Ftag of the Week – F600 Free from Abuse & Neglect (Part 4)

For this week’s Ftag of the Week on the CMSCG Blog, we are wrapping up our review of F600 by discussing the regulation as it relates to the right to be free from Neglect. The definition of Neglect, per Appendix PP, is failure by the facility or facility employees/service providers to provide necessary goods and services to a resident to avoid physical harm or pain, mental anguish or emotional distress. The Interpretive Guidance (IG) notes that failure to provide the necessary care and services to a resident may not only have a negative physical outcome, but could result in a negative psychosocial outcome for the resident as well.

Neglect can be identified when as facility does not provide “required structures and processes” to meet the needs of its residents, which includes things like ensuring there is sufficient staffing, staff supervision and resident care policies in place. Neglect can also occur when staff are aware of, or should be aware of, residents’ care needs but do not meet those needs based on factors such as inability to perform an intervention due to lack of training, sufficient supplies, or lack of knowledge about the resident. The IG notes that if a facility admits a resident, it should have determined that it has the ability to take care of that resident and provide the goods and services that he or she needs. To ensure it can meet each individual resident’s needs, the facility needs to have in place structures such as:

  • Sufficient numbers of qualified, competent staff based on the facility’s assessment of the residents’ needs
  • Resident care P&Ps that ensure that facility provides care based on current standards of practice, provide clinical/technical direction for provision of care and services and address each diagnosis of a resident.
  • A safe, sanitary environment
  • Sufficient provisions of items such as clean linens and food

Facilities cannot disavow the actions of the staff that have been hired to care for their residents. This makes it important to ensure that staff are following the individualized care plan for each resident to avoid negative outcomes.

Office of the Inspector General Reports

The Office of the Inspector General released two reports this week that discuss how potential incidents of abuse and neglect in nursing homes were not always thoroughly reported and how CMS could use Medicare data to identify potential situations of abuse and neglect. You can view CMSCG’s blog posts on these OIG reports here and here.

 Final Thoughts on Abuse & Neglect

We all have a responsibility no matter what health care setting we work in as well as in our daily lives to understand that our tolerance level for abuse and neglect should be ZERO. And, once again in regulation, we are shown another instance of the importance that should be placed on the Facility Assessment and using this assessment as a guide for staffing levels, educational/training programs needed and ensuring that we meet each resident’s needs based on their individualized plan of care.

You can view CMS Compliance Group’s Ftag of the Week blog series related to F600 to view the other 3 posts you may have missed related to abuse and neglect. This is a topic that has been receiving increased regulatory scrutiny, including as evidenced by the newly released OIG reports, and will continue to be a regulatory hot topic going forward. Does your organization need assistance with enhancing its systems related to preventing abuse or neglect? CMS Compliance Group can help – contact us to learn how we can work together.

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