CMS Manual System - Louisiana Department of Health and Hospitals

that the menu no longer reflects the food preferences of residents, see F165, F242, and
F243 to determine compliance with these requirements.
(iii) Requests for items and services.
(A) The facility must not charge a resident (or his or her representative) for
any item or service not requested by the resident.
(B) The facility must not require a resident (or his or her representative) to
request any item or service as a condition of admission or continued stay.
(C) The facility must inform the resident (or his or her representative)
requesting an item or service for which a charge will be made that there will
be a charge for the item or service and what the charge will be.
Interpretive Guidelines §483.10(c)(8)(iii) Requests for Items and Services
A facility may not charge a resident or the resident‘s representative for items and services
that are not requested by the resident or representative, whether or not the item or
services is requested by a physician. The item or service ordered by the physician should
fit in with the resident‘s care plan.
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§483.10(d) Free Choice
The resident has the right to--
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F163
§483.10(d)(1) -- Choose a personal attending physician
Interpretive Guidelines §483.10(d)(1)
The right to choose a personal physician does not mean that the physician must or will
serve the resident, or that a resident must designate a personal physician. If a physician
of the resident‘s choosing fails to fulfill a given requirement, such as §483.25(l)(1),
Unnecessary drugs; §483.25(l)(2), Antipsychotic drugs; or §483.40, frequency of
physician visits, the facility will have the right, after informing the resident, to seek
alternate physician participation to assure provision of appropriate and adequate care and
treatment. A facility may not place barriers in the way of residents choosing their own
physicians. For example, if a resident does not have a physician, or if the resident‘s
physician becomes unable or unwilling to continue providing care to the resident, the
facility must assist the resident in exercising his or her choice in finding another
physician.
Before consulting an alternate physician, one mechanism to alleviate a possible problem
could involve the facility‘s utilization of a peer review process for cases which cannot be