The Commonwealth of Massachusetts

Executive Office of Health and Human Services
Department of Public Health
Division of Health Care Quality
10 West Street, Boston, MA 02111
617-753-8000
MITT ROMNEY
GOVERNOR
KERRY HEALEY
LIEUTENANT GOVERNOR
RONALD PRESTON
SECRETARY
PAUL J. COTE
COMMISSIONER	
CIRCULAR LETTER: DHCQ 05-04-448

						

TO: 		Long-Term Care Facility Administrators	

FROM: 	Paul Dreyer, Ph.D., Associate Commissioner
		
DATE:	April 8, 2005
	
RE:		Do Not Resuscitate Orders in Long Term Care Facilities

It has come to our attention that upon occasion, nursing homes may call 911 for residents with valid D.N.R. orders who are in cardiac or respiratory arrest.  Such a situation might occur when a licensed nurse is on duty who is unfamiliar with a resident’s plan of care.  The purpose of this letter is to provide guidance to Long Term Care providers in this circumstance. 

When an ambulance is summoned to a Long Term Care Facility for a resident in cardiac or respiratory arrest and a D.N.R. order is subsequently found, the facility has the right to cancel the ambulance run, or upon arrival, turn the ambulance away, and by so doing, honor the resident’s D.N.R. order.

Please contact Jill Mazzola at (617) 753-8106 if you have any questions in this matter.