CMS SOM App. J, Tag W149

prohibit mistreatment, neglect or abuse of the client.

Guidance §483.420(d)(1)

The facility, through implementation of its policies, must set up a structure that screens and

trains employees, protects clients and prevents, identifies, investigates and reports abuse,

neglect and mistreatment of clients.

The policies must designate who (either by name or title) has the authority to act in the

Administrator’s absence and take any immediate corrective actions necessary to assure a

client’s safety such as removing a staff person from direct client contact.

"Mistreatment", for the purposes of this guideline, includes behavior or facility practices that

result in any type of client exploitation such as financial, physical, sexual, or criminal.

Mistreatment also refers to the use of behavioral management techniques outside of their use

as approved by the specially constituted committee and facility policies and procedures.

"Neglect" means failure to provide goods and services necessary to avoid physical harm, mental

anguish or mental illness. Staff failure to intervene appropriately to prevent self-injurious

behavior may constitute neglect. Staff failure to implement facility safeguards, once client to

client aggression is identified, may also constitute neglect.

Refer to W127 for definitions of abuse.