We’re in the business of saving lives. CPR classes have been available to the public for over 50 years now. Resuscitation rates have increased over time, however they are not where they should be. When reflecting on this, we must examine CPR instructor mistakes and the lessons we can learn from them.

The reality is that 50 years of CPR education isn’t that much. When it comes to advances in our medical understandings, there are long periods of trial and error. Every 5 years the Emergency Cardiovascular Care Update (ECCU) is published and reveals new changes to the way we perform CPR. Many people don’t realize that CPR has changed over time and unfortunately this sometimes includes CPR instructors.

The American Heart Association and American Red Cross have both largely tasked designated Training Centers as responsible for quality assurance in their training programs. These Training Centers must monitor and ensure their instructors follow the guidelines of course administration. (Read: Top Three CPR Instructor Mistakes) However, in an industry where growth and need for this training has exploded, it has been an ever changing environment to figure out how to ensure quality is not compromised.

Let’s discuss the top three lessons you should learn from instructors who made some big mistakes.

CPR Instructor Lesson #1. No one gets a certification card without attending a class.

The number one thing that gets CPR instructors in trouble, is giving certifications to students who did not attend training. This is a fast way to not only lose your CPR Instructor certification, but be put under review by your medical licensing board. In short, this kind of action is fraud and can be prosecuted.

It’s actually quite concerning the number of doctors who haven’t taken a CPR certification class in the last decade. If they’re a doctor they know who to do CPR right?! Wrong. The ‘good ole boy system’ has made people feel like it’s okay to hand out CPR certifications to people who have taken CPR a million times before or do CPR regularly. However, this is one of the biggest mistakes being made in the medical field. In fact, oftentimes it’s found that the CPR students who struggle the most are the ones who have been previously certified. They often fall back to outdated practices and are discouraged from learning the latest guidelines.

Giving certifications to students who didn’t attend a class can be costly. It could even cost someones life when a certified person fails to respond… because they don’t know how. It can also cost your career as an instructor and your medical license. In 2022, a Miami firefighter was charged with a 3rd degree felony for ‘Organized Scheme to Defraud.’ (Read story here.) In this case, the State Attorney said

“Falsification of any certification always has the potential of placing people in danger. However, falsifications of training in life-saving techniques creates an obvious risk if a life-or-death situation arises, something these certifications were intended to avoid.”

This story is not unique. In 2021, a Washington State man confessed to selling fake CPR certifications to people who did not receive training. In this case, the District Attorney asserted that people bearing these certification cards could also be prosecuted. (Read: Fort Bend County man char

ged with selling fake CPR certifications to hundreds of healthcare workers.)

If you are ever pressured by someone to give them a CPR certification card without them attending class, do not do it! While some CPR instructor’s have made this mistake and some people think it’s the norm, it should not be a practice furthered.

CPR Instructor Lesson #2. Students use the latest textbooks and course videos.

Cardiovascular Resuscitation guidelines are updated every five years. Generally, so are all course materials including course videos and printed material. Unfortunately, sometimes instructors are not made aware of this by their Training Center or they try to save money by not buying the new stuff. Using old materials and issuing the new course completion cards is incompatible and gross error.

The AHA PAM stipulates that “Each AHA course must follow the guidelines and core curriculum in the most current editions of the course textbook or Instructor Manual. Current editions of AHA course materials must serve as the primary training resource during the course.”

There have been significant changes to CPR and content in just the last decade. Teaching anything other than the latest curriculum is less than effective and means your students did not earn the latest certification they need. In cases finding this error made, the AHA has revoked certification cards and made people retake the training.

CPR Instructor Lesson #3. The appropriate certification cards are always issued.

When copyrighted materials are used for instruction, it comes with guidelines that must be adhered to. For starters, you typically can not photocopy any copyrighted material.

Prior to 2017, CPR certifications were issued on paper certification cards that were purchased through the copyrighted brand. Each certification card cost precious dollars. It was not uncommon to see these blank certification cards photocopied and then students information populated. However, these cards are considered fraudulent and in violation of copyright law. In some really bad cases, there are stories of Training Centers that would sell these photocopied cards to instructors instead of sending the legitimate certification cards.

Once, I had an instructor ask if I would buy the certification cards back that their previous Training Center had sold them. The instructor showed me a printed stack of certification cards that were photocopied twice over and even a little crooked. This was a gross issue of integrity as it was clear individuals were pocketing the costs that should have been used to buy the legitimate product. I think it would be fair to say that people doing this were not CPR Instructors making mistakes, but instead people intentionally trying to skirt the rules.

To combat this issue, the AHA and Red Cross have made their certifications digital. They are both issued with unique QR codes that prove their validity. This hasn’t stopped all people from faking certifications. However, it has cut down on the issue substantially. (Read more: How to Spot Fake CPR Certifications)

Another note on issuing certification cards for courses copyrighted through the AHA and Red Cross is that the organizations both stipulate students who complete a course must be issued a course completion card. This means that even if someone doesn’t want or need a certification, the instructor is still obligated to provide them with it. According to the AHA Program Administration Manual (PAM): “Each student who successfully completes an AHA ECC course must be issued the appropriate course completion card unless prohibited by local or state statutes or regulations.”

In 2008, a California hospital system was under scrutiny for having found virtually all of their employees had received fraudulent cards. (Read story: Hospital Faulted in Fake CPR Cards Case) Even though most all of them said they completed training, their physical certification cards were not legitimate. This incident resulted in 59 employees being fired. The staff with medical licenses were then reported to the state licensure board for discipline.

AHA Fraud Warning

The American Heart Association keeps a webpage up to date with the latest fraud warnings. They are constantly working to make sure training is done legitimately. Warnings like this and others can be viewed on the AHA website here.

Conclusion

Do it right the first time. The cost of these errors is far from small. The reality is that most of these ‘mistakes’ are not ‘mistakes’ at all but gross misconduct. CPR instructors are in the business of saving lives and integrity in this pursuit is vital. Remember that any of your students could one day be responsible for saving the life of one of your loved ones.

Watch: How to Know if Your AED is Still Working

Big sigh. We all know the feeling of a last minute cancellation or rescheduling in our CPR business. Maybe you’ve had an instructor move their day around to accommodate teaching a private class and now you have to call them and tell them it’s cancelled. The instructor has already loaded up their vehicle with equipment. The client now needs to reschedule and you’ll go through the process again. This administrative time costs and there’s also the cost of business you turned away to schedule a client.

At the same time, we all know life happens and we care intently about our clients at Vitali Partners. We look to serve our clients and hope they find us as accommodating whenever we can be. Let’s discuss how we can accommodate people while also responsibly operating a CPR business.

Contracts & Terms of Service

First, let’s cover the basics. You can make up any rules you want and on the go. However, when push comes to shove and you are talking to a credit card company or lawyer, you will need a contract or Terms of Service to point them to.

Generally, most CPR business’s have two types of clients. There are individual and business/corporate clients.

For the general public (individuals), you should have Terms of Service. When an individual books a class with you it’s ideal that they pay up front and agree to your terms of service. You can set the terms of service as you would like. The terms of service should include your rescheduling policy, cancellation policy, and any video or photography waivers.

For corporate clients, we always recommend having a contract in place. This contract does not need to be overly complicated. A contract should be simple and enforceable. Having your business’s lawyer read over and refine the contract is best practice. Many people will fill contracts with items that are not able to be upheld. Your contract should state straightforward. It should include details about when payment is due, how much they are paying, how you handle changes in number of attendants, and what your rescheduling or cancellation policy is.

If you are interested in learning more about government contracts, read our article here.

Rescheduling

There are many reasons a client may need to reschedule a class with your CPR business. In the event of illness, bad weather, schedule changes, or family emergencies people may need to change the date of their training. For every legitimate reason, there are also other reasons that are less understandable. We suggest having a policy that protects your business. However, we also recommend using the policy at your discretion.

Your rescheduling policy may vary between corporate clients and individuals. For individuals, we suggest allowing free rescheduling up to 24 hours in advance. You will need to choose what makes the most sense for your business based on how you compensate your contractors and employees effected. After the free rescheduling window, you may charge a fee to move their class registration. We recommend the rescheduling be 50% the cost of tuition.

Why charge a rescheduling fee? People that sign up for a class and move their registration last minute may have taken a seat from another student. Often, our classes are full and our students have to sign up for a class at a later date. If people are allowed to reschedule for free, then that means you can end up with an empty seat last minute and take away a seat from what would have been another paying student in your next class. A rescheduling fee allows you to recoup a margin of what would otherwise have been lost to your CPR business

Cancellations

Furthermore, we care intently about our instructors. When they make time in their schedule to teach for us, we intend to pay them regardless if students cancel. If a student cancels last minute, we reserve the right to not refund them so we can cover our cost to pay the instructor. This is always stated up front in our Terms of Service or Contract. Without our instructors, a CPR business can not run. We look to protect both our instructors and our business so we can continue our mission of saving lives.

Example Cancellation/Rescheduling Policy

‘Cancellations or rescheduling must be made no later than 24 hours before the class start time in order to receive a full refund minus 3.5% processing fees if paid by credit card. If you choose to reschedule or cancel within 24 hours of your class start time, you will be refunded or assessed a rescheduling fee of 50% of your tuition.

Students have 30 days to reschedule their class before forfeiting their entire tuition. A student may only reschedule once. A second rescheduling will require repayment of full tuition.

Students that do not attend class and make no attempt to contact us in advance of their absence will forfeit 100% of their tuition.’

For an example of how you could use this, visit our partners website and follow the process to sign up for a class (no need to complete registration) and see the terms of service and cancellation policy here. 

Considerations

Another thing to consider beyond administration time, is the cost of credit/debit card processing. Be careful to note that if you are using a card processor, you are paying fees on the transaction. Most CPR businesses pay 1.5-6% on transaction fees a year. You pay these fees both when you accept payment and when you refund payment. This means that you can actually end up paying to refund a student! Be aware of your processing fees and pass them off to the customer if the change was due to their own obligations.

More CPR Business Help: How to Become an AHA Training Site