11/23/2022

Survey Tip of the Week: Cultural Competency

The Long-Term Care Survey Process was updated with the Requirements of Participation Phase 3 guidance that became effective on October 24 and the surveyor resources were subsequently posted to the CMS Nursing Home webpage. The State Operations Manual Appendix PP states that cultural competency is a developmental process in which individuals or institutions achieve increasing levels of awareness, knowledge, and skills along a cultural competence continuum. Cultural competence involves valuing diversity, conducting self-assessments, avoiding stereotypes, managing the dynamics of difference, acquiring and institutionalizing cultural knowledge, and adapting to diversity and cultural contexts in communities. The MDS and the facility assessment are two tools facilities should use to identify a resident’s cultural identity and any culturally-specific preferences. Once the facility identifies the culturally-specific preferences,  a care plan must be developed. Staff must be informed of the individual’s identity, preferences and its impact on the delivery of care. CMS notes this may impact:

• Food preparation and choices;
• Clothing preferences such as covering hair or exposed skin;
• Physical contact or provision of care by a person of the opposite sex; or
• Cultural etiquette, such as avoiding eye contact or not raising the voice.

Additionally, facilities should consider:

• Offering activities that are culturally relevant to resident populations within the facility;
• Group activities with both sexes may not be permitted or appropriate in some cultures, or the type of programming may be in conflict with his/her cultural preferences;
• Providing reading materials, movies, newspapers in the resident’s preferred language may help orient a resident to date, times and events;
• Allowing the performance of religious rites at end of life to the extent possible; and
• Certain medications, procedures or treatments may be prohibited.

The State Operations Manual Appendix PP provides additional detail and resources that facilities can use to ensure compliance with cultural competency. LeadingAge Ohio encourages members to utilize the survey pathways to evaluate their processes and the survey pathways can be found on the CMS Nursing Home webpage and under the downloads section on this CMS webpage.

LeadingAge continues to develop webinars and resources on the updated guidance, which will be located on the LeadingAge learning hub. A QuickCast on the regulatory groups continues to be added.  Updated checklists have also been added on the Nursing Home RoP Tools and Resources webpage. 

For more information about the updated requirements of participation and citations occurring in Ohio, please join us on the monthly STAT: Survey Tips and Tactics call. Register now for the December 14 call at 10:00AM. LeadingAge Ohio is sharing tips to assist members during the survey process. Send questions you’d like addressed in future Tips of the Week to Stephanie DeWees at sdewees@leadingageohio.org.