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F–Tag 256 Environment Cheat Sheet (DRAFT) by [deleted]

CMS F–Tag 256 Environment

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

§483.15(h) (5) Adequate & Comfor­table Lighting

The facility must provide –
§483.1­5(h)(5) Adequate and comfor­table lighting levels in all areas;

§483.15(e) (1) Interp­retive Guidel­ines:

“Ade­quate lighting” means levels of illumi­nation suitable to tasks the resident chooses to perform or the facility staff must perform.
“Com­for­table lighting” means lighting that minimizes glare and provides maximum resident control, where feasible, over the intensity, location, and direction of illumi­nation so that visually impaired residents can maintain or enhance indepe­ndent functi­oning.
As a person ages, their eyes usually change so that they require more light to see what they are doing and where they are going. An adequate lighting design has these features:
Suff­icient lighting with minimum glare in areas frequented by reside­nts;
Even light levels in common areas and hallwa­ys, avoiding patches of low light caused by too much space between light fixtures, within limits of building design constr­aints;
Use of daylight as much as possib­le;
Elim­ination of high levels of glare produced by shiny flooring and from unshielded window openings (no-shine floor waxes and light filtering curtains help to alleviate these sources of glare);
Extra lighting, such as table and floor lamps to provide sufficient light to assist residents with tasks such as reading;
Lighting for residents who need to find their way from bed to bathroom at night (e.g., red colored night lights preserve night vision); and
Dimming switches in resident rooms (where possible and when desired by the resident) so that staff can tend to a resident at night with limited distur­bances to them or a roommate. If dimming is not feasible, another option may be for staff to use flashl­igh­ts/pen lights when they provide night care.


Some facilities may not be able to make some of these changes due to voltage or wiring issues. For more inform­ation about adequate lighting design for long term care facili­ties, a facility may consult the lighting guidance available from the Illumi­nating Engine­ering Society of North America, which provides author­itative minimum lighting guidance.

The following are additional visual enhanc­ements a facility should consider making as fiscal constr­aints permit in order to make it easier for residents with impaired vision to see and use their enviro­nment:
Use of contra­sting color between flooring and basebo­ard to enable residents with impaired vision to determine the horizontal plane of the floor;
Use of contrast painting of bathroom walls and/or contra­sting colored toilet seats so that residents with impaired vision can distin­guish the toilet fixture from the wall; and
Use of dishware that contrasts with the table or tablecloth color to aid residents with impaired vision to see their food.