The Department of Health and Human Services (HHS), Office for Civil Rights (OCR) recently issued guidance for nursing homes on how to better “…comply with their civil rights obligations by administering the Minimum Data Set (MDS) appropriately so that residents receive services in the most integrated setting appropriate to their needs…”
Here is a summary from LeadingAge National:
- The OCR guidance specifically addresses MDS Section Q–Participation in Assessment and Goal Setting.o The intent of this section is to document residents’, family members’, significant others’ participation and expectations in the assessment process; to understand residents’ overall goals; and to ensure that all residents have the opportunity to learn about home-and community-based services and to receive long term care in the least restrictive setting possible. “…Discharge planning follow-up is already a regulatory requirement (CFR 483.20 (i) (3)).”
- OCR’s concern is that many nursing homes may be misinterpreting and/or administering Section Q improperly, potentially preventing residents for receiving information and/or opportunities to transition from the home into community settings.
- The guidance also advises that interested residents must be referred to the “Local Contact Agency” designated to assist residents in moves into the community, and that “ A facility should not short-circuit the process based on its estimation that the resident would not be able to live in the community, or on the opinions of the resident’s family…”o “A Local Contact Agency is a local community organization responsible for providing counseling to nursing facility residents on community support options. Long term care facilities must make referrals to the Local Contact Agency whenever a resident would like more information about community living or alternative living situations to the facility.” View the listing of Local Contact Agencies.o OCR provides a series of recommendations / steps that nursing homes can take to ensure proper administration of Section Q.
The guidance may serve as a reminder to nursing care members and staff who are responsible for coding that review of Section Q may be beneficial in ensuring the rules in the RAI manual are followed.
