Nursing homes and other healthcare facilities must provide necessary care and services to ensure that residents' abilities in activities of daily living (ADLs) do not diminish, unless the individual's clinical condition demonstrates that such diminution was unavoidable. This includes providing appropriate treatment and services to maintain or improve ADLs such as hygiene, mobility, elimination, dining, and communication. The facilities must also provide guidance in accordance with F677. This letter will require nursing homes and healthcare facilities to ensure they are providing appropriate care and services to maintain or improve ADLs, as well as provide guidance in accordance with F677.

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