CMS sets LTC ‘resident rep’ standards

CMS also replaces references to the term “legal representative” with the term “resident representative.”

Some LTC advisors help clients and clients’ families deal with LTC providers, or work with case managers and counseling services that help with LTC management.

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Officials suggested that an LTC facility resident could designate an individual to manage the resident’s finances, make decisions about the resident’s care, and participate in discussions about the resident’s care.

“For purposes of this regulation, we would define the term ‘resident representative’ broadly to include both an individual of the resident’s choice who has access to information and participates in health care discussions as well as personal representative with legal standing, such as a power of attorney for health care, legal guardian, or health care surrogate or proxy appointed in accordance with state law to act in whole or in part on the resident’s behalf,” officials write in the preamble. “One individual may or may not fulfill both of these roles.”

Officials note that the scope of resident representatives’ authority may depend on whether the reps are appointed by a court, are named in documents a resident has created before entering the facility, or are acting in an informal capacity.

In most cases, officials say, a resident representative should have the right to get immediate access to the resident. 

Even residents who have been found to be incompetent under the law should still have the right to help shape their care, officials add.

“We believe that it is important for a resident who has been adjudicated incompetent to be treated with respect and dignity and to continue to make those decisions that are appropriate for him or her to make,” officials say. “Continuing to honor these residents’ preferences and involving them in care planning will improve both quality of life and quality of care, resulting in better outcomes.”