Page 79 - The Deep Seated Issue of Choice

THE DEEP SEATED ISSUE OF CHOICE
APPENDIX D
F309
483.25
Interpretive Guidelines
Clarify the facility responsibility to honor the resident right to self-determination in decision of avoidable or unavoidable decline or failure to reach the highest practicable wellbeing.
Resident/Representative Interview
Add probes to determine if resident self-determination was respected.
Care Plan Revision
Detail the resident right to self-determination and treatment refusal as one of the conditions determining compliance.
Interpretive Guidelines for Selected Specific Quality of Care Issues at 483.24
Add review of a resident regarding self-determination, similar to guidance on pain.
F325
483.25(i)(2)
Intent
Expand first bulleted intent to include consistent with the resident’s right to self-determination in addition to comprehensive assessment.
Expand third bulleted intent to include resident’s right to self-determination in addition to clinical condition and preferences.
Definitions
Expand avoidable/unavoidable to include resident right to self-determination in addition to needs, goals and recognized standards of practice.
Overview
Change implement to offer in the sentence allow the IDT to develop and implement interventions to stabilize...
Care Planning and Interventions
Remove the qualifier “to the extent possible”.
End of Life
Expand the guidance to unseat the long standing expectation that the facility must continue to monitor weight and intake and to adjust care plan approaches continually until the resident is unwilling/unable to swallow.
Investigative Protocol – Objectives
Change the third bulleted point to read offered instead of received a therapeutic diet.
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