WS Chronicle

Policies of senior homes under increased scrutiny after California woman’s death

How far would you go to save someone else’s life?

Bayless

For a staffer in a California retirement facility, it wasn’t worth violating her company’s policy. The death of 87-year-old Lorraine Bayless last month has sparked a firestorm of criticism for the staffer, whom ABC News identifies as a resident services director, who refused to administer CPR to Bayless when she collapsed at her Bakersfield retirement facility. The staffer told a 911 operator that it was against company policy to give medical assistance to residents.

Brookdale Senior Living, which owns the facility where Bayless resided, initially sided with the employee, saying she was correct to refuse treatment and wait until emergency personnel arrived, but later rescinded its statement, saying the employee had misinterpreted the Brookdale’s guidelines, according to national news reports.

Bayless did not have a “do not resuscitate” order, or DNR, but her family said later that she wanted to die naturally and they were satisfied with the care she received at the Glenwood Gardens facility.

Nevertheless, the seven minute 911 tape, wherein the dispatcher repeatedly implored the staffer to administer CPR or give the phone to someone who would, has been met with outrage. As is the case across the nation, many in the local community are baffled by the staffer’s callous response to the life and death situation, and shocked by the fact that a company would see fit to institute such a policy in the first place.

Darleen Kotey, director of Golden Lamb Rest Home in Winston-Salem, said she found it hard to believe that a facility that serves senior citizens – even healthy ones – would not have someone on staff who is qualified to act in the case of an emergency. Such a circumstance would not be tolerated in the state of North Carolina, said Kotey, who has helmed the 40-bed facility since its inception nearly two decades ago.

“North Carolina does require that someone is in this building 24 hours a day who is licensed to provide CPR to a patient,” said the city native. “…I don’t know what California’s laws are, but to me, if it’s a licensed home in any state, I don’t see why they wouldn’t require that.”

Kotey said the presence of a DNR – a signed legal document that prohibits emergency medical personnel from performing resuscitation or transferring the patient to a hospital for CPR – would be the only instance where she would approve of one of her staffers abstaining from care as the Glenwood Gardens employee did.

“When there’s a DNR, our hands are basically tied as far as staff (intervention),” she said. “In California, I don’t know what the rules are, but statewide, our hands are tied.”

Distinctions can be made between nursing homes like Golden Lamb, where medical care is routinely given, and the retirement home where the Bayless incident occurred, but many in the local community say that distinction still doesn’t warrant the staffer’s refusal to heed the dispatcher’s pleas.

Pat Halsey, executive director of Homestead Hills retirement community, said her facility makes emergency preparedness a priority.

“We do not have a policy against providing CPR. In fact, we train all of our employees in CPR and AED every two years,” she said. “…I’ve been in this business for 24 years. I’ve been trained myself in CPR, and if I see someone that is in a life threatening situation, then I’m certainly going to do whatever it takes to keep that person alive, and hopefully, save their life.”

Halsey said she wasn’t certain what the minimum requirements are of retirement communities with respect to staff training, but Homestead Hills and Senior Living Communities, LLC, its parent company, see such training as a necessary component in providing excellent service to senior citizens.

“That’s certainly something that our corporate office, the home office, feels is very important,” Halsey said. “You never know when something’s going to happen and we just feel that it’s very important, even in everyday life.”

Even though Bayless’ family has said she wouldn’t have wanted to be revived, from a legal standpoint, Elleton McCullough, a registered nurse for more than four decades, said action should have been taken.

McCullough

“The family knew that she didn’t want to be resuscitated, but they did not have it in writing, so by law, something should have been done,” stated McCullough, who also serves as an assistant professor in the School of Health Sciences at Winston-Salem State University.

McCullough said an untrained person could do more harm than good in trying to perform CPR, but these days most facilities have AED (automated external defibrillator) machines with step by step instructions that are easy for a layman to follow. If the staffer was unable or unwilling to help, McCullough said she should have summoned someone who would.

“She should have either orchestrated it or told someone to go get the AED,” she said. “…They’re going to have to re-educate that company, even though the daughter (of Bayless) says she’s not going to sue.”

Michael Green, the Bess and Walter Williams Distinguished Chair at Wake Forest University School of Law, believes the threat of a lawsuit is precisely what indirectly sealed Bayless’ fate.

“We have this disease in the United States called ‘liability-itis,’ the morbid fear of litigation,” declared Green, who has taught at the law school for over a dozen years. “I’m pretty sure the reason for the policies at this independent living place of not permitting staff to provide CPR was because of liability (concerns).”

Green, an expert on tort law, said though the staffer’s actions were reprehensible, she was well within her rights to stand by and allow Bayless to die.

Green

“That’s the case in about 48 states – there’s no duty to rescue,” related the University of Pennsylvania alumnus. “Many European countries have criminal statutes for not engaging in an easy rescue, but we don’t in the US.”

Green, who has been an attorney for nearly 40 years, said litigation in cases of good Samaritans is extremely rare, and refusing to save a life because of it is misguided at best.

“You’re not liable simply for attempting to rescue if it doesn’t work,” he said. “…I just don’t think that this was a good instance to not try and provide CPR.”

California authorities are reportedly investigating the Bayless case to determine if the staffer’s refusal to help Bayless, or get help, constitutes a crime.