CMS SOM App. J, Tag W344

care for clients' health needs including those clients with medical care plans.

Guidance §483.460(d)(2)

The facility provides for nursing services based on the health needs and conditions of clients

residing there. Examples include:

1) physician ordered treatments that require the skills of a licensed nurse;

2) preventive screenings ;

3) assessment and intervention;

4) direct physical examination and examination of body systems;

5) teaching; and

6) advocacy for the medical services needed by the client.

Client health care needs are met in a timely manner (within 24 hours) by the available nursing

staff.

If nurses who do not have experience in the care of persons with intellectual disabilities are

employed by the facility, they should be provided with a formal orientation period and on-going

educational opportunities to increase their understanding of the client population.

When one or more clients in the facility has an active medical care plan, there must be 24 hour

nursing services available to come to the facility as needed to make skilled assessments and

interventions.