CMS SOM App. J, Tag W125

facility, and as citizens of the United States, including the right to file complaints, and the right

to due process;

Guidance §483.420(a)(3)

To the extent that a client is able, choices are made on his/her own. Each client has autonomy

of decision making and choice.

They are free to move about without limitations imposed due to staff preferences or staff

convenience.

Clients are not restricted without due cause or due process.

To the extent that the client is able to make decisions for him or herself, it is inappropriate to

delegate the person’s right to others (e.g. parents, family members, etc.).

The facility has an obligation to assure client health and safety and must balance that obligation

with the rights of clients.

If the facility has implemented a restriction, the following should be in place:

• An assessment supporting the need for the restriction;

• An individualized behavior plan to reduce the need for the restriction has been

developed and implemented;

• A written informed consent for the behavior plan which includes the restriction;

• Approval of the Specially Constituted Committee; and

• Monitoring by the Committee of the progress of the training program, designed to

reduce and eventually eliminate the restriction.

Clients, families, and legal guardians have the right to register a complaint with the facility and

the State Survey Agency. If so, the facility must respond promptly and appropriately. The

facility must ensure protection of the client from any form of reprisal or intimidation as a result

of a complaint or grievance reported by the client, family, or legal guardian.

Issues involving the exercise of constitutional rights such as voting should be addressed as a

component of the IPP when the Interdisciplinary Team (IDT) determines a need for training.

Clients who have been adjudged to need guardianship or have been assessed as needing

assistance to advocate for themselves should receive assistance or support so they may exercise

their rights as citizens of the United States.