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identified by the comprehensive assessment required by paragraph (c)(3) of this section,

Guidance §483.440(c)(4)

Objectives are developed for those needs that are identified by the CFA and which are

considered to be most likely to improve the client’s ability to independently function in his/her

daily life, as determined by the IDT.

There is a clear link between the specific objectives and the functional assessment data and

recommendations.

Objectives are developed for those needs that are observed to most likely impact the client’s

ability to function in daily life. Training objectives should be developed to address client needs

rather than staff oriented objectives.

Clients are expected to have training objectives in the areas of activities of daily living, based on

the client’s assessed needs and as prioritized by the IDT. If clients have eyeglasses, dentures

and/or other assistive devices it is expected that the team considers objectives, based upon the

assessment of client needs, addressing the care and use of such devices. However, in the area

of programs to teach the clients’ money management it is not expected that every client will

automatically have a formal training objective to participate in such a program. The decision to

prioritize such a program and to what level the program is developed is decided by the IDT

based upon the results of the CFA and in consideration of such factors as, transferable skills, the

ability to make choices, the ability to identify preferences and cognitive abilities such as

attention span and an understanding of the principle of cause and effect.

Similarly, the decision to prioritize and develop a training objective for a client to participate in a

self-administration program for medications must be made by the IDT and be based upon

information from the CFA. Formal self administration programs should not be confused with

informal efforts to include the client in the administration process such as allowing them to hold

a glass of water, identify the box where his/her medications are stored or put a pill into their

own mouth themselves under the supervision of a person who is qualified to administer

medications.