Nursing Home
THE GOOD THE BAD, THE UGLY
Nursing homes, like most health care providers run the gamut in the quality of care provided to their patients. Unfortunately, it is not as easy for a nursing home patient to switch facilities as it is for a patient who doesn't like something about their internist or orthopedist.
Bed sores, falls, malnutrition, misdiagnosis and a many other serious events can befall a nursing home patient.
Nursing home patients have legal rights and nursing homes can be held to set established standards.
Each person admitted to a nursing home in the United States has resident rights guaranteed by the 1987 Nursing Horne Reform Law. A summary of their rights appear on the National Long-Term Care Ombudsman Resource Center.
Residents' Rights
Residents Rights are guaranteed by the federal 1987 Nursing Horne Reform Law. The law requires nursing homes to "promote and protect the rights of each resident" and places a strong emphasis on individual dignity and self-determination. Nursing homes must meet federal resident's rights requirements if they participate in Medicare or Medicaid. Some states have residents' rights in state law or regulation for nursing homes, licensed assisted living, adult care homes, and other board and care facilities. A person living in a long-term care facility maintains the same rights as an individual in the larger community.
What are Residents' Rights?
Residents' Rights Guarantee Quality of Life
The 1987 Nursing Home Reform Law requires each nursing home to care for its residents in a manner that promotes and enhances the quality of life of each resident, ensuring dignity, choice and self determination. All nursing homes are required "to provide services and activities to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident in accordance with a written plan of care that is initially prepared, with participation, to the extent practicable, of the resident, the resident's family, or legal representative." This means a resident should not decline in health or well-being as a result of the way a nursing facility provides care.
The Right to Be Fully Informed of
- Available services and the charges for each service
- Facility rules and regulations, including a written copy of residents rights
- Address and telephone number of the State Ombudsman and state survey agency
- State survey reports and the nursing home's plan of correction
- Advance plans of a change in rooms or roommates
- Assistance if a sensory impairment exists
- Residents have a right to receive information in a language they understand (Spanish, Braille, etc.)
Right to Complain
- Present grievances to staff or any other person, without fear of reprisal and with prompt efforts by the facility to resolve those grievances
- To complain to the ombudsman program
- To file a complaint with the state survey and certification agency
Right to Participate in One's Own Care
- Receive adequate and appropriate care
- Be informed of all changes in medical condition
- Participate in their own assessment, care-planning, treatment and discharge
- Refuse medication and treatment
- Refuse chemical and physical restraints
- Review one's medical record
- Be free from charge for services covered by Medicaid or Medicare
Right to Privacy and Confidentiality
- Private and unrestricted communication with any person of their choice
- During treatment and care of one's personal needs
- Regarding medical, personal or financial affair
Rights During Transfers and Discharges
- Remain in the nursing facility unless a transfer or discharge:
- (a) is necessary to meet the resident's welfare;
- (b) is appropriate because the resident's health has improved and she/he no longer requires nursing home care;
- (c) is needed to protect the health and safety of other residents or staff;
- (d) is required because the resident has failed, after reasonable notice, to pay the facility charge for an item or service provided at the resident's request
- Receive thirty-day notice of transfer or discharge which includes the reason, effective date, location to which the resident is transferred or discharged, the right to appeal, and the name, address, and telephone number of the state long-term care ombudsman
- Safe transfer or discharge through sufficient preparation by the nursing home
Right to Dignity, Respect, and Freedom
- To be treated with consideration, respect, and dignity
- To be free from mental and physical abuse, corporal punishment, involuntary seclusion, and physical and chemical restraints
- To self-determination
- Security of possessions
Right to Visits
- By a resident's personal physician and representatives from the state survey agency and ombudsman programs
- By relatives, friends, and others of the residents' choosing
- By organizations or individuals providing health, social, legal, or other services
- Residents have the right to refuse visitors
Right to Make Independent Choices
- Make personal decisions, such as what to wear and how to spend free time
- Reasonable accommodation of One's needs and preferences
- Choose a physician
- Participate in community activities, both insides and outside the nursing home
- Organize and participate in a Resident Council
- Manage one's own financial affairs
These rights are complex and extensive. Many nursing home residents have designated a care manager or representative to oversee their care. New Jersey also has an ombudsman office that people can communicate their concerns regarding nursing home care. The State of New Jersey also conducts unannounced inspections and these results are available to the public.
If patients or their concerned loved ones cannot get the relief they are seeking from the nursing home an attorney experienced in nursing home law should be consulted. This can usually be done with a free initial consultation.