CMS Guidance on Nursing Home Resident Dignity and Quality of Life

In April 2009, the Centers for Medicare and Medicaid Services (CMS) announced the promulgation of new guidelines for assessing resident dignity and quality of life, effective June 17, 2009. These guidelines are not the result of any change in the law but, rather, are meant to clarify and illustrate how to assess whether a facility is meeting the minimum standards that have been in place since the passage of the Nursing Home Reform Law in 1987.

The guidance addresses important areas relating to providing a home-like environment; meeting the needs and desires of residents in terms of waking up and going to sleep, dining, dressing, bathing, etc... and more. The purpose of the guidelines is to clarify and ensure understanding of every nursing homes' responsibility to each of its residents and to improve accountability for meeting these standards.

In May 2009 CMS released an updated version of the assessment tool for all nursing home residents – Minimum Data Set (MDS) 3.0.  As of October 2010, all nursing home residents will be assessed using this new tool.   A number of new components of this tool will help encourage facilities to respect resident dignity and improve quality of life.  (This tool will also be used as CMS rolls out a new version of the Medicare reimbursement system for nursing homes - RUGs IV.  See information on nursing home reimbursement.)  The MDS 3.0 increases the resident’s voice by requiring more resident interviews. Residents are now going to be asked directly how they feel and about their preferences in sections involving cognitive patterns, mood, preferences for customary routine and activities, pain and return to the community and overall goals.  We look forward to seeing how this is implemented and how this affects care planning.

Following are useful materials and resources for more information.