Ftag of the Week – F745 Provision of Medically Related Social Services

This week’s “Ftag of the Week” on the CMSCG Blog is part of the Behavioral Health Services regulatory group that was added to the regulations under the updated Requirements of Participation. The emphasis on behavioral health and involvement of the interdisciplinary team in ensuring nursing facility residents have their needs met has been significantly expanded under the RoPs. F745 requires that residents are provided with sufficient and appropriate medically related social services that help them to attain/maintain their mental and psychosocial health. This means that facilities need to identify the required services needed by a resident and ensure that these services are provided.  The regulation is clear that all services do not necessarily have to be provided by a qualified social worker except as required by State law. If needed services are not covered by Medicaid, the facility still must attempt to obtain these services on behalf of the resident, such as arranging for transportation services.

The Interpretive Guidance (IG) provides a lengthy list of medically related social services that the facility has the responsibility to provide, including services such as:

  • Advocating for residents and assisting them with asserting their rights with in the facility
  • Assisting residents with voicing grievances and obtaining resolution to grievances
  • Making referrals and obtaining needed services provided by outside entities
  • Arranging for transition of care services, such as helping the resident identify community placement options and assisting with the application process or arranging for home care services for residents returning to home
  • Providing/arranging for mental and psychosocial health counseling services
  • Assisting residents with advance care planning, including completion of advance directives
  • Identifying and promoting individualized, non-pharmacological approaches to care the meet the resident’s needs
  • Assisting with financial and legal matters

Additionally, tasks such as educating and providing information to residents/representatives about care options and identifying ways to ensure that residents’ needs are met through assessment and care planning are listed as medically related social services. The IG also provides information on situations where the facility should provide/obtain services by outside entities, such as when there is lack of an effective family support system, in situations where there is any type of abuse, or when a resident expresses/ indicates distress that impacts his/her mental and psychosocial well-being. The medically related social services list, as mentioned above, has been expanded and the role of the social worker related to resident-centered care should not be underestimated, including the importance of sharing information between the resident/representative and team members regarding what the facility is or should be doing to ensure that the resident achieves the highest practicable physical, mental and psychosocial well-being.  This verbiage has been in place for years and a facility needs to ensure appropriate and necessary service are provided to ensure each resident’s individual needs are met.

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