State and Federal Laws
Protect Residents From Abuse
What rights do nursing home residents have?
Federal and state regulations offer extensive protections for nursing home residents. The laws address such critical areas as privacy rights, financial matters, personal treatment and medical care.
The federal Nursing Home Reform Law protects the rights of all residents in nursing homes that receive Medicare and Medicaid funds, which includes almost all such facilities. Regulations in every state closely mirror the federal requirements.
You can obtain a copy of these laws by contacting your local long-term care ombudsman program or state survey agency, sometimes called a state licensing agency. Regulations require every facility to post contact information for the local ombudsman program and state survey agency.
The policies on residents’ rights allow for exceptions if authorized medical personnel determine patients’ actions threaten their own or others’ health and safety or if complying with the regulations in particular circumstances would violate other laws. The regulations vary from state to state but generally require the facility to provide:
· Full notification of patients’ rights, rules of the facility and rules and regulations pertaining to patient conduct and responsibilities. The facility must obtain written acknowledgement from the patient or patient’s representative that they have received this information before or at the time of admission.
· Complete information about a patient’s medical condition to the patient or patient’s representative.
· Freedom to choose a personal physician, participate in decisions about treatment options and refuse treatments.
· The right to refuse participation in experimental research.
· The right to be treated with respect, dignity and consideration, including the right of residents to set their own schedules, eat meals when they want and engage in activities as they see fit.
· The right to manage one’s own financial affairs, including the right to know the cost of services and the ones Medicare and Medicaid cover. Residents who choose to have the facility manage their financial affairs have the right to receive a regular accounting of transactions made on their behalf.
· Confidentality of personal and medical records, including the right to approve or refuse the release of medical records to any individual outside the facility except as part of a transfer to another facility.
· Equal access to care without regard to whether a resident pays privately or through private or government insurance programs.
· Freedom from abuse, including physical, sexual, financial, emotional and mental abuse.
· Freedom from chemical or physical restraints, unless a medical professional with appropriate authority has ordered those restraints in writing for a specified and limited period of time and for specific medical or safety reasons. A facility cannot use restraints simply to punish residents or make it easier to care for a particular patient.
· Freedom of association with family members, a personal physician or other healthcare provider, an ombudsman or other resident advocate, government representatives or other visitors of the patient’s choice.
· Freedom to participate in religious, social and community groups.
· Freedom to use personal clothing, furniture and other possessions as space permits.
· Personal privacy, including physical privacy during spousal visits and privacy in telephone calls, written communications and personal visits with family members, physicians and other chosen visitors.
Do the laws also cover discharge, transfer and readmission policies?
Federal and state laws also address facilities’ policies on discharge, transfer and readmission of patients. Typical guidelines include:
Transfer to another setting. If a facility is transferring a resident to the hospital or another therapeutic setting, it must provide written notice of how long it will hold the resident’s bed open. This time period is called a bedhold.
Priority readmission. If residents want to return to a nursing home from the hospital after the bedhold period has passed, the facility must readmit them immediately when a semi-private bed becomes available.
Discharge. A nursing home can insist residents leave only if:
· Their condition has improved or worsened and the facility no longer offers the appropriate level of care.
· They have failed to pay reasonable and appropriate charges.
· Their presence endangers their own or other patients’ health and safety.
· The nursing home is shutting down.
If the senior you care for lives in a nursing home and you believe the facility is violating these rights in any way, you should immediately inform the administrator and contact the local long-term ombudsman program or state survey agency, or both. Federal and state laws require the nursing home itself and government regulators to investigate any alleged abuse, and state survey agencies have the power to issue sanctions against facilities with deficient practices.