Residents of independent living communities can still take care of themselves, but may need help getting to doctor's appointments. In skilled nursing facilities and nursing homes, many residents require around-the-clock care.
Staff members are "required to perform and provide CPR" unless there's a do-not-resuscitate order, said Greg Crist, a senior vice president at the American Health Care Association.
Bayless did not have such an order on file at the facility, said Battalion Chief Anthony Galagaza of the Bakersfield Fire Department, which was the first on the scene. That's when firefighters immediately began CPR, continuing until she reached the hospital.
Dr. Patricia Harris, who heads the University of Southern California's geriatrics division, said the survival odds are slim among elderly who receive CPR. Even if they survive, they are never the same. She said she would override the home's policy and risk getting fired "rather than watch somebody die in front of me."
During the call, an unidentified woman called from her cellphone, and asked for paramedics to be sent to help the woman. Later, a woman who identified herself as the nurse got on the phone and told dispatcher Tracey Halvorson she was not permitted to do CPR on the woman.
Halvorson urged the nurse to start CPR, warning the consequences could be dire if no one tried to revive the woman, who had been laid out on the floor on her instructions.
"I understand if your boss is telling you, you can't do it," the dispatcher said. "But . . . as a human being . . . you know, is there anybody that's willing to help this lady and not let her die?"
"Not at this time," the nurse answered.
Halvorson assured the nurse that Glenwood couldn't be sued if anything went wrong in attempts to resuscitate the resident, saying the local emergency medical system "takes the liability for this call."
Later in the call, Halvorson asked, "Is there a gardener? Any staff, anyone who doesn't work for you? Anywhere? Can we flag someone down in the street and get them to help this lady? Can we flag a stranger down? I bet a stranger would help her."
"I understand if your facility is not willing to do that. Give the phone to a passer-by. This woman is not breathing enough. She is going to die if we don't get this started, do you understand?"
The woman had no pulse and wasn't breathing when fire crews reached her, Galagaza said.
Sgt. Jason Matson of the Bakersfield Police Department said its investigation so far had not revealed criminal wrongdoing, but the probe is continuing.
First responders say often it's hard to find someone willing to provide CPR in an emergency.
"It's not uncommon to have someone refuse to provide CPR if they physically can't do it, or they're so upset they just can't function," Kern County Fire Department Deputy Chief Michael Miller said. "What made this one unique was the way the conversation on the phone went. It was just very frustrating to anyone listening to it, like, why wasn't anyone helping this poor woman, since CPR today is much simpler than it was in the past?"