CALA News & Views | Issue 53 | CALA at 30

● Onsite medical professionals acting within their scope of practice can assist in determining if an injury or other circumstance is an imminent threat to a resident’s health. This is an important change. Previously, an onsite nurse or doctor could not assess a resident and 9-1-1 would still have to be called. ● A list of alternative options to calling 9-1-1 is included when a circumstance doesn’t constitute an imminent threat. ● The regulation for Advance Directives and Requests Regarding Resuscitative Measures is included for ease of reference. It outlines licensee responsibilities to ensure care aligns with a resident's wishes and how to handle situations for residents on hospice. ● A section on resident rights is included to remind licensees that they have the right to refuse medical treatment, but in cases where the licensee is required to call 9-1-1 the resident or their representative, if applicable, will have to refuse medical treatment, transportation to the hospital, etc. when the emergency responder arrives. DSS recommends documenting refusal in the resident record as a best practice. ● A reminder about having adequate staff to assist residents with mobility or transferring from one position to another when there is no apparent injury (“lift assists”). Information on developing fall prevention plans is also included. We are grateful for the additional guidance to help residents receive timely care that is appropriate and not have to call 9-1-1 unnecessarily. Documentation is key when an alternative to 9-1-1 is used to show LPAs how resident care was addressed. As with any new guidance, let Selena know if you run into challenges or have questions that should be shared with DSS as they evaluate the effectiveness of these changes. g

Considerations for Calling 9-1-1 for a Resident Fall Josh Allen, RN and principal, Allen Flores Consulting Group If a resident falls, 9-1-1 should be called if there is an imminent threat but if they seem fine otherwise, staff should assist residents getting up but not lifting a resident that is immobile. If a resident is unable to participate in getting up, then licensees should consider calling 9-1-1 as that could be a sign of injury. Licensees should notify their healthcare professional and their representative, if applicable, and utilize an alternative option for resident evaluations to ensure there is no unseen injury. Licensees should continue to monitor the resident for 48 hours as a best practice.

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