CMS SOM App. PP, Tag F696

The facility must ensure that a resident who has a prosthesis is provided care and

assistance, consistent with professional standards of practice, the comprehensive

person-centered care plan, the residents’ goals and preferences, to wear and be able

to use the prosthetic device.

GUIDANCE §483.25(j)

The non-availability of program funding does not relieve a facility of its obligation to

ensure that its residents receive all needed services listed in §1819(b)(4)(A)

of the Social

Security Act for Medicare and §1919(b)(4)(A) of the Act for Medicaid. For services not

covered under Medicare or Medicaid, a facility is required to assist the resident in

securing any available resources to obtain the needed services.

This requirement does not mean that the facility must purchase or provide funding for the

prosthetic.

PROBES §483.25(j)

Refer to appropriate sections of the RAI/MDS, as applicable.

For residents selected for review, as appropriate:

• Is resident able to apply the prosthesis by himself/herself or with some assistance?

• Are residents wearing their prostheses?

• Does the prosthesis fit correctly?

• Is skin/mucous membrane in contact with the prosthesis free of abrasions,

wounds, irritation?

• Is the prosthesis in good condition and functioning as intended?

• Is the prosthesis in need of repair?