This regulation (F-Tag F676) governs nursing facilities' obligations to maintain or improve residents' abilities in activities of daily living (ADLs), including hygiene, mobility, elimination, dining, and communication. Facilities must provide appropriate treatment and services based on each resident's comprehensive assessment and individual choices to prevent avoidable decline in ADL function. This is a Centers for Medicare & Medicaid Services (CMS) nursing facility standard and does not govern behavioral health, IDD, ABA, or foster care licensed settings.
View official sourceF676 (Rev. 173, Issued: 11-22-17, Effective: 11-28-17, Implementation: 11-28-17) §483.24(a) Based on the comprehensive assessment of a resident and consistent with the resident’s needs and choices, the facility must provide the necessary care and services to ensure that a resident's abilities in activities of daily living do not diminish unless circumstances of the individual's clinical condition demonstrate that such diminution was unavoidable. This includes the facility ensuring that: §483.24(a)(1) A resident is given the appropriate treatment and services to maintain or improve his or her ability to carry out the activities of daily living, including those specified in paragraph (b) of this section … §483.24(b) Activities of daily living. The facility must provide care and services in accordance with paragraph (a) for the following activities of daily living: §483.24(b)(1) Hygiene –bathing, dressing, grooming, and oral care, §483.24(b)(2) Mobility—transfer and ambulation, including walking, §483.24(b)(3) Elimination-toileting, §483.24(b)(4) Dining-eating, including meals and snacks, §483.24(b)(5) Communication, including (i) Speech, (ii) Language, (iii) Other functional communication systems. See Guidance at F677