Ftag of the Week – F550 Resident Rights/Exercise of Rights

This week’s Ftag of the Week is F550 Resident Rights/Exercise of Rights, which was effective under Phase 1 of the Requirements of Participation (RoPs) but continues to need attention since it’s one of the most frequently cited deficiencies on survey nationally. The regulation states that “the resident has a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility.” The Interpretive Guidance (IG) notes that all activities and interactions that staff and volunteers have with residents must help the residents to maintain or enhance their self-esteem, self-worth and incorporate their goals, preferences and choices. Staff must also consider residents’ physical limitations, assure communication and maintain respect.

Specific rights included under F550 include:

  • The right to be treated with respect and dignity
  • The right to be provided care in a manner and in an environment that promotes maintenance or enhancement of quality of life, recognizing each resident as an individual
  • The right to equal access to quality care regardless of payment source, severity of condition or diagnoses, including for provision of discharges and transfer/discharge
  • The right to exercise rights as a resident of the facility as well as a citizen/resident of the United States and the right to exercise these rights without interference, coercion, discrimination or reprisal from the facility

The rights of Justice-Involved Individuals – who are defined as residents who are under the care of law enforcement, under community supervision or inmates of a public institution – are also outlined under F550. The Centers for Medicare and Medicaid Services (CMS) issued a May 3, 2016 S&C Memo clarifying requirements related to justice-involved residents which is referenced in the IG for additional guidance that can be found here.  

The IG states that residents’ rights deficiencies may have a negative psychosocial outcome for the resident, and that surveyors need to consider the potential for both physical and psychosocial harm when they have identified dignity-related deficiencies. Surveyors are instructed to observe, among other things, if staff respond in a timely manner to residents’ requests for assistance, if staff know a resident’s specific needs/preferences, and if staff respond to residents with cognitive impairments in a manner that facilitates communication and provides the resident with enough time to respond.  It is time for you to pull out and review the Psychosocial Harm Severity Guide with your staff.

Don’t forget – as we mentioned in our last Ftag of the Week post, F942 Resident’s Rights Training becomes effective November 28, 2019.


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