Residents’ Rights

Residents Rights
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Residents’ rights for both long-term care and short-term care residents are protected by the federal Nursing Home Reform law. The law ensures that a nursing home resident does not lose his/her self-determination, dignity, or quality-of-life while living in a nursing home. Residents’ rights cover a broad range of care and aspects of daily living. These rights are in place to make sure residents are not taken advantage of in a nursing home.  They also are in place to make sure residents are safe and comfortable. Below is a summary of nursing home residents’ federal rights which can be found in detail in this link: §483.10   Resident rights.

1. Residents’ rights

The resident has a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility.  The facility must protect and promote the rights of the resident.

2. Exercise of rights

The resident has the right to exercise his or her rights without interference, coercion, discrimination or reprisal as a resident of the facility and as a citizen or resident of the United States.

3. Planning and implementing care

The resident has the right to be informed of, and participate in, his or her treatment.

Residents have a right to:

  • Be fully informed of health status in language he/she can understand.
  • Participate in the development of, implementation of, and revisions to his/her person-centered care plan, including the right to request meetings.
  • Request, participate in, refuse, and/or discontinue his/her treatment.
  • Participate in or refuse experimental research.
  • Formulate an advance directive.
  • Self-administer drugs, if determined clinically appropriate by the interdisciplinary team.
  • Visitations are subject to the resident’s right to deny/withdraw consent to a visitor at any time and must not impose on the rights of another resident.
  • Facilities must have a written visitation policy and reasons for any restrictions or limitations.

Residents have a right to be informed, in advance, of:

  • Changes to the plan of care.
  • Care and care giver/professional providing that care.
  • Risks and benefits of proposed care, including treatment and treatment alternatives.

4. Choice of attending physician

The resident has the right to choose his or her attending physician.  However, if the physician refuses or does not meet certain requirements, the facility may seek an alternate physician.  A resident’s new choice of physician who meets defined requirements supersedes the facility’s selection.

5. Respect and dignity

The resident has a right to be treated with respect and dignity.

Residents have a right to:

  • Be free from any physical or chemical restraints imposed for discipline or convenience, and not required to treat the resident’s medical symptoms.
  • Use personal possessions, unless this infringes upon the health and safety of other residents.
  • Reasonable accommodation of resident needs and preferences, unless this endangers the health and safety of the resident or other residents.
  • Share a room with a consenting spouse or with a consenting roommate of choice when practicable.
  • Receive written notice and reason for change before resident’s room or roommate is changed.
  • Refuse room transfer solely for the convenience of staff and other defined situations.

6. Self-determination

The resident has the right to, and the facility must promote and facilitate, resident self-determination through support of resident choice.

Residents have a right to:

  • Choose schedules (e.g. sleeping and waking times), activities, health care/plan issues, and other areas important to resident.
  • Interact with community members and participate in community activities.
  • Receive visitors of his/her choosing at the time of his/her choosing, including the resident’s representative and a spouse/domestic partner.
  • Choose or refuse to perform services for the facility.
  • Manage his/her financial affairs.

Nursing homes must:

  • Adhere to deposit and accounting/records requirements.
  • Not impose a charge against resident funds for items and services that are:
    • Paid for by Medicaid or Medicare (excludes applicable deductibles and copayments).
    • Required to achieve care plan goals.
    • Charged without the facility notifying the resident.
  • Not charge for special foods, including medically prescribed dietary supplements, ordered by the resident’s physician or other medical provider.

7. Information and communication

The resident has the right to be informed of his or her rights and of all rules and regulations governing resident conduct and responsibilities during his/her stay in the facility.

Residents have a right to:

  • Receive notices in a language/format understood by the resident.
  • Have reasonable access to the use of a telephone (including TTY ad TDD services) and the internet (to extent available in facility) and to send/receive mail and other deliveries.
  • Access/copy personal and medical records within specified periods. Facility may impose a reasonable, cost-based fee for copies.

 Nursing homes must:

  • Provide to each resident a written description of legal rights, including a statement that the resident may file a complaint with the Massachusetts Department of Public Health concerning any suspected violation of state or federal nursing facility regulations.
  • Post most recent facility survey in an accessible place, and have available for review, upon request, surveys, certifications, and complaint investigations for 3 preceding years, and any plan of correction in effect.
  • Inform and provide written information on a resident’s right to accept or refuse medical or surgical treatment and, at resident’s option, formulate an advance directive.
  • Immediately inform the resident and the resident’s representative and consult with the resident’s physician when there is an accident involving the resident that may require physician intervention and when there are other defined serious medical situations.
  • Provide information about how to apply for/use Medicare and Medicaid benefits.
  • Inform the resident of changes to charges for covered items and services by Medicare and Medicaid as soon as reasonably possible.
  • Inform the resident of changes to charges for non-Medicaid/non-Medicare covered items, in writing, at least 60 days in advance.

8. Privacy and confidentiality

The resident has a right to personal privacy and confidentiality of his or her personal and medical records.

9. Safe environment

The resident has a right to a safe, clean, comfortable and “home like” environment, including but not limited to receiving treatment and supports (e.g., physical therapy and other non-medical treatments) for daily living safely.  One explanation of “home-like” suggests “using soft lighting to avoid glare, providing areas that stimulate interest or allow safe, unobstructed walking, or eliminating loud noises thereby reducing unnecessary auditory environment stimulation.”  In addition, the facility must exercise reasonable care to protect the resident’s property from loss or theft.

10 Grievances

The resident has the right to voice grievances without discrimination or reprisal to the facility or other agency or entity that hears grievances.  Such grievances include care and treatment issues, behavior of staff and other residents, and other concerns regarding life in the nursing home.

Nursing homes must:

  • Establish a grievance policy.
  • Notify residents on how to file a grievance/complaint.
  • Ensure the prompt resolution of all grievances.

11. Contact with external entities

A facility must not prohibit or in any way discourage a resident from communicating with Federal, State, or local officials regarding any matter, whether or not subject to arbitration or any other type of judicial or regulatory action.

Remember, rights do not go away for a nursing home resident just because he/she is in a nursing home.   This is a detailed list, but there are many more rights throughout Federal and Massachusetts regulations, and you should feel free to always ask if you have a question.  You can ask the nursing home, and the Long-Term Care Ombudsman also can provide background on resident rights.  Ultimately, when and if the time comes, it is important to know your loved one’s rights.

→ Next: Long-Term Care Ombudsman