CMS SOM App. W, Tag C-1608

The CAH is substantially in compliance with the following SNF requirements

contained in subpart B of part 483 of this chapter:

§485.645(d)(1) Resident Rights (§483.10(b)(7), (c)(1), (c)(2)(iii), (c)(6), (d), (e)(2) and

(4), (f)(4)(ii) and (iii), (g)(8) and (17), (g)(18) introductory text, (h) of this chapter).

• §483.10(b)(7) In the case of a resident adjudged incompetent under the laws

of a State by a court of competent jurisdiction, the rights of the resident

devolve to and are exercised by the resident representative appointed under

State law to act on the resident's behalf. The court-appointed resident

representative exercises the resident's rights to the extent judged necessary

by a court of competent jurisdiction, in accordance with State law.

• §483.10(c) Planning and implementing care. The resident has the right to be

informed of, and participate in, his or her treatment, including:

(1) The right to be fully informed in language that he or she can understand

of his or her total health status, including but not limited to, his or her

medical condition.

• §483.10(c)(2)(iii) The right to be informed, in advance, of changes to the plan

of care.

• §483.10(c)(6) The right to request, refuse, and/or discontinue treatment, to

participate in or refuse to participate in experimental research, and to

formulate an advance directive.

• §483.10(d) Choice of attending physician. The resident has the right to

choose his or her attending physician.

(1) The physician must be licensed to practice, and

(2) If the physician chosen by the resident refuses to or does not meet

requirements specified in this part, the facility may seek alternate

physician participation as specified in paragraphs (d)(4) and (5) of this

section to assure provision of appropriate and adequate care and

treatment.

(3) The facility must ensure that each resident remains informed of the name,

specialty, and way of contacting the physician and other primary care

professionals responsible for his or her care.

(4) The facility must inform the resident if the facility determines that the

physician chosen by the resident is unable or unwilling to meet

requirements specified in this part and the facility seeks alternate

physician participation to assure provision of appropriate and adequate

care and treatment. The facility must discuss the alternative physician

participation with the resident and honor the resident's preferences, if

any, among options.

(5) If the resident subsequently selects another attending physician who

meets the requirements specified in this part, the facility must honor that

choice.

• §483.10(e)(2) The right to retain and use personal possessions, including

furnishings, and clothing, as space permits, unless to do so would infringe

upon the rights or health and safety of other residents.

• §483.10(e)(4) The right to share a room with his or her spouse when married

residents live in the same facility and both spouses consent to the

arrangement.

• §483.10(f)(4)(ii) The facility must provide immediate access to a resident by

immediate family and other relatives of the resident, subject to the resident's

right to deny or withdraw consent at any time;

• §483.10(f)(4)(iii) The facility must provide immediate access to a resident by

others who are visiting with the consent of the resident, subject to reasonable

clinical and safety restrictions and the resident's right to deny or withdraw

consent at any time;

• §483.10(g)(8) The resident has the right to send and receive mail, and to

receive letters, packages and other materials delivered to the facility for the

resident through a means other than a postal service, including the right to:

(i) Privacy of such communications consistent with this section; and

(ii) Access to stationery, postage, and writing implements at the resident's

own expense.

• §483.10(g)(17) The facility must—

(i) Inform each Medicaid-eligible resident, in writing, at the time of

admission to the nursing facility and when the resident becomes

eligible for Medicaid of—

(A) The items and services that are included in nursing facility

services under the State plan and for which the resident may not

be charged;

(B) Those other items and services that the facility offers and for

which the resident may be charged, and the amount of charges for

those services; and

(ii) Inform each Medicaid-eligible resident when changes are made to the

items and services specified in §483.10(g)(17)(i)(A) and (B) of this

section.

• §483.10(g)(18)[introductory text only] The facility must inform each resident

before, or at the time of admission, and periodically during the resident's

stay, of services available in the facility and of charges for those services,

including any charges for services not covered under Medicare/Medicaid or

by the facility's per diem rate.

• §483.10(h) Privacy and confidentiality. The resident has a right to personal

privacy and confidentiality of his or her personal and medical records.

(1) Personal privacy includes accommodations, medical treatment, written

and telephone communications, personal care, visits, and meetings of

family and resident groups, but this does not require the facility to

provide a private room for each resident.

(2) The facility must respect the residents right to personal privacy,

including the right to privacy in his or her oral (that is, spoken), written,

and electronic communications, including the right to send and promptly

receive unopened mail and other letters, packages and other materials

delivered to the facility for the resident, including those delivered

through a means other than a postal service.

(3) The resident has a right to secure and confidential personal and medical

records.

(i) The resident has the right to refuse the release of personal and medical

records except as provided at §483.70(i)(2) or other applicable federal

or state laws.

(ii) The facility must allow representatives of the Office of the State Long-Term Care Ombudsman to examine a resident's medical, social, and

administrative records in accordance with State law.

Interpretive Guidelines §485.645(d)(1)

Refer to Appendix PP of the State Operations Manual (SOM) for interpretive guidelines.

Survey Procedures §485.645(d)(1)

Refer to Appendix PP of the State Operations Manual (SOM) for survey procedures.