CMS Pub. 100-11, ch. 5, § 20.7

Each participant has the right to participate fully in all decisions related to his or her

treatment. A participant who is unable to participate fully in treatment decisions has the

right to designate a representative.

Specifically, each participant has the right:

• To have all treatment options explained in a culturally competent manner and

to make health care decisions, including the right to refuse treatment, and be

informed of the consequences of the decisions;

• To have the PACE organization explain advance directives and to establish

them, if the participant so desires, in accordance with 42 CFR §§ 489.100 and

489.102;

• To be fully informed of his or her health and functional status by the

interdisciplinary team;

• To participate in the development and implementation of the plan of care;

• To request a reassessment by the interdisciplinary team;

• To be given reasonable advance notice, in writing, of any transfer to another

treatment setting and the justification for the transfer (that is, due to medical

reasons or for the participant’s welfare, or that of other participants). The

PACE organization must document the justification in the participant’s

medical record.

[42 CFR § 460.112(e)]