42 C.F.R. § 483.10(e)(2) provides that the resident has a right to be treated with respect and dignity, including:

(2) The right to retain and use personal possessions, including furnishings, and clothing, as space permits, unless to do so would infringe upon the rights or health and safety of other residents.

Appendix PP:

All residents’ possessions, regardless of their apparent value to others, must be treated with respect.

Guidance

The right to retain and use personal possessions promotes a homelike environment and supports each resident in maintaining their independence.

If residents’ rooms have few personal possessions, ask residents, their families, or representative(s), as well as the local ombudsman if:

• • Residents are encouraged to have and to use them; and
  • Residents may choose to retain personal possessions.

Procedures

If facility staff refused to allow a resident to retain his or her personal possession(s), determine if such a restriction was appropriate due to insufficient space, protection of health and safety, and maintaining other resident rights, and whether the reason for the restriction was communicated to the resident.

Examples of noncompliance may include, but are not limited to:

• • Residents, their representatives, or family members have been discouraged from bringing personal items to the facility.
  • A decision to refuse to allow a resident to retain any personal belongings was not based on space limitations or on a determination that the rights, health or safety of other residents would be infringed.
  • Facility staff searching a resident’s body or personal possessions without the resident’s or, if applicable, the resident’s representative’s consent.

It is important for facility staff to have knowledge of signs, symptoms, and triggers of possible illegal substance use; such as changes in resident behavior, increased unexplained drowsiness, lack of coordination, slurred speech, mood changes, and/or loss of consciousness, etc. This may include asking residents, who appear to have used an illegal substance (e.g., cocaine, hallucinogens, heroin), whether or not they possess or have used an illegal substance.

If the facility determines through observation that a resident may have access to illegal substances that they have brought into the facility or secured from an outside source, the facility should not act as an arm of law enforcement. Rather, in accordance with state laws, these cases may warrant a referral to local law enforcement. To protect the health and safety of residents, facilities may need to provide additional monitoring and supervision. If facility staff identify items or substances that pose risks to residents’ health and safety and are in plain view, they may confiscate them. But, facility staff should not conduct searches of a resident or their personal belongings, unless the resident, or resident representative agrees to a voluntary search and understands the reason for the search. For concerns related to the identification of risk and the provision of supervision to prevent accidental overdose, investigate potential non-compliance at F689, §483.25(d) – Accidents.

For concerns related to the behavioral health services that are provided, investigate potential non-compliance at F740, §483.40 – Behavioral Health Services.