CMS SOM App. J, Tag W247

Guidance §483.440(c)(6)(vi)

Choice and self-management are integral components of becoming independent. Clients should

be given opportunities for choice and self-management in both formal and informal settings

through the IPP process, leisure activities, and other life choices.

The ICF/IID must incorporate opportunities into daily life experiences that promote choice

making and decision making by clients. Examples of some activities leading toward

responsibility for one's own self-management include, but are not limited to:

1) choosing housing or roommates;

2) choosing clothing to purchase or wear;

3) choosing what, where, and how to eat (e.g., the use of family style dining, access to

condiments and second helpings).

Choices can be made by all clients. The type of choices the person makes may vary from simple

to complex, dependent upon client abilities.

Clients are provided opportunities for choice and self-management and the facility does not

limit choices by making decisions for the people being served without their input. Clients are

provided the opportunity to demonstrate skills to the degree they are capable and only assisted

by staff as indicated in their IPP. A lack of facility staffing or staff convenience must not result in

a limitation of choices of self-management for the clients.