Core Rights for Maryland Nursing Home Residents
Maryland law, in conjunction with federal regulations like the Nursing Home Reform Act of 1987, grants a fundamental set of rights to all nursing home residents. These are designed to promote and enhance each resident's quality of life by ensuring dignity, choice, and self-determination. Under the Code of Maryland Regulations (COMAR), these rights include receiving care in an environment that maintains and enhances their well-being, as well as being free from interference or reprisal when exercising their rights.
Rights to Dignity, Respect, and Freedom
Maryland's regulations explicitly state that residents have the right to a dignified existence and to be treated with consideration, respect, and full recognition of their individuality. This includes the right to be free from mental, physical, verbal, and sexual abuse, as well as from involuntary seclusion. Furthermore, residents are protected from physical or chemical restraints that are imposed for disciplinary reasons or for the convenience of the staff. Exceptions are only permitted with a physician's authorization for a clearly indicated medical need.
Rights Regarding Medical Care and Treatment
Residents have the right to be fully informed in advance about their care and treatment, and any proposed changes. This encompasses several key components:
- Informed Consent: The right to participate in planning their care and treatment, including the ability to consent to or refuse treatment.
- Choosing Providers: The right to choose an attending physician, provided the physician agrees to abide by the facility's policies and regulations.
- Access to Records: The right to access their own medical records within 24 hours of an oral or written request (excluding weekends and holidays) and to purchase copies.
- Pain Management: The right to expect and receive appropriate assessment, management, and treatment of pain.
Privacy and Confidentiality
Every nursing home resident has a right to personal privacy and the confidentiality of their medical and financial records. The regulations specify that staff must knock before entering a resident's room unless they know the resident is asleep. This extends to personal care and medical treatment. Written communication, such as mail, must be sent and received promptly without being opened by anyone other than the resident, unless assistance is requested. Residents also have the right to have private visits with any individual they choose, subject to reasonable restrictions.
Financial and Personal Affairs
Residents can manage their own personal financial affairs to the extent permitted by law. They also have the right to make independent personal decisions, such as choosing what to wear and how to spend their free time, with reasonable accommodations made for individual needs and preferences.
Complaints and Grievances
Voicing grievances is a protected right for nursing home residents in Maryland. They can recommend changes to policies and services without fear of retaliation or discrimination. The nursing facility is obligated to promptly resolve any complaints a resident may have. Residents also have the right to contact and receive information from client advocate agencies, including the Long-Term Care Ombudsman Program.
Discharge and Transfer Protections
Federal and state laws impose strict rules on involuntary transfers and discharges from a nursing home. A nursing home can only discharge or transfer a resident for very specific, limited reasons, such as improved health, failure to pay, or endangering the health or safety of others.
In most non-emergency cases, the facility must provide the resident with a 30-day written notice of the transfer or discharge. Residents have the right to appeal this decision by requesting a hearing from the Office of Administrative Hearings within 30 days of receiving the notice. If an appeal is filed, the nursing home cannot transfer or discharge the resident until a final decision is made.
Comparison of Federal vs. Maryland Nursing Home Rights
While Maryland's regulations are comprehensive, it's useful to understand how they align with federal law, primarily the Nursing Home Reform Act of 1987.
| Right | Federal Mandate (OBRA '87) | Maryland Regulations (COMAR) |
|---|---|---|
| Dignity & Respect | Ensures care promotes dignity and enhances the resident's quality of life. | Explicitly guarantees a dignified existence, self-determination, and respect for individuality. |
| Freedom from Abuse | Residents must be free from verbal, sexual, physical, and mental abuse, as well as involuntary seclusion. | Aligns completely, and adds protections from abuse specifically outlined in COMAR. |
| Restraints | Prohibits physical and chemical restraints for convenience or discipline. | Adheres to federal standards, prohibiting restraints unless medically necessary and authorized by a physician. |
| Medical Decisions | Guarantees residents the right to participate in their own care planning and to refuse treatment. | Fully supports this, including the right to choose an attending physician and accept or reject artificially administered sustenance. |
| Involuntary Discharge | Strict rules and a 30-day notice requirement for most involuntary transfers/discharges. | Adopts the federal standard and details the appeal process via the Office of Administrative Hearings. |
| Grievance Process | Residents have the right to voice grievances without fear of reprisal. | Mandates prompt facility investigation and resolution of complaints within 30 days. |
| Access to Ombudsman | Right to confidential access to the State Long-Term Care Ombudsman. | Mandates reasonable access to the State Long-Term Care Ombudsman and provides contact information for local offices. |
What to Do When Rights are Violated
If a nursing home resident's rights are violated, there are several avenues for recourse. The first step is often to raise the concern directly with the nursing home's staff or administrator. If the issue is not resolved, residents or their representatives can proceed with more formal complaints.
- Contact the Maryland Office of Health Care Quality (OHCQ): As the state's licensing agency, the OHCQ monitors the quality of care and investigates complaints against facilities. Complaints can be filed online, by mail, or by phone.
- Reach Out to the Long-Term Care Ombudsman Program: This program, part of the Maryland Department of Aging, provides free and confidential advocacy for residents. An ombudsman can investigate and work to resolve complaints on a resident's behalf.
- Report Elder Abuse: If abuse is suspected, reports can be made to Adult Protective Services (APS) for financial exploitation cases in nursing homes, while OHCQ handles non-financial abuse claims.
- Consult a Legal Professional: For severe or unresolved issues, consulting an elder law attorney is an option to pursue legal action against the facility.
Conclusion
Nursing home residents in Maryland have comprehensive rights that are protected by both state and federal law, ensuring they are treated with dignity, respect, and are free from abuse. These rights provide autonomy over medical decisions, privacy, and personal affairs. The law also outlines a clear process for appealing involuntary transfers and voicing grievances without fear of retaliation. In the event of a rights violation, multiple state and local resources, including the Long-Term Care Ombudsman and the Office of Health Care Quality, are available to assist residents and their families in seeking resolution and protection.
Long-Term Care Ombudsman Program - Maryland Department of Aging
