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CMS: F-Tag 241 Dignity Cheat Sheet (DRAFT) by [deleted]

F-Tag 241 Dignity

This is a draft cheat sheet. It is a work in progress and is not finished yet.

§483.15(a) F 241- Dignity

The facility must promote care for residents in a manner and in an enviro­nment that maintains or enhances each resident’s dignity and respect in full recogn­ition of his or her indivi­dua­lity.

§483.15(a) Interp­retive Guidelines

“Dignity” means that in their intera­ctions with residents, staff carries out activities that assist the resident to maintain and enhance his/her self-e­steem and self-w­orth. Some examples include (but are not limited to):
Grooming residents as they wish to be groomed (e.g., hair combed and styled, beards shaved­/tr­immed, nails clean and clipped);
Encour­aging and assisting residents to dress in their own clothes approp­riate to the time of day and individual prefer­ences rather than hospit­al-type gowns;
Assisting residents to attend activities of their own choosing;
Labeling each resident’s clothing in a way that respects his or her dignity (e.g., placing labeling on the inside of shoes and clothing);
o Promoting resident indepe­ndence and dignity in dining such as avoidance of:
 ­ ­ ­  Day-to-day use of plastic cutlery and paper/­plastic dishware;
 ­ ­ ­  Bibs (also known as clothing protec­tors) instead of napkins (except by resident choice);
 ­ ­ ­  Staff standing over residents while assisting them to eat;
 ­ ­ ­  Staff intera­cti­ng/­con­versing only with each other rather than with residents while assisting residents;

Respecting residents’ private space and property (e.g., not changing radio or television station without resident’s permis­sion, knocking on doors and requesting permission to enter, closing doors as requested by the resident, not moving or inspecting resident’s personal posses­sions without permis­sion);

Respecting residents by speaking respec­tfully, addressing the resident with a name of the resident’s choice, avoiding use of labels for residents such as “feeders,” not excluding residents from conver­sations or discussing residents in community settings in which others can overhear private inform­ation;
 

Focusing on residents as indivi­duals

Focusing on residents as indivi­duals when they talk to them and addressing residents as indivi­duals when providing care and services;
Mainta­ining an enviro­nment in which there are no signs posted in residents’ rooms or in staff work areas able to be seen by other residents and/or visitors that include confid­ential clinical or personal inform­ation (such as inform­ation about incont­inence, cognitive status). It is allowable to post signs with this type of inform­ation in more private locations such as the inside of a closet or in staff locations that are not viewable by the public. An exception can be made in an individual case if a resident or respon­sible family member insists on the posting of care inform­ation at the bedside (e.g., do not take blood pressure in right arm). This does not prohibit the display of resident names on their doors nor does it prohibit the display of resident memora­bilia and/or biogra­phical inform­ation in or outside their rooms with their consent or the consent of the respon­sible party if the resident is unable to give consent. (This restri­ction does not include the CDC isolation precaution transm­iss­ion­-based signage for reasons of public health protec­tion, as long as the sign does not reveal the type of infect­ion);
Grooming residents as they wish to be groomed (e.g., removal of facial hair for women, mainta­ining the resident’s personal prefer­ences regarding hair length­/style, facial hair for men, and clothing style). NOTE: For issues of failure to keep dependent residents’ faces, hands, finger­nails, hair, and clothing clean, refer to Activities of Daily Living (ADLs), Tag F312;
Mainta­ining resident privacy of body including keeping residents suffic­iently covered, such as with a robe, while being taken to areas outside their room, such as the bathing area (one method of ensuring resident privacy and dignity is to transport residents while they are dressed and assist them to dress and undress in the bathing room). NOTE: For issues of lack of visual privacy for a resident while that resident is receiving ADL care from staff in the bedroom, bathroom, or bathing room, refer to§483.10(e), Privacy and Confid­ent­iality, Tag F164. Use Dignity F241 for issues of visual privacy while residents are being transp­orted through common areas or are uncovered in their rooms and in view of others when not receiving care; and
Refraining from practices demeaning to residents such as keeping urinary catheter bags uncovered, refusing to comply with a resident’s request for toileting assistance during meal times, and restri­cting residents from use of common areas open to the general public such as lobbies and restrooms, unless they are on transm­iss­ion­-based isolation precau­tions or are restricted according to their care planned needs. An exception can be made for certain restrooms that are not equipped with call cords for safety.