CMS SOM App. J, Tag W123

client's rights and the rules of the facility;

Guidance §483.420(a)(1)

The obligation to inform requires that the facility presents information on rights to the client, his

or her family or his or her legal guardian in a manner and form which they can understand. In

most instances, family means parent. However, in those instances where parents are deceased

or choose not to be active in the client’s life and there is another family member who does wish

to be active, but is not the legal guardian, this family member should be informed of the client’s

rights. Printed materials should be provided in understandable terms and provided in the

language necessary to ensure understanding. Specialized methods, as indicated, should be

provided for communication with clients, families or legal guardians with hearing or vision

impairment.

Pro-active assertion of client rights includes, but is not limited to:

• Signed evidence that the client, his or her family and/or his or her legal guardian have

been informed of the client’s rights, and

• Evidence that the communication of these rights were provided at the client’s level of

comprehension, and in the language understandable to the client.

The obligation to inform also requires that the facility make some determination of whether the

client and his or her family, or legal guardian understood the rights presented and made

additional efforts to communicate the rights if the rights were not understood.

If the facility has written “rules of the facility”, these rules must be communicated to the client,

their family and or legal guardians at the time of admission and must not be in conflict with any

of the rights listed in 42 CFR 483.420 (a) (1-13).