F561 - Resident Self-Determination 

F561 is not a deficiency that reaches the “top 5” category, however, it has been noted at least one time for the last few months. This regulation states that the residents have the right to choose how they spend their time, what health related care they receive and who provides that care. The residents also have choices in activities, interaction with members of the community, participating in community activities, schedules such as sleeping and waking times, and aspects of their life that are significant to them. The only caveat in the regulation is that the choices a resident makes must not interfere with the rights of other residents.  

Real examples of when this has been cited include but are not limited to:

• When the resident was not allowed to go to breakfast before receiving their shower in the morning.
• Making the resident take a shower instead of a whirlpool which they prefer.
• Requiring the resident to take a shower at night when their preference is to shower in the morning.
• Making the resident go to bed at times that are not consistent with their preferences.

It is important that resident’s preferences are included in the resident-centered care plan. When completing the MDS, Section F is an assessment that determines several of these factors and how important they are to the resident. This would be a great tool to use when developing the care plan to ensure that items the resident feels are important to them are carried out, despite living in a nursing home.