Ftag of the Week – F558 Reasonable Accommodation of Needs/Preferences

This week’s “Ftag of the Week” is F558 Reasonable Accommodation of Needs/Preferences, which is part of the Resident Rights regulatory group. This regulation states that the resident has the right to receive services with reasonable accommodation of resident needs and preferences except when the health or safety of the resident or other residents could be jeopardized.

The Interpretive Guidance (IG) states that this accommodation of needs and preferences reflects the facility’s efforts to individualize the physical environment for each resident, which is essential to creating a home-like environment. This includes ensuring that common areas accommodate residents’ physical limitations as well as the resident’s bedroom and bathroom. The IG notes that these accommodations may help with assisting the resident to maintain and/or achieve independent functioning, dignity and well-being.

That is a relatively broad area where multiple issues could be identified, so let’s take a look at some examples of deficient practices that have been cited under F558:

  • Call bells not within reach – such citations are abundant under F558
  • The bedrails of a paralyzed resident who wanted them available to self-reposition were removed but she was not given an option to keep them
  • A visually impaired resident was provided with books on tape but told a surveyor that he was never told how to use them and that the headphone for the machine was broken
  • A facility did not provide a resident with an oxygen tank that allowed free movement and prevented the resident from independently visiting other residents, going outside or getting beverages
  • A resident was observed with a roll of toilet paper on his bedside table and mentioned to the surveyor that he had asked for tissues multiple times and no one provided them to him so he used toilet paper since it would be refilled regularly

In each of these situations, the resident’s ability to maintain independence was diminished. Additionally, many of the call bell-related citations prevented residents from requesting help when they needed it, leaving them vulnerable to not having their needs met. Surveyors are instructed to observe residents in their rooms and determine if staff keep needed items within the resident’s reach and provide assistance as necessary to help the resident remain independent and dignified. Many of these situations could be identified and addressed simply by conducting your own rounds and visual inspections to see how the environment accommodates the residents’ needs.  While you are conducting these observation rounds, include sample interviewing of residents to gather information as to whether or not they think their individual needs and preferences are being addressed.

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