman had no pulse and wasn't breathing when fire crews reached her, Galagaza said.
Sgt. Jason Matson of the Bakersfield Police Department said its investigation so far had not revealed criminal wrongdoing, but the probe is continuing.
First responders say often it's hard to find someone willing to provide CPR in an emergency.
"It's not uncommon to have someone refuse to provide CPR if they physically can't do it, or they're so upset they just can't function," Kern County Fire Department Deputy Chief Michael Miller said. "What made this one unique was the way the conversation on the phone went. It was just very frustrating to anyone listening to it, like, why wasn't anyone helping this poor woman, since CPR today is much simpler than it was in the past?"
===========================
A 911 dispatcher pleaded with a nurse at a Bakersfield, Calif., senior living facility to save the life of an elderly woman by giving her CPR, but the nurse said policy did not allow her to, according to a newly released audiotape of the call.
“Is there anybody there that’s willing to help this lady and not let her die?” the dispatcher asked in a recording of the 911 call released by the Bakersfield Fire Department.
“Not at this time,” the nurse said.
The incident unfolded on Tuesday when 87-year-old Lorraine Bayless collapsed at Glenwood Gardens, a senior living facility in Bakersfield.
In the seven-minute, 16-second recording, the nurse told the dispatcher it was against the facility’s policy for employees to perform CPR on residents.
With every passing second, Bayless’ chances of survival were diminishing. The dispatcher’s tone turned desperate.
“Anybody there can do CPR. Give them the phone please. I understand if your facility is not willing to do that. Give the phone to that passerby,” the dispatcher said. ”This woman is not breathing enough. She is going to die if we don’t get this started.”
After several minutes, an ambulance arrived and took Bayless to Mercy Southwest Hospital, where she died.
Glenwood Gardens released a statement confirming its policy prohibiting employees from performing CPR.
“In the event of a health emergency at this independent living community, our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives. That is the protocol we followed,” the statement said.
Despite protocol being followed, the nursing home said it would launch an internal investigation into the matter.
=============================
The “no CPR” policy that has embroiled Brentwood-based Brookdale Senior Living Inc. in controversy is fairly common among independent living facilities but not always fully understood by residents, senior housing experts say.
Independent living facilities, such as the one in California where an employee said company policy prevented her from performing CPR on an elderly resident who subsequently died, are not required and usually are not equipped to perform CPR or other emergency medical care, they say.
“Independent living does not provide care,” said Paul J. Williams, senior government relations director for the Assisted Living Federation of America, whose members also operate independent centers. “It’s like renting a senior apartment, with meals and social activities included. There is no care provided.”
The controversy erupted after authorities released a taped 911 call surrounding the Feb. 26 death of 87-year-old Lorraine Bayless in Glenwood Gardens, a Brookdale-owned facility in Bakersfield, Calif.
In the call, an unidentified employee who said she was a nurse refused to perform CPR — despite the 911 operator’s pleas — on Bayless because it was against the facility’s policy. The local police department is now investigating the episode, the Los Angeles Times reported.
Parent company Brookdale Senior Living said in a statement Tuesday that the incident “resulted from a complete misunderstanding of our practice” regarding emergency care. Brookdale says that employee is on voluntary leave while the company investigates.
“Glenwood Gardens is an independent living facility, which by law is not licensed to provide medical care to any of its residents,” according to a separate statement from the facility. “We are conducting an internal review to determine all of the facts about what occurred while waiting for the paramedics, who arrived moments later. Our associate who was involved was serving in the capacity of a resident services director, not as a nurse.”
The publicly traded company, the nation’s largest owner and operator of senior living communities, operates more than 645 assisted living and retirement communities with nearly 60,000 residents in 33 states, according to its website.
Independent facilities essentially are senior-housing complexes in which residents pay rent in exchange for living quarters and other services, such as prepared meals and home maintenance. As such, they’re not regulated by Tennessee or any other state.
“Living in an independent living facility is just like having a landlord-tenant relationship,” said Jerry Blasingame, Tennessee’s long-term care ombudsman. “They’re not required to have any medical staff or provide any medical care.”
That differs from assisted living facilities and nursing homes, which are regulated and licensed. All but nine states require those facilities to have at least one employee who is certified in first aid and CPR on duty at all times, Williams said.
The only time they can refuse to perform CPR is when the resident has a “do not resuscitate” order or other pre-existing directives against such attempts, he said.
It’s a distinction that residents and their families need to understand, an AARP of Tennessee spokeswoman said.
“This heartbreaking situation in California absolutely points to the need to get as much information as possible about facilities and what their policies are,” Karin Miller said.
But those policies can differ, even among the same type of facility.
Five Star Quality Care Inc. has a policy similar to Brookdale’s for its more than 260 facilities nationwide, including a dozen in Tennessee, said Lisa Cooney, associate general counsel for the Newton, Mass.-based company.
“Our response to incidents and issues involving our independent residents is dictated based on the specific circumstances of each incident,” she wrote in an email. “In the event of an emergency, staff immediately call 911, remain with the resident, follow all reasonable instructions, and provide whatever assistance is needed to emergency responders upon arrival at the scene.”
She declined to elaborate on whether “following all reasonable instructions” includes performing CPR as directed by a 911 operator.
Elmcroft Senior Living, though, has a different policy for its 103 facilities in 19 states, including those offering independent living, said an official of the Louisville, Ky.-based company.
In the event a resident suffers cardiac or respiratory arrest, to the extent allowed under state law, our policy is to call 911 and perform CPR unless the resident has a do-not-resuscitate order,” said Bob Goyette, Elmcroft’s senior operations vice president. “That is a standard practice in the assisted living industry. Performing CPR at independent facilities — it’s up to the facility.”
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NASHVILLE, Tenn. — The "no CPR" policy that has embroiled a California independent living facility in controversy is fairly common but not always fully understood by residents, senior housing experts say.
Facilities, such as the one in Bakersfield, Calif., where an employee said company policy prevented her from performing CPR on an elderly resident who subsequently died, are not required and usually are not equipped to perform CPR or other emergency medical care, they say.
"Independent living does not provide care," said Paul J. Williams, senior government relations director for the Assisted Living Federation of America, whose members also operate independent centers. "It's like renting a senior apartment, with meals and social activities included. There is no care provided."
The controversy erupted after authorities released a taped 911 call surrounding the Feb. 26 death of 87-year-old Lorraine Bayless in Glenwood Gardens, a facility owned by Brentwood, Tenn.-based Brookdale Senior Living Inc. in Bakersfield.
In the call, an unidentified employee who said she was a nurse refused to perform CPR — despite the 911 operator's pleas — on Bayless because it was against the facility's policy. The local police department is now investigating the episode, the Los Angeles Times reported.
So is Brookfield, the company said in a statement.
"Glenwood Gardens is an independent living facility, which by law is not licensed to provide medical care to any of its residents," the statement said. "We are conducting an internal review to determine all of the facts about what occurred while waiting for the paramedics, who arrived moments later. Our associate who was involved was serving in the capacity of a resident services director, not as a nurse."
Brookdale did not respond to repeated requests for further comment Tuesday. The publicly traded company, the largest owner and operator of senior living communities in the country, operates more than 645 assisted living and retirement communities with nearly 60,000 residents in 33 states, according to its website.
Independent facilities essentially are senior housing complexes in which residents pay rent in exchange for living quarters and other services, such as prepared meals and home maintenance. As such, they're not regulated by Tennessee or any other state.
"Living in an independent living facility is just like having a landlord-tenant relationship," said Jerry Blasingame, Tennessee's long-term-care ombudsman. "They're not required to have any medical staff or provide any medical care."
That differs from assisted living facilities and nursing homes, which are regulated and licensed. All but nine states require those facilities to have at least one employee who is certified in first aid and CPR on duty at all times, Williams said.
The only time they can refuse to perform CPR is when the resident has a "do not resuscitate" order or other pre-existing directives against such attempts, he said.
It's a distinction that residents and their families need to understand, an AARP of Tennessee spokeswoman said.
"This heartbreaking situation in California absolutely points to the need to get as much information as possible about facilities and what their policies are," Karin Miller said.
But those policies can differ, even among the same type of facility.
Five Star Quality Care Inc. has a policy similar to Brookdale's for its more than 260 facilities nationwide, said Lisa Cooney, associate general counsel for the Newton, Mass.-based company.
"Our response to incidents and issues involving our independent residents is dictated based on the specific circumstances of each incident," she wrote in an email. "In the event of an emergency, staff immediately call 911, remain with the resident, follow all reasonable instructions, and provide whatever assistance is needed to emergency responders upon arrival at the scene."
She declined to elaborate on whether "following all reasonable instructions" includes performing CPR as directed by a 911 operator.
Elmcroft Senior Living, though, has a different policy for its 103 facilities in 19 states, including those offering independent living, said an official of the Louisville, Ky.-based company.
"In the event a resident suffers cardiac or respiratory arrest, to the extent allowed under state law, our policy is to call 911 and perform CPR unless the resident has a do-not-resuscitate order," said Bob Goyette, Elmcroft's senior operations vice president. "That is a standard practice in the assisted living industry. Performing CPR at independent facilities — it's up to the facility."
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BAKERSFIELD, Calif. (AP) — A nurse's refusal to give CPR to a dying 87-year-old woman at a California independent living home despite desperate pleas from a 911 dispatcher has prompted outrage and spawned a criminal investigation.
The harrowing 7-minute, 16-second call also raised concerns that policies at senior living facilities could prevent staff from intervening in medical emergencies. It prompted calls for legislation Monday to prevent a repeat of what happened Feb. 26 at the Glenwood Gardens in Bakersfield.
Lorraine Bayless collapsed in the dining room of the retirement home that offers many levels of care. She lived in the independent living building, which state officials said is like a senior apartment complex and doesn't operate under licensing oversight.
"This is a wakeup call," said Assemblywoman Mariko Yamada, chair of the California Assembly Aging and Long-term Care Committee. "I'm sorry it took a tragedy like this to bring it to our attention."
Yamada cautioned that while it's not yet known whether intervention would have saved the woman's life, "we want to investigate because it has caused a lot of concern and alarm."
Independent living facilities "should not have a policy that says you can stand there and watch somebody die," said Pat McGinnis, founder of California Advocates for Nursing Home Reform, a consumer advocacy group. "How a nurse can do that is beyond comprehension."
In all her years of advocating for the elderly, McGinnis said: "This was so horrifying. I've never seen this happen before."
State officials did not know Monday whether the woman who talked to the 911 dispatcher actually was a nurse, or just identified herself as one during the call. She said one of the home's policies prevented her from doing CPR, according to an audio recording of the call.
"The consensus is if they are a nurse and if they are at work as a nurse, then they should be offering the appropriate medical care," said Russ Heimerich, spokesman for the California Board of Registered Nursing, the agency that licenses health care providers.
The executive director of Glenwood Gardens, Jeffrey Toomer, defended the nurse in a written statement, saying she followed the facility's policy.
"In the event of a health emergency at this independent living community, our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives," Toomer said. "That is the protocol we followed."
Toomer offered condolences to the woman's family and said a thorough internal review would be conducted. He told KGET-TV that residents of the facility are informed of the policy and agree to it when they move in. He said the policy does not apply at the adjacent assisted living and skilled nursing facilities.
Multiple calls to the facility and its parent company seeking more information were not returned.
Unlike nursing homes, which provide medical care, independent living facilities generally do not.
"These are like apartments for seniors. You're basically living on your own. They may have some services provided by basic nursing staff, but it's not their responsibility to care for the individual," said Dr. Susan Leonard, a geriatrics expert at the University of California, Los Angeles.
Residents of independent living communities can still take care of themselves, but may need help getting to doctor's appointments. In skilled nursing facilities and nursing homes, many residents require around-the-clock care.
Staff members are "required to perform and provide CPR" unless there's a do-not-resuscitate order, said Greg Crist, a senior vice president at the American Health Care Association.
Bayless did not have such an order on file at the facility, said Battalion Chief Anthony Galagaza of the Bakersfield Fire Department, which was the first on the scene. That's when firefighters immediately began CPR, continuing until she reached the hospital.
Dr. Patricia Harris, who heads the University of Southern California's geriatrics division, said the survival odds are slim among elderly who receive CPR. Even if they survive, they are never the same. She said she would override the home's policy and risk getting fired "rather than watch somebody die in front of me."
During the call, an unidentified woman called from her cellphone, and asked for paramedics to be sent to help the woman. Later, a woman who identified herself as the nurse got on the phone and told dispatcher Tracey Halvorson she was not permitted to do CPR on the woman.
Halvorson urged the nurse to start CPR, warning the consequences could be dire if no one tried to revive the woman, who had been laid out on the floor on her instructions.
"I understand if your boss is telling you, you can't do it," the dispatcher said. "But ... as a human being ... you know, is there anybody that's willing to help this lady and not let her die?"
"Not at this time," the nurse answered.
Halvorson assured the nurse that Glenwood couldn't be sued if anything went wrong in attempts to resuscitate the resident, saying the local emergency medical system "takes the liability for this call."
Later in the call, Halvorson asked, "Is there a gardener? Any staff, anyone 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 would help her."
"I understand if your facility is not willing to do that. Give the phone to a passer-by. This woman is not breathing enough. She is going to die if we don't get this started, do you understand?"
The woman had no pulse and wasn't breathing when fire crews reached her, Galagaza said.
Sgt. Jason Matson of the Bakersfield Police Department said its investigation so far had not revealed criminal wrongdoing, but the probe is continuing.
First responders say often it's hard to find someone willing to provide CPR in an emergency.
"It's not uncommon to have someone refuse to provide CPR if they physically can't do it, or they're so upset they just can't function," Kern County Fire Department Deputy Chief Michael Miller said. "What made this one unique was the way the conversation on the phone went. It was just very frustrating to anyone listening to it, like, why wasn't anyone helping this poor woman, since CPR today is much simpler than it was in the past?"
