Nursing Home Regulations: F-150

Taken From the State Operations Manual

Appendix PP – Guidance to Surveyors for Long Term Care Facilities

F150

§483.5
Definitions

(a)Facility defined. For purposes of this subpart “facility” means, a skilled nursing facility (SNF) or a nursing facility (NF) which meets the requirements of §§1819 or 1919(a), (b), (c), and (d) of the Social Security Act, the Act.
“Facility” may include a distinct part of an institution specified in §440.40 of this chapter, but does not include an institution for the mentally retarded or persons with related conditions described in §440.150 of this chapter. For Medicare and Medicaid purposes (including eligibility, coverage, certification, and payment), the “facility” is always the entity which participates in the program, whether that entity is comprised of all of, or a distinct part of a
larger institution. For Medicare, a SNF (see §1819(a)(1)), and for Medicaid, a NF (see §1919(a)(1)) may not be an institution for mental diseases as defined in §435.1009.

Interpretive
Guidelines §483.5

The following are the statutory definitions at §§1819(a) and 1919(a) of the Act for a SNF and a NF:

“Skilled nursing facility” is defined as an institution (or a distinct part of an
institution) which is primarily engaged in providing skilled nursing care and
related services for residents who require medical or nursing care, or
rehabilitation services for the rehabilitation of injured, disabled, or sick
persons, and is not primarily for the care and treatment of mental diseases;
has in effect a transfer agreement (meeting the requirements of §1861(1)) with one or more hospitals having agreements in effect under §1866; and meets the requirements for a SNF described in subsections (b), (c), and (d) of this section.

“Nursing facility” is defined as an institution (or a distinct part of an
institution) which is primarily engaged in providing skilled nursing care and
related services for residents who require medical or nursing care,
rehabilitation services for the rehabilitation of injured, disabled, or sick
persons, or on a regular basis, health-related care and services to individuals
who because of their mental or physical condition require care and services
(above the level of room and board) which can be made available to them only
through institutional facilities, and is not primarily for the care and
treatment of mental diseases; has in effect a transfer agreement (meeting the
requirements of §1861(1)) with one or more hospitals having agreements in
effect under §1866; and meets the requirements for a NF described in
subsections (b), (c), and (d) of this section.

If a provider does not meet one of these definitions, it cannot be certified for participation in the Medicare and/or Medicaid programs.

NOTE:
If the survey team finds substandard care in §§483.13, 483.15, or
483.25, follow the instructions for partial extended or extended surveys.

________________________________________________________________________

§483.10
Resident Rights

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. A facility must protect and promote the rights of each resident, including each of the following rights.

Interpretive Guidelines §483.10

All residents in long term care facilities have rights guaranteed to them under Federal and State law. Requirements concerning resident rights are specified in §§483.10, 483.12, 483.13, and 483.15. Section 483.10 is intended to lay the foundation for the remaining resident’s rights requirements which cover more specific areas. These rights include the resident’s right to:

  • • Exercisehis or her rights (§483.10(a));
  • • Be informed about what rights and responsibilities he or she has (§483.10(b));
  • • If he or she wishes, have the facility manage his personal funds (§483.10(c));
  • • Choose a physician and treatment and participate in decisions and care planning (§483.10(d));
  • • Privacy and confidentiality (§483.10(e));
  • • Voice grievances and have the facility respond to those grievances (§483.10(f));
  • • Examine survey results (§483.10(g));
  • • Work or not work (§483.10(h));
  • • Privacy in sending and receiving mail (§483.10(i));
  • • Visit and be visited by others from outside the facility (§483.10(j));
  • • Use a telephone in privacy (§483.10(k));
  • • Retain and use personal possessions (§483.10(1)) to the maximum extent that space and safety permit;
  • • Share a room with a spouse, if that is mutually agreeable (§483.10(m));
  • • Self-administer medication, if the interdisciplinary care planning team determines it is safe (§483.10(n)); and
  • • Refuse a transfer from a distinct part, within the institution (§483.10(o)).

A facility must promote the exercise of rights for each resident, including any who face barriers (such as communication problems, hearing problems and cognition limits) in the exercise of these rights. A resident, even though determined to be incompetent, should be able to assert these rights based on his or her degree of capability.

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