Which of the following is a right of a nursing home resident?

Enacted in 1987, the Nursing Home Reform Act established a set of federal rights to protect residents in Medicare and Medicaid-certified facilities. The law mandates that nursing homes must “promote and protect the rights of each resident.” Knowing which of the following is a right of a nursing home resident is crucial for ensuring their well-being and dignity.

Quick Summary

All nursing home residents are entitled to a wide range of rights guaranteed by federal law, including the right to dignity, respect, self-determination, and freedom from abuse. They also have rights regarding their care, privacy, personal property, and finances, and the ability to voice complaints without fear of reprisal.

Key Points

• Freedom from Restraints: A resident has the right to be free from physical or chemical restraints for staff convenience or discipline, used only when medically necessary.

• Right to Self-Determination: Residents have the right to participate in developing their care plan, make personal choices, and choose their activities and schedules.

• Dignity and Respect: Every resident has the right to be treated with consideration, dignity, and respect, and to be free from abuse, neglect, and exploitation.

• Right to Visitors: Residents have the right to have private visits with family and friends at any time, within reasonable limits.

• Financial Autonomy: Residents can manage their own financial affairs, and the facility must manage their funds transparently if requested.

• Grievance Process: Residents have the right to voice complaints to staff or outside advocates, such as the Long-Term Care Ombudsman, without fear of reprisal.

Understanding the Foundation of Resident Rights

For many, moving into a nursing home is a significant life transition. To ensure this change does not strip individuals of their fundamental freedoms, comprehensive laws are in place. The federal Nursing Home Reform Act of 1987 is the cornerstone of these protections, requiring facilities to care for residents in a way that enhances their quality of life, promotes dignity, and encourages self-determination. This is not an exhaustive list but a foundation for the protections that ensure a high standard of care.

The Right to Dignity, Respect, and Freedom

At the core of resident rights is the principle of being treated with respect and dignity. This encompasses several key areas:

• Right to be treated with consideration, respect, and dignity: This is the most basic right, ensuring that residents are treated as individuals with personal preferences and choices.
• Freedom from abuse and neglect: Residents have the right to be free from physical, mental, sexual, and verbal abuse, as well as neglect and involuntary seclusion.
• Freedom from chemical and physical restraints: Restraints can only be used when medically necessary and prescribed by a physician, never for staff convenience or discipline. Less restrictive alternatives must always be considered first.
• Right to a homelike environment: Residents have the right to keep and use personal belongings, such as furniture, photographs, and other items that make their space feel like home, provided it doesn’t infringe on the rights of others.

The Right to Participate in Your Own Care

Residents are not passive recipients of care; they are active participants in their treatment planning. This means they have several crucial rights regarding their medical and personal care.

1. Be fully informed of your medical condition: Residents have the right to be informed about their health status, medical care, and potential risks and benefits of proposed treatments in a language and manner they can understand.
2. Participate in care planning: Residents, and their representatives if applicable, have the right to participate in developing, implementing, and revising their person-centered plan of care.
3. Refuse treatment: This includes the right to refuse medication and medical treatment, even if it is recommended by the physician. This upholds the resident’s autonomy over their own body.
4. Choose your attending physician: Residents can choose their own doctor, so long as the physician is willing to follow the facility's policies.

The Right to Privacy and Confidentiality

Personal privacy is a cornerstone of individual dignity. Nursing home residents retain these rights, even within a communal living environment.

• Private communication: Residents have the right to private and unrestricted communication, including sending and receiving mail, using the telephone, and having visitors.
• Privacy during care: Facilities must ensure privacy during medical examinations, treatment, and personal care needs like bathing and dressing.
• Confidentiality of records: Residents have the right to access all their personal and medical records, and their information must be kept confidential.

Comparison of Common Resident Rights

Right Category	Key Aspects	Restrictions/Considerations
Dignity & Respect	Freedom from abuse, neglect, and restraints; considerate and respectful treatment.	Must not infringe on the health or safety of others. Restraints are allowed only for medical necessity.
Self-Determination	Choice of activities, schedule, and participation in care planning.	Facilities may accommodate needs as long as they are reasonable and don't affect other residents' safety or rights.
Privacy & Confidentiality	Private communication, personal care, and medical records.	Visitation can be limited if it infringes on another resident's rights.
Complaints & Grievances	Right to voice complaints without reprisal. Access to ombudsman services.	The facility must provide a prompt and written response to grievances.

The Right to Manage Financial Affairs

A resident’s financial independence is protected under federal law. They have the right to manage their own money. If they ask the facility to manage their funds, the facility must:

• Keep the resident's money separate from the facility's operating funds.
• Deposit any funds over $50 ($100 for private-pay) in an interest-bearing account.
• Provide a quarterly written statement detailing all transactions.

The Right to Visits and Advocacy

Staying connected to family, friends, and advocates is vital for a resident's mental and emotional health. The law ensures robust access to visitors and external support systems.

• Right to visitors: Residents have the right to have visitors of their choosing at any time, and to refuse visitors. Family members and legal guardians may participate in family councils.
• Access to ombudsman programs: A resident has the right to access representatives from the Long-Term Care Ombudsman program to help resolve complaints and advocate for their rights. For more information, you can visit the National Long-Term Care Ombudsman Resource Center.
• Organize resident groups: Residents can organize and participate in resident and family councils to voice concerns about facility policies and operations.

Protection Against Transfer or Discharge

Residents are protected against unfair or illegal transfers and discharges. A nursing home can only transfer or discharge a resident for specific, federally recognized reasons, such as a change in medical condition or a failure to pay. The facility must provide a 30-day written notice and an explanation of appeal rights.

Conclusion

Recognizing and advocating for nursing home residents' rights is essential for ensuring their well-being. By understanding the rights to dignity, self-determination, participation in care, and freedom from abuse and unnecessary restraints, family members and residents can hold facilities accountable. These rights are not just policies; they are a promise of respect, dignity, and a high quality of life for those in long-term care.

Frequently Asked Questions

Which of the following is a right of a nursing home resident regarding care planning?

A nursing home resident has the right to participate in the development and revision of their care plan. This includes being fully informed about their health condition and potential treatments, and having the right to refuse care.

Can a nursing home resident be involuntarily restrained?

No, a nursing home resident cannot be involuntarily restrained for staff convenience or discipline. Physical and chemical restraints can only be used when medically necessary to treat a resident's symptoms, and with a physician's order and informed consent.

What is the resident's right to privacy in a nursing home?

The right to privacy extends to a resident's personal care, medical treatment, and communications. This includes the right to private visits, phone calls, and mail, as well as the confidentiality of their medical records.

Does a nursing home resident have the right to manage their own money?

Yes, residents have the right to manage their own financial affairs. If the facility manages their money for them, it must do so transparently, keep the funds separate from its own, and provide regular financial statements.

What protection does a nursing home resident have against unfair discharge?

Residents are protected by law from unfair transfer or discharge. A facility must provide a 30-day written notice and a valid reason for the transfer or discharge, and residents have the right to appeal the decision.

Can a nursing home resident complain without fear of retaliation?

Yes, residents have the right to voice complaints and present grievances to facility staff, the Long-Term Care Ombudsman, or state survey agencies without fear of discrimination or retaliation.

How can a family member help ensure a nursing home resident's rights are protected?

Family members can help by staying involved in their loved one's care plan, attending family councils, monitoring the resident's condition and environment, and contacting the Long-Term Care Ombudsman if they have concerns.