Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
F578 in Massachusetts. Pick another state for the same tag.
Against expectation — 2025
Massachusetts cites F578 less often than its own record predicts
Versus expected share0.86×
0.86 times the national share — cited less often here than elsewhere.
Share of Massachusetts citations0.81%
Of every deficiency written in Massachusetts in 2025, this is the portion that was F578.
Massachusetts0.81%
National0.95%
Share of all citations that were F578.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Massachusetts surveyors wrote
F578 findings written in Massachusetts, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
G · Actual harm, isolatedAugust 2, 2023
Based on record review and interview, the facility failed to implement advance directives and follow policies pertaining to advance directives for two Residents (#48 and #91) out of a total sample of 24 residents.
Specifically, the facility staff failed to:
1. For Resident #48, follow the advance directive for a Do Not Resuscitate (DNR - a medical order issued by a physician or other authorized non-physician practitioner that directs healthcare providers not to administer CPR [cardiopulmonary resuscitation] in the event of cardiac or respiratory arrest), and provided CPR, with resulting hospitalization , rib fractures, and uncontrolled pain.
2. …
D · No harm, potential for more than minimal, isolatedMay 8, 2026
Based on interviews, and record review, the facility failed to afford the opportunity to formulate an advance directive relative to orders for life sustaining treatment, for one Resident (#5) out of a total sample of 18 residents, increasing the Resident's risk for undesired care in the event of a medical emergency.Specifically, the facility failed to review life sustaining treatment options with Resident #5's healthcare proxy (HCP) when:-the Resident was incapacitated at the time of admission.-the Resident's HCP was invoked.-the Resident's Medical Orders for Life Sustaining Treatment (MOLST), indicating Do Not Resuscitate (DNR) and Do Not Intubate (DNI), was not signed by the Resident's invoked HCP. …
B · No harm, potential for minimal, patternAugust 27, 2025
Based on record review and interview, the facility failed to accurately execute Advance Directives for one Resident (#39), out of a total sample of 12 residents. Specifically, the facility failed to ensure that the Massachusetts Medical Order for Life-Sustaining Treatment (MOLST) form was valid and reflected the signature of Resident #39's invoked (made active by a Physician) Health Care Proxy (HCP- the person chosen as the healthcare decision maker when the individual is unable to do so for themself).Findings include:Review of the facility's policy for MOLST, dated [DATE], indicated:-A do not resuscitate form/advance directive/five wishes document must be completed and signed by the resident or legal surrogate as permitted by state law. …
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