US · guidance
CMS SOM App. J, Tag W185
§483.430(c)(4) The facility must provide sufficient support staff so that direct care staff are not
required to perform support services to the extent that these duties interfere with the
exercise of their primary direct client care duties.
Guidance §483.430(c)(4)
Direct care staff should not be performing support services (e.g., making beds, cooking,
cleaning, etc.) independently which takes them away from client interaction and teaching. If
support services in the house cannot be done jointly as chores between clients, as part of their
training program, and the support staff, additional staff should be added to perform the chores.
This does not include any staff chores done during client’s sleeping hours.
"Support staff" include all personnel hired by the facility that are not either direct care staff or
professional staff. For example, support staff includes, but are not limited to, secretaries, clerks,
housekeepers, maintenance and laundry personnel.
(d) Standard: Direct care residential living unit staff
History
Rev. 135, Issued: 02-27-15, Effective: 04-27-15, Implementation: 04-27-15
Provenance
- Source
- cms.gov
- Retrieved
- 2026-07-22
- Edition
- som-2026-07-22
- Content hash
431ab86870f0f8668146d8c269f7ade712d9716841d21a6cda015b52506cab55
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