Summary of Federal Residents' Rights
- Exercise of Rights
The resident has a right to exercise his or her rights as a resident of the facility and as a citizen or resident of the United States of America. The resident has a right to be free of interference, coercion, discrimination or reprisal from the facility in exercise of his or her rights.
- Notice of Rights and Services
The facility must inform the resident, both orally and in writing, in a language the resident understands, of his or her rights and all rules and regulations governing resident responsibilities. This should be done on admission and during the resident's stay. The resident has the right to inspect all of his own records.
The resident has the right to be fully informed in language he or she can understand of his or her total health condition.
The resident has the right to refuse treatment.
The resident should be informed of what he or she is entitled to in Medicaid benefits and the items and services that are included in those benefits, and for which the resident may not be charged.
The resident should be informed of other items and services for which he or she may not be charged, and the amount of the charge. The facility must inform each resident of services available and charges for those services.
The facility must furnish a description of rights, including: The manner of protecting personal funds and a statement that the resident may file a complaint with the state survey agency concerning abuse, neglect or misappropriation of resident property.
The facility must inform each resident of the name and way of contacting their physician.
The facility must display information about how to apply and use Medicare and Medicaid benefits.
The facility must notify the resident's physician, legal representative or interested family member within 24 hours when there is an accident, a significant change in condition, or a decision or transfer or discharge.
The facility must notify the resident, the legal representative or family member when there is a change in room or roommate assignment or a change in residents' rights.
- Protection of Residents' Funds
The resident has the right to manage his or her financial affairs or to ask the facility to manage the funds.
The facility must provide an accounting of funds and the individual financial record must be available, upon request, to the resident or his or her legal representative. The facility may not impose a charge against the personal funds of a resident for any item or service for which payment is made under Medicaid or Medicare.
- Free Choice
The resident has the right to choose his or her physician.
The resident has a right to be fully informed, in advance, about care and treatment and any changes in that care and treatment which may affect his well-being.
- Privacy and Confidentiality
The resident has a right to personal privacy and confidentiality of his or her personal and clinical records. Personal privacy means accommodations, medical treatment, written and telephone communications, personal care visits meetings of family and resident groups.
A resident has the right to voice grievances with respect to treatment or care without discrimination or reprisal for voicing the grievance.
The resident has the right to prompt efforts by the facility to resolve grievances including those of other residents.
- Examination of Survey Results
The resident has the right to examine the results of the most recent survey of the facility conducted by federal or state surveyors. The results must be posted by the facility in a place readily accessible to residents.
The resident has the right to receive information from agencies acting as client advocates and be afforded the opportunity to contact these agencies.
The resident has the right to privacy in written communications including sending and receiving mail, promptly, that is unopened and having access to stationery, postage and writing implements at the resident's own expense.
- Access to Facility
The resident has the right to receive visitors at any reasonable hour. The facility must provide access to any resident by federal and state officials, the resident's physician, state and local long-term care ombudsmen, the agency responsible for protection and advocacy system, and any entity or individual that provides health, social, legal or other services to the resident, subject to the resident's right to deny or withdraw consent.
The facility must allow representatives of the State Ombudsman to examine a resident's clinical records with the permission of the resident or the resident's legal representative and consistent and consistent with state law.
The resident has the right to have regular access to the private use of a telephone.
- Personal Property
The resident has the right to retain and use personal possessions including furnishings, clothing, and so forth, as space permits.
- Married Couples
The resident has the right to share a room with his or her spouse when married residents live in the same facility and both spouses consent.
- Self-Administration of Drugs
The resident has the right to self-administer drugs unless the inter-disciplinary tem has determined, for each, resident, that this is unsafe.
- Transfer and Discharge
The facility must not transfer or discharge a resident unless it is for the resident's welfare and the resident's needs cannot be met in the facility, because the resident's health is improved sufficiently so the services are no longer needed, the safety of individuals in the facility is endangered, the health of individuals in the facility would be endangered, or the resident has failed after reasonable and appropriate notice to pay for a stay at the facility.
Before a facility transfers or discharges a resident, the facility must notify the resident, a family member or legal representative about the reasons. 30 days notice must be given, unless it is an emergency.
The written notice must include:
- the reason for the transfer
- the effective date of transfer
- the location to which the resident is transferred, and
- a statement that the resident has the right to appeal the action to the state agency.
The transfer notice must also include the name, address the phone number of the State Long-Term Care Ombudsman, and for residents with developmental disabilities or mental illness, the name, mailing address and telephone number of the agency responsible for protection and advocacy.
The facility must provide sufficient preparation and orientation to the residents to ensure safe transfer or discharge from the facility.
- Notice of Bed Hold Policy and Re-Admission
Before a facility transfers a resident to a hospital, the facility must provide written information that specifies the terms of the bed hold policy. Written notice must be provided to the resident and family member who specifies the facility policy. If a resident's hospitalization exceeds the bed hold leave, the person may be readmitted to the facility upon the first availability of a bed in semi-private room if the resident requires the services provided by the facility and is eligible for Medicaid nursing facility services.
- Equal Access to Quality Care
A facility may not discriminate against an individual because of their financial status.
- Admissions Policy
The facility may not require a third party guarantee of payment as a condition of admission.
The facility may not solicit or accept any amount other than that required to be paid under the state plan.
A facility may not require residents or potential residents to waive their rights to Medicare or Medicaid.
The resident has the right to be free from any physical restraints or chemical restraints administered for the purpose of discipline or convenience.
The resident has the right to be free from verbal, sexual, physical or mental abuse.
- Staff Treatment of Residents
The facility must not use verbal, mental or physical abuse nor employ individuals who have been convicted of abusing, neglecting or mistreating residents.
The facility must promote care for residents in a manner that maintains or enhances each individual's dignity and respects his or her individuality.
The resident has the right to choose activities, interact with members of the community and make choices about his or her life in the facility that are significant to the resident.
- Participation in Resident and Family Groups
A resident has the right to participate in resident groups in the facility.
A resident's family has the right to meet in the facility with families of other residents.
Staff or visitors may attend meetings at the group's invitation.
The facility must provide a designated staff person responsible for providing assistance and responding to written requests that result from group meetings.
When the resident or family group exists, the facility must listen to views and act upon grievances and recommendations of residents and families concerning proposed policy and operational decisions affecting resident care and life in the facility.
- Participation in Other Activities
A resident has the right to participate in social, religious and community activities.
- Accommodation of Needs
The resident has the right to receive services with reasonable accommodation of individual needs and preferences.
The resident has the right to receive notice before the resident's room or roommate in the facility is changed.
The facility must provide for an on-going program of activities designed to meet the interest and the physical, mental and psycho-social well-being of each resident.
- Social Services
The facility must provide social services to attain or maintain the highest practicable physical, mental or psycho-social well-being of each resident.
The facility must provide a safe, clean, comfortable and home-like environment with housekeeping and maintenance services necessary to maintain sanitation and order.
The facility must provide clean bed and bath linens in good condition, private closet space, adequate lighting, safe and comfortable temperature levels, and comfortable sound levels.