Technology holds promise for CMS compliance

At a glance…

Technology now holds promise for compliance with some of the new CMS interpretive guidance (effective June 12, 2009), for several of the quality of life requirements and ultimately contributes additional means for good care.

Technology certainly enhances quality of life. We’ve all personally experienced it. Oddly enough, technology now holds promise for compliance with some of the new CMS interpretive guidance for several of the quality of life requirements and ultimately contributes additional means for good care. The new guidance went into effect June 12, 2009, and includes many person-centered care practices.

Self-determination and participation or “choices”

F-tag 242-The resident has a right to:

  1. Choose activities, schedules, and healthcare consistent with his or her interests, assessments, and plans of care

  2. Interact with members of the community both inside and outside of the community

  3. Make choices about aspects of his or her life in the facility that are significant to the resident.

New Interpretive Guidance. Now a facility is expected to be actively seeking information from the resident regarding significant interests and preferences in order to provide necessary assistance to help residents fulfill their choices over their lives. (Wow, actively seeking is definitely new.)

Technology now holds so much potential for gathering and sharing data, including resident preferences. For instance, a technology company called It’s Never 2 Late (IN2L) out of Colorado uploads personal information collected during the admissions process to its system and it’s ready for staff even before the resident moves in. Not only that but IN2L has actually figured out how to get all the “all staff” information and “approaches” from the care plan in front of those who are supposed to know it in a program called My Way. And they take knowing the person so seriously that social history information about the person is available in a program called My Story. Simply using a program such as PowerPoint can also be used in creating such valuable information and making it available to staff to assist with providing good care.

Additionally, systems like IN2L’s offer meaningful choices to residents with a computer personal profile, which has everything and anything a person might want such as games, Internet links, music, and more. And certainly connection with the Internet makes interaction with members of the community more possible than ever before-the other requirement of this tag.

Accommodation of needs

F-tag 246-The resident has the right to reside and receive services in the facility with reasonable accommodation of individual needs and preferences.

The new Interpretive Guidance clarifies that staff should strive to reasonably accommodate the resident’s needs and preferences as the resident makes use of the physical environment.

Technology certainly accommodates us. IN2L for instance, offers adaptive keyboards, touch screens, and adaptive “mice.” Keys U See is a company that IN2L uses for a keyboard on which the keys have large print letters and words. Another adaptive keyboard has an A-Z layout for the person who never learned the standard keyboard. Touch screens sure make things easy. IN2L has found an actual flat screen computer that is the touch screen and the actual computer all in one.

Another new feature to the new guidance at F-tag 246 Accommodation of Needs is language pointing out the need for more outlets for all the computer, phone, iPod, Blackberry, and who-knows-what-else equipment people now bring with them wherever they live. This is being seen as a quality of life issue for residents because they should have the outlets they need. So this is a “heads-up” for facilities to begin looking at this issue with a certified electrician to meet such a common need safely.


F-tag 241-The facility must care for residents in a manner or in an environment that maintains or enhances each resident’s dignity and respect in full recognition of his or her individuality.

The new Interpretive Guidance gives many examples of refraining from practices demeaning to residents and states that: “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.”

Technology. A customized computer experience enhances self-worth and self-esteem as a resident learns new things, explores the world, and communicates with family. Additionally, dignity is protected thanks to the adaptive computer features making using the computer possible for anyone. Knowing a person’s “story” and “way” certainly contribute to a person’s dignity. With technology, videos can be created to train staff in exactly how a resident prefers care to be given.


F-tag 248-The facility must provide for an ongoing program of activities designed to meet, in accordance with the comprehensive assessment, the interests and the physical, mental, and psychosocial well-being of each resident.

The Interpretive Guidance guidelines are lengthy, but highlight individualized lifelong interests, connection to the community, development of new interests, identification with past roles, and activities that enhance a sense of well-being and promote physical, cognitive, and emotional health.

Technology. This regulation and its “new” (since 2006) interpretive guidance align perfectly with technology such as the person-centered profiles which certainly enhance a resident’s well-being. For instance, cognitive games and flight and driving simulators promote physical and mental well-being. Group socialization and healthy competition in the form of Jeopardy or Wheel of Fortune can promote emotional well-being. A former farmer can tap into his past role by watching a live chicken coop thanks to a webcam. Residents are developing many new interests such as games and computer/Internet skills.

Quality of life

F-tag 240-The facility must care for residents in a manner and in an environment that promotes maintenance or enhancement of each resident’s quality of life.

The Interpretive Guidance calls for creating and sustaining an environment that humanizes and individualizes each resident.

Technology now holds so much potential for gathering and sharing data, including resident preferences.

Technology. With technology in your community you can create an enhanced environment of interactivity among residents, connection with family and friends, and growth via lifelong learning.

More important than even regulatory compliance are these things in and of themselves: a person’s choices honored, a person’s needs accommodated, a person’s activity interests pursued, a person’s dignity upheld and … a person’s precious and priceless quality of life!

Carmen Bowman, MHS, ACC, is the Owner of Edu-Catering: Education for Compliance and Culture Change in LTC, a consulting and training company in Firestone, Colorado. She can be reached at (303) 833-1492.

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Long-Term Living 2009 November;58(11):38-39

Topics: Articles , Technology & IT