Ftag of the Week – F576 Right to Forms of Communication with Privacy

This week’s Ftag of the Week on the CMSCG Blog is part of the Resident Rights regulatory group, F576 Right to Forms of Communication with Privacy. The regulation includes several requirements for residents, including:

  • Ensuring the right to “reasonable access” to use a phone, as well as a place in the facility, to make calls without being overheard. The Interpretive Guidance (IG) for F 576 clearly spells out that simply providing access to telephones located in staff offices at the facility or at nurses’ stations does not fulfill this requirement. Facilities have been cited when surveyors observed – and heard – residents on the nurses’ stations phones providing bank account numbers and other details over the phone within earshot of staff, other residents and visitors.
  • Protecting and facilitating the residents’ ability to communicate both inside the facility as well as with parties outside the facility  by providing reasonable access to communication devices. Reasonable access means that communication devices are easily accessible to the residents and that they have been adapted to meet the residents’ needs, such as through the use of TTY/TTD for residents with vision or hearing problems. These devices include phones, internet and writing materials. The ability to send mail must also be provided.
  • Ensuring residents who are using electronic forms of communication (such as email, video chat such as Skype or an internet browser for research) are afforded with reasonable access to and privacy in their use of this communication format. General use computers are expected to be located in an area in the facility where residents have privacy with their internet use, communications and email. This is required only if this access is available in the facility and it can be at the resident’s expense if the facility incurs additional expense to provide this access to the resident. All internet usage should be in accordance with Federal and State laws.
  • Protecting the residents’ right to send and receive mail, including packages and other items delivered to the facility that may not be delivered by the US postal service. Residents should have access to stationary and other materials (at their own expense) There is an expectation of privacy in this right, specifically that residents should receive their mail unopened.

It is this last requirement that proves to be the most frequently cited issue under F576. Why? The Resident Council interview on survey specifically asks residents if they receive their mail on Saturdays. How do they respond? They say they can’t remember a time when they received their mail on Saturdays, and sometimes that it is even more delayed than that. When surveyors follow up with staff, there often seem to be a lack of clear procedures for mail delivery on weekends, either due to certain departments not having staff over the weekend, such as the Business Office or Reception, and thus, mail delivery is delayed. One citation reviewed at F576 stated that since mail was not being delivered to residents on Saturdays, the residents were being denied “the same rights as other citizens of the general community.” This is true – if your residents lived in a community-based setting, they would receive their mail on Saturdays like everyone else. That means that if you don’t have a process in place for ensuring mail is delivered timely, you need to put a plan in place.

In general, reviewing these deficiencies led to identification of detailed citations by surveyors who listened to residents on the phone at the nurses’ station providing all kinds of personal information – a body rash, information regarding medications being taken, and as mentioned prior, financial information. It is essential that residents have the ability to make phone calls in private, and if they do not have a cell phone, the facility should ensure there is a backup plan to allow residents to conduct their business as needed or socialize as they wish. It might just be worth the investment for having a few cordless phones available for resident use.

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