IAS | Your Rights and Protections as a Nursing Home Resident (Summer 2022)

Your Rights and Protections as a Nursing Home Resident

By: Financial Hotline
Summer 2022 (Vol. 40, No. 2)

As a nursing home resident, you have certain rights and protections under Federal and state law that help ensure you get the care and services you need. At a minimum, Federal law specifies that nursing homes must protect and promote the following rights of each resident. According to the Center for Medicare and Medicaid, these are your legal rights:

You have the right to be treated with dignity and respect, as well as make your own schedule and participate in the activities you choose. This means you can decide when you go to bed, rise in the morning, and eat your meals.

Nursing homes don’t have to accept all applicants, but they must comply with Civil Rights laws that say they can’t discriminate based on race, color, national origin, disability, age, or religion.

You have the right to be free from verbal, sexual, physical, and mental abuse. Nursing homes can’t isolate you against your will. If you feel you have been mistreated (abused) or the nursing home isn’t meeting your needs (neglect), report this to the nursing home, your family, your local Long-Term Care Ombudsman, or State Survey Agency. The nursing home must investigate and report all suspected violations and any injuries of unknown origin within 5 working days of the incident to the proper authorities.

Nursing homes can’t use any physical restraints (like side rails) or chemical restraints (like drugs) to discipline you for the staff’s own convenience.

You have the right to make a complaint to the staff of the nursing home, or any other person, without fear of punishment. The nursing home must address the issue promptly.

You have the following rights regarding your medical care:

To be fully informed about your total health status in a language you understand.

To be fully informed about your medical condition, prescription and over-the-counter drugs, vitamins, and supplements.

To be involved in the choice of your doctor.

To participate in the decisions that affect your care.

By law, nursing homes must develop a care plan for each resident. You have the right to take part in this process.

To access all your records and reports, including clinical records (medical records and reports) promptly.

Your legal guardian has the right to look at all your medical records and make important decisions on your behalf.

To create advance directives (a health care proxy or power of attorney, a living will) in accordance with State law.

To refuse to participate in experimental treatment.

The nursing home must notify your doctor and, if known, your legal representative or an interested family member when the following occurs:

You’re involved in an accident and are injured and/or need to see a doctor.

Your physical, mental, or psychosocial status starts to get worse.

You have a life-threatening condition.

You have medical complications.

Your treatment needs to change significantly.

The nursing home decides to transfer or discharge you from the nursing home.

You have the right to be told in writing about all nursing home services and fees before you move into the nursing home and at any time when services and fees change. In addition: The nursing home can’t require a minimum entrance fee if your care is paid for by Medicare or Medicaid.

For people seeking admission to the nursing home, the nursing home must tell you (both orally and in writing) and also display written information about how to apply for and use Medicare and Medicaid benefits.

Get Proper Privacy, Property, and Living Arrangements:

You have the right to keep and use your personal belongings and property as long as they don’t interfere with the rights, health, or safety of others.

To have private visits. To make and get private phone calls.

To have privacy in sending and getting mail and email and to have the nursing home protect your property from theft.

To share a room with your spouse if you both live in the same nursing home (if you both agree to do so).

The nursing home has to notify you before your room or your roommate is changed and should take your preferences into account.

To have visitors at any time, as long as you wish to see them, as long as the visit does not interfere with the provision of care and privacy rights of other residents.

To see any person who gives you help with your health, social, legal, or other services may at any time. This includes your doctor, a representative from the health department, and your Long-Term Care Ombudsman, among others.

The nursing home must provide you with any needed social services, including counseling, help solving problems with other residents, help in contacting legal and financial professionals, discharge planning.

You can choose to move to another place.

You have protections against involuntary transfer or discharge. Once you become a resident in the nursing home, you can’t be made to leave unless any of the following are true:

It’s necessary for the welfare, health, or safety of you or others.

Your health has improved to the point that nursing home care is no longer necessary.

The nursing home hasn’t been paid for services you got.

The nursing home closes.

You have the right to appeal a transfer or discharge to the State. Once you are in a nursing home, unless you have recovered enough to safely go home, it’s not easy for them to get you out. Regardless, some homes will try to intimidate or bully you into leaving. If this happens to you, contact your state ombudsman, and ask them to intervene. For example, the nursing home can’t just kick you out when Medicare payments stop. You must be given time to make payment arrangements.

They can’t kick you out if you’re waiting to get Medicaid or they don’t have a Medicaid bed available. They can’t just send you to the hospital and not hold a bed for you. Except in specific emergencies, nursing homes must give a 30-day written notice of their plan and reason to discharge or transfer you. The nursing home must safely and orderly transfer or discharge you and give you proper notice of bed-hold and/or readmission requirements.

You have a right to form or participate in a resident group to discuss issues and concerns about the nursing home’s policies and operations. Most homes have such groups, often called “resident councils.”

You have the right to have your family and friends Involved in your care.

Helpful Resources:

The National Consumer Voice for Quality Long-Term Care www.theconsumervoice.org provides information on quality care, residents’ rights, and quality of life issues for nursing home residents. An easy to use map connects you to the key long-term care agencies in each state including citizen advocacy groups and their websites.

You can find links to your local and state ombudsman offices through on the National Ombudsman Resource Center (NORC) website at www.ltcombudsman.org Ombudsmen are resident advocates who work at the state, regional and national level. Many programs sponsor hotlines and websites with consumer information.

At http://www.ahfsa.org (The Association of Health Facility Survey Agencies) Consumers can find links to state government offices responsible for licensing and certifying nursing homes.

The website at http://www.eldercare.gov is sponsored by the U.S. Administration On Aging. It provides links to information and referral (I&R) services for state and area agencies on aging.

If you are getting conflicting information or you don’t understand the verbal communication, ask for the nursing home administrator. If they are not available, ask for their name and email address. Send a written request for clarification to the nursing home administrator. Send your written request by certified mail and follow up with an email. As always, you can contact us here at the Financial Hotline for help and support.