Understanding Residents' Rights Under Federal Law
Federal law establishes a framework of rights for residents in long-term care facilities, particularly those receiving Medicare and Medicaid. The Nursing Home Reform Act of 1987 is a key piece of legislation, requiring facilities to uphold resident rights. Individuals in long-term care facilities retain the same basic rights as other members of the community.
These rights cover various aspects of a resident's life, including:
- Dignity and Respect: Residents have the right to be treated with consideration, respect, and dignity, free from abuse, neglect, and exploitation.
- Self-Determination: Residents can make their own choices about daily activities, schedules, and healthcare providers. They also have the right to form and participate in resident councils.
- Information: Residents must be informed about facility services, costs, rules, and contact information for advocacy groups like the state ombudsman. They also have the right to be fully informed about their medical condition and participate in developing their care plan.
- Privacy: Residents are entitled to privacy regarding their personal, financial, and medical information. They also have the right to private communication with visitors.
- Right to Refuse: Residents can refuse medical treatment. Physical or chemical restraints can only be used when medically necessary and authorized, not for convenience.
Financial and Personal Belongings Rights
Residents maintain control over their personal finances and possessions. Facilities cannot mandate managing a resident's money. If a resident permits facility management of their funds, regulations apply to prevent financial abuse.
Financial rights include managing one's own finances and, if the facility manages funds, receiving quarterly statements. Residents can refuse to deposit personal funds with the facility.
Regarding personal property, residents can keep and use their belongings, as long as it does not compromise the safety of others. Labeling items and creating an inventory is advisable. Facilities are responsible for investigating missing items and can be liable for loss or theft.
Transfer and Discharge Protections
Federal law limits the reasons a resident can be transferred or discharged from a facility. Valid reasons include the resident's or others' welfare, nonpayment, or a change in the resident's medical needs.
Protections include receiving at least 30 days' written notice of a transfer or discharge plan, except in emergencies. Residents have the right to appeal these decisions and remain in the facility during the appeal process. Facilities must ensure safe transfers. Residents must also be informed of their right to return after hospitalization.
Nursing Homes vs. Assisted Living Facilities: A Comparison of Rights
The rights of residents vary depending on whether they reside in a nursing home or an assisted living facility (ALF). Nursing homes that receive federal funding are subject to federal and state regulations, while ALFs are primarily regulated at the state level.
| Feature | Nursing Home (Skilled Nursing Facility) | Assisted Living Facility (ALF) |
|---|---|---|
| Primary Regulation | Federal and state laws. | State laws only. |
| Federal Oversight | Yes, subject to CMS regulations. | No federal oversight. |
| Inspection/Survey | Mandated unannounced inspections and complaint investigations. | Varies by state, often less frequent than nursing homes. |
| Care Plans | Required written plan involving resident. | Varies by state. |
| Enforcement | Stronger federal and state mechanisms. | Varies by state. |
| Rights to Transfer/Discharge | Federally defined conditions and appeal rights. | Defined by state law. |
The Role of the Long-Term Care Ombudsman Program
The Long-Term Care Ombudsman Program (LTCOP) is authorized to advocate for residents' rights. Ombudsmen are independent individuals who address complaints on behalf of residents in various long-term care settings.
Ombudsmen assist by investigating and resolving complaints, educating residents and families about their rights, and advocating for residents' interests. Their services are free, confidential, and prioritize the resident's wishes. To contact an ombudsman, individuals can reach out to their state or local office.
Conclusion
Residents in long-term care facilities possess fundamental rights that protect their well-being. Federal law provides a baseline for nursing home residents, while state laws govern rights in assisted living facilities. The Long-Term Care Ombudsman Program serves as a vital resource for residents and families to address concerns and ensure rights are upheld. Understanding these rights is crucial for residents to receive appropriate care and maintain their autonomy.
Know Your Rights... As a Long-Term Care Resident offers further information on resident rights.
