This regulation requires nursing facilities to ensure residents needing colostomy, urostomy, or ileostomy care receive services consistent with professional standards, their person-centered care plan, and their own goals and preferences. Staff must monitor for skin breakdown around the ostomy site, respond to resident discomfort, and provide self-care instructions where appropriate. This is a skilled nursing facility (long-term care) quality-of-care standard and does not govern any behavioral health, IDD, ABA, or foster care level of care.
View official sourceF691 (Rev. 173, Issued: 11-22-17, Effective: 11-28-17, Implementation: 11-28-17) §483.25(f) Colostomy, urostomy, or ileostomy care. The facility must ensure that residents who require colostomy, urostomy, or ileostomy services, receive such care consistent with professional standards of practice, the comprehensive person-centered care plan, and the resident’s goals and preferences. INTENT §483.25(f) The intent of this provision is that the resident receives the necessary care and treatment including medical and nursing care and services when they need colostomy, urostomy, or ileostomy care. PROCEDURES AND PROBES §483.25(f) Refer to appropriate sections of the MDS, as applicable. Identify if the resident triggers any Care Area Assessments for urinary incontinence, nutritional status, and/or pressure injuries (skin care). • If appropriate, is the resident provided with self-care instructions? • Does the staff member observe and respond to any signs of the resident’s discomfort about the ostomy or its care? • Is skin surrounding the ostomy free of excoriation (abrasion, breakdown)? • If excoriation is present, does the clinical record indicate an onset and a plan to treat the excoriation?