Providers shared that DNR (Do Not Resuscitate) policies for community-based ADDT programs typically include the following elements:

1. **Documentation**: Require a signed, physician-ordered DNR (or POLST — Physician Orders for Life-Sustaining Treatment) to be on file before honoring the order. A verbal request from a family member alone is not sufficient.
2. **Staff notification and training**: All direct care staff working with a client who has a DNR must be specifically informed of this and trained on what it means for emergency response at your facility.
3. **File placement**: The DNR should be easily accessible in the client’s record; in residential settings, it is often posted in a visible, secure location per DHS requirements.
4. **Coordination**: Notify the client’s PASSE care coordinator, physician, and guardian (if applicable) that the DNR is on file.
5. **Annual review**: Confirm DNR status at each annual ISP meeting and obtain updated documentation if the order has changed.
6. **Emergency response guidance**: Clarify in your policy whether staff call 911 and present the DNR to responders (standard practice) vs. any other response — this varies by facility type.

A DNR means do not initiate resuscitation — it does not mean withhold all care or comfort.