F558 Reasonable Accommodation & Resident Preference

F558 is included in the resident rights section of Appendix PP and relates to the resident’s rights to have reasonable accommodation of their needs and preferences unless it would endanger the health or safety of the resident and other residents. The interpretive guidance defines reasonable accommodation as the nursing home’s efforts to individualize the resident’s physical environment. However, this regulation is often cited for more than the physical environment and can include routines and schedules.

When reviewing this regulation, you want to ensure that you are doing the most you can to meet the residents’ requests for personal items and equipment they may desire. Examples of noncompliance are included in Appendix PP including storing items where the resident may not be able to reach it when they are otherwise ambulatory, not having accessible areas for the residents in the building, and providing equipment necessary to maintain independence.

If the nursing home cannot meet the resident’s preference and requested accommodation documentation in the record should include what the resident requested, how it would interfere with the other resident’s rights, health or safety, and what you did to attempt to accommodate a similar request or modify the original request. An example of this could include when the resident reports not being able to hear their TV because the noise in the hallway. In this example perhaps the resident turns up the volume on the TV to be able to hear it but then other residents complain about the noise level and want it turned down. You should meet with the resident and determine if there are steps that can be taken to both allow the resident to hear the TV while other resident’s rights are being protected with the accommodation such as the use of headphones.