What regulatory standards dictate how you would handle requests for substitutions in long term care?

Federal Regulations:

- Centers for Medicare & Medicaid Services (CMS):

- Residents' Rights (42 CFR §483.10): Nursing homes must protect and promote residents' rights, including the right to make choices about their own care.

- Comprehensive Personal Care Plan (42 CFR §483.20): Nursing homes must develop a comprehensive personal care plan for each resident that includes medical treatment and care, nutritional needs, activities, and social services. This plan must be reviewed regularly and updated as necessary.

- Resident Assessment (42 CFR §483.20): Nursing homes must conduct resident assessments that include information on the resident's physical, cognitive, and psychosocial well-being. This assessment should include the resident's preferences for care, including any requests for substitutions.

- Food and Nutrition Services (42 CFR §483.35): Nursing homes must provide a variety of food options that meet the residents' nutritional needs and preferences. This includes providing alternatives when residents request substitutions.

State Regulations:

- State Nursing Home Regulations: Each state has its own nursing home regulations that may include specific requirements for substitutions in long-term care. These regulations may be more stringent than federal regulations, so it is important to be familiar with the regulations in your state.

- State Department of Health and Human Services: Some states have a Department of Health and Human Services that oversees nursing homes and may provide additional guidance on substitutions in long-term care.

Organizational Policies:

- Facility's Policies and Procedures: Each long-term care facility should have its policies and procedures for handling requests for substitutions. These policies should be consistent with federal and state regulations and should be communicated to staff.

- Resident Consent: In most cases, residents have the right to consent to or refuse substitutions in their care. However, there are some exceptions, such as when the resident is unable to make informed decisions or when the substitution is necessary to protect the health and safety of the resident.

In addition to the above regulations and standards, it is also important to consider the resident's individual needs, preferences, and rights when making decisions about substitutions in long-term care.