03/26/2026

Survey Tip of the Week: Accommodation of Preferences

Recent survey activity has included citations under the Reasonable Accommodation of Needs F-tag 558, with a common theme of residents’ needs and preferences not being consistently accommodated. A frequent concern involves residents being unable to access their call lights, as well as residents not being assisted out of bed in accordance with their preferences. The Long-Term Care Survey Process directs surveyors to observe situations where residents seated in chairs or wheelchairs in their rooms do not have their call light within reach, limiting their ability to request assistance and maintain independence.

Under §483.10(e)(3), residents have the right to reside and receive services in a facility that reasonably accommodates their needs and preferences, unless doing so would endanger their health or safety or that of others. This requirement intends to ensure the environment and care practices support each resident’s individualized needs, dignity, and functional independence.

During resident interviews, surveyors will ask questions to determine whether the environment and care provided accommodate resident needs and preferences, including:

• Is your room set up so you can easily get around the room, get to and from the bathroom, use the sink?
• Do you have any concerns with your roommate’s personal items taking over your space?
• Have there been any recent issues with the call light working? What did the facility do when the call light wasn’t working? Can you reach it?
• Are the call lights located in the resident’s room (in bed or other sleeping accommodations), toilet and bathing facilities?
• If you have been on the floor near your bed, toilet, or bath, were you able to reach the emergency call light?
• Do you have enough light in your room to do what you want or need to do?

The State Operations Manual Appendix PP further emphasizes that common areas should accommodate residents’ physical limitations. Furnishings in common areas may enhance residents’ abilities to maintain their independence. Resident seating should have appropriate seat height, depth, and firmness, and have arms that assist residents to independently rise to a standing position.