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HB 5447

Changes to the requirements for do not resusitate orders.

2026 Regular Session Introduced by Elliott Pritt and 1 co-sponsor

WV HB 5447 adds a two-tier DNR system (DNR-CCA and DNR-CC) with explicit scope, consent discussions, and standardized forms across settings.

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Bill Summary · HB 5447

Bill Summary: HB 5447 (West Virginia, 2026 Regular Session)

Title

Changes to the requirements for do not resuscitate orders.

Primary purpose

To recognize and implement a two-tier system for code statuses within the Do Not Resuscitate Act, specifically creating and formalizing:

  • DNR-CCA: Do-not-resuscitate comfort care arrest
  • DNR-CC: Do-not-resuscitate comfort care

The bill requires clearer definitions, consistency in compliance, and hospital policy alignment to reflect these two categories. It aims to promote patient-centered care by ensuring explicit documentation of the chosen code-status category and the scope of permitted interventions.

Key provisions and changes

Definitions (amendments to §16-30C-3)

  • Clarifies terms related to DNR orders, including:
    • DNR-CCA: A code-status order permitting all medically indicated interventions up to arrest, but prohibiting CPR at the moment of cardiopulmonary arrest.
    • DNR-CC: A code-status order for comfort-focused care only, withholding or withdrawing life-prolonging therapies while ensuring palliative measures.
  • Establishes standardized terminology for DNR identification (necklace, bracelet, card, or orders).
  • Retains and clarifies related terms: attending physician, POST form, health care facility, surrogate decision maker, capacity, etc.

Compliance with DNR orders (amendment to §16-30C-7)

  • Health care providers must comply with DNR orders when presented in specified forms or identifications, including:
    • Physician-completed DNR orders on the standard form under §16-30C-6
    • DNR identifications per §16-30C-6
    • DNR orders issued in health care facilities per facility policy
    • POST forms documenting a DNR order by a qualified physician
  • Extends recognition of DNR orders across health care facilities, ambulances, homes, and communities within the state.

In-hospital order specifics

  • Every in-hospital DNR order must explicitly specify the code-status category (Full Code / DNR-CCA / DNR-CC).
  • The order form or POST form must include:
    • Discussion with the patient or surrogate about the full scope of interventions under the chosen category
    • The selected code-status category
    • Scope of permitted interventions for DNR-CCA or DNR-CC (e.g., ventilation, vasopressors, IV fluids, nutrition, antibiotics for life-prolonging purposes, and comfort measures)
    • Name and credentials of the ordering provider, date/time
    • Capacity assessment or surrogate identification, consent documentation, and revocation instructions consistent with §16-30C-8

Facility policy requirement (new §16-30C-7a)

  • Hospitals and other health-care facilities must adopt or amend internal policies to reflect the two-tier system (DNR-CCA and DNR-CC).
  • Policies should include:
    • Staff training
    • Standardized order sets or electronic health record (EHR) templates incorporating the new categories

Who would be affected

  • Health care providers (physicians, APRNs/PAs, nurses, EMS personnel) who encounter DNR orders.
  • Hospitals, clinics, nursing facilities, and other health-care facilities operating within West Virginia.
  • Patients and their surrogates/representatives making health care decisions regarding resuscitation preferences.
  • Health care systems and IT departments responsible for EHR/template updates and order sets.

Procedural and timeline aspects

  • Status: Introduced February 11, 2026; referred to the House Committee on Health and Human Resources.
  • Effective date: Not specified in the text provided. Typically, if enacted, effective dates are set in the bill as the legislature approves (often upon passage or a specified future date). Notable is the requirement for facilities to adopt or amend policies, implying a practical implementation timeline post-enactment.

Observations

  • The bill adds explicit recognition of two distinct code-status categories, aiming to reduce ambiguity in Do Not Resuscitate decisions.
  • Emphasizes informed consent through required discussion of the scope of interventions before finalizing the order.
  • Seeks uniformity across settings via standardized forms, identification, and facility policies.

If you’d like, I can provide a quick comparison to current DNR provisions in WV or draft a one-page briefing for a non-lawyer audience.

Compiled from official sources — confirm details with the bill’s official record.

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