Laws requiring care and services for mental or psychosocial adjustment difficulties

Key:

USC – United States Code

CFR – Code of Federal Regulations

H&S – Code California Health and Safety Code

Laws requiring care and services for mental or psychosocial adjustment difficulties:

  • 42 CFR §483.25(f)
  • 42 USC §§ 1395i-3(b)(2) & (4) and 1396r(b)(4)
  • Note: The excerpt of the following regulation contains pertinent provisions concerning services for residents with mental or psychosocial adjustment difficulties but excludes other parts of the regulation.

    Code of Federal Regulations, Title 42, Section 483.25(f)

    Quality of care.

    Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance

    with the comprehensive assessment and plan of care.

    (f) Mental and Psychosocial functioning. Based on the comprehensive assessment of a resident, the facility must ensure that–

    (1) A resident who displays mental or psychosocial adjustment difficulty, receives appropriate treatment and services to correct the assessed problem, and

    (2) A resident whose assessment did not reveal a mental or psychosocial adjustment difficulty does not display a pattern of decreased social interaction and/or increased withdrawn, angry, or

    depressive behaviors, unless the resident’s clinical condition demonstrates that such a pattern was unavoidable.

    United States Code, Title 42, Section 1395i-3(b)(4)

    (4) Provision of services and activities

    (A) In general

    To the extent needed to fulfill all plans of care described in paragraph (2), a skilled nursing facility must provide, directly or under arrangements (or, with respect to dental services, under agreements) with others for the provision of–

    (i) nursing services and specialized rehabilitative services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident;

    (ii) medically-related social services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident;

    (iii) pharmaceutical services (including procedures that assure the accurate acquiring, receiving, dispensing, and administering of all drugs and biologicals) to meet the needs of each resident;

    (iv) dietary services that assure that the meals meet the daily nutritional and special dietary needs of each resident;

    (v) an on-going program, directed by a qualified professional, of activities designed to meet the interests and the physical, mental, and psychosocial well-being of each resident;

    (vi) routine and emergency dental services to meet the needs of each resident; and

    (vii) treatment and services required by mentally ill and mentally retarded residents not otherwise provided or arranged for (or required to be provided or arranged for) by the State.

    The services provided or arranged by the facility must meet professional standards of quality. Nothing in clause (vi) shall be construed as requiring a facility to provide or arrange for dental services described in that clause without additional charge.

    (B) Qualified persons providing services

    Services described in clauses (i), (ii), (iii), (iv), and (vi) of subparagraph (A) must be provided by qualified persons in accordance with each resident’s written plan of care.

    United States Code, Title 42, Section 1396r(b)(4)

    (4) Provision of services and activities

    (A) In general

    To the extent needed to fulfill all plans of care described in paragraph (2), a nursing facility must provide, directly or under arrangements (or, with respect to dental services, under agreements) with others for the provision of–

    (i) nursing services and specialized rehabilitative services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident;

    (ii) medically-related social services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident;

    (iii) pharmaceutical services (including procedures that assure the accurate acquiring, receiving, dispensing, and administering of all drugs and biologicals) to meet the needs of each resident;

    (iv) dietary services that assure that the meals meet the daily nutritional and special dietary needs of each resident;

    (v) an on-going program, directed by a qualified professional, of activities designed to meet the interests and the physical, mental, and psychosocial well-being of each resident;

    (vi) routine and emergency dental services to meet the needs of each resident; and

    (vii) treatment and services required by mentally ill and mentally retarded residents not otherwise provided or arranged for (or required to be provided or arranged for) by the State.

    The services provided or arranged by the facility must meet professional standards of quality. Nothing in clause (vi) shall be construed as requiring a facility to provide or arrange for dental services described in that clause without additional charge.

    (B) Qualified persons providing services

    Services described in clauses (i), (ii), (iii), (iv), and (vi) of subparagraph (A) must be provided by qualified persons in accordance with each resident’s written plan of care.

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