I work in LTC also and we do not send out our res. to get a vac. from them--tho that is a thought. It has already been said that they can have normal vs and still have loc. we do labs. and ect. and place on doctor's board to eval and tx. and most of the time for the very noncompliantand aggres. they are sent to Psych. ward for two or three weeks. The families do insist on sending their loved one to the hosp. and the doctors comply with their wishes! DNR status---well families do not fully understand and / or change their mind when they see a change in family member.I have encountered issue with Hosp. nurses and doctors reguarding DNR ---HEY I agree DNR does not mean --Do not tx.------BUBBLE