ICYMI: Focus F-Tag of the Week – §483.24 Activities of Daily Living

In the fall of 2022, CMS issued Admin Info: 22-09-ALL which outlined several regulatory focus areas for Federal Monitoring Surveys related to specific F-tags for FY2022 and FY2023. One area of regulatory focus is Quality of Life, specifically Activities of Daily Living at F676.


F676 states:
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:

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 Activities of daily living.

The facility must provide care and services in accordance with paragraph (a) for the following activities of daily living:

  • Hygiene –bathing, dressing, grooming, and oral care,
  • Mobility—transfer and ambulation, including walking,
  • Elimination-toileting,
  • Dining-eating, including meals and snacks,
  • Communication, including
    • Speech,
    • Language,
    • Other functional communication systems.

Actions for Facilities

  1. Review the facility’s policies and procedures to confirm there are processes in place to ensure all residents can communicate and have any communication devices they may need.
  2. Review the facility’s care plans to ensure any communication needs and/or devices are care planned as appropriate. Ensure the residents’ choices are included in the care planning process.
  3. Review the facility’s activities program to ensure activities are being provided in a manner that is responsive to individual hearing, vision, or communication concerns.
  4. Review the facility’s environment to ensure there are no concerns surrounding any individual hearing, vision, or communication needs (e.g., adequate lighting, reduction of glare, removal of clutter, reduction of background noise).
  5. Examine processes for if a resident refuses to utilize any needed communication devices, and how the facility ensures the resident’s safety under these circumstances.