Carroll county board of developmental disabilities
policy Reference: Health Policy. Do Not Resuscitate (DNR) Orders.
Ohio Revised Code Reference: 2133
Ohio Administrative Code Reference: 37-01-62
If an individual enrolled in a program operated by the Carroll County Board of DD has a Do Not Resuscitate (DNR) Comfort Care order written under Chapter 2133 of the Ohio Revised Code and 37-01-62 of the Ohio Administrative Code, the Carroll County Board of DD shall comply with the DNR Comfort care order. Compliance with the DNR Comfort Care, order creates immunity from criminal prosecution, civil liability, and professional disciplinary action for the withholding of CPR when a DNR Comfort Care order has been identified and the DNR protocol is followed.
Any staff member who becomes aware of the existence of an individual who is enrolled in a program operated by the Carroll County Board of DD who has a DNR Comfort Care order or a DNR identification about which the Board has no knowledge, shall immediately bring this information to the attention of the nursing staff.
A copy of the existing DNR Comfort Care order or DNR identification will be given to Emergency Medical Services (EMS) staff when emergency treatment and transport are required. The Carroll County Board of DD shall comply with applicable laws on DNR orders:
Medicaid 1902 (a)(57) and 42 USC 1396 a (w):
- Provides that all Medicaid managed care organizations receiving funds must ensure compliance with the requirements of state law respecting advance directives.
Patient self-determination Act:
This law requires that covered entities (i.e., the Board) must:
- Provide written information to each individual concerning their right under state law to make decisions concerning medical care including the right to accept and refuse medical treatment and the right to formulate advance directives.
- Provide to enrollees and families written policies of the organization respecting the implementation of these rights.
- Document in the medical record whether or not an individual has an advance directive.
- Not discriminate based on whether or not an individual has an advance directive.
- Ensure compliance with state and federal laws respecting advance directives.
- Provide for education of staff, providers, and the community on issues concerning advance directives.
If a DNR is received by the Board in writing, but does not indicate whether the order is a Comfort Care order, or Comfort Care Arrest order, the nurse shall immediately contact the physician involved.
If there is no DNR order on file with the Board, and a DNR identification is found on an enrollee for whom CPR appears necessary, before taking any action, the nurse shall contact the physician noted in the DNR identification.
If the Board is not advised of the existence of a DNR order, and no DNR identification is found on an enrollee at the time Cardio-Pulmonary Resuscitation (CPR) is necessary, Board staff shall take all steps necessary to preserve the health and safety of the enrollee.
The Board authorizes the Superintendent to develop and implement written procedures consistent with Board policy and applicable rule, regulations, and statutes to effectively implement this policy.