The number of seniors who have transitioned from home or hospital to a nursing home has begun to dwindle slightly as more are able to age in place, but their numbers remain strong.
As of 2014, according to the CDC, there were 1.7 million licensed nursing home beds and 1.4 million nursing home residents.
Is your senior one of those residents?
Nursing homes provide a crucial need in our country for healthcare services. They are staffed by trained professionals and regulated by the Centers for Medicare and Medicaid Services (CMS).
“Long-term care services include a broad range of health, personal care, and supportive services that meet the needs of frail older people and other adults whose capacity for self-care is limited because of a chronic illness; injury; physical, cognitive, or mental disability; or other health-related conditions” — HHS/CDC report
Long-term care services include help with activities of daily living such as dressing, bathing, and toileting and instrumental activities of daily living such as medication management.
Long-term care services assist people to improve or maintain an optimal level of physical functioning and quality of life.
Need to Ensure Seniors are Protected
Most nursing homes provide excellent care for the elders in their care.
At the same time, no facility is perfect. Some days things may not go as we expect and create concern your senior loved one is not being treated properly.
Do caregivers or seniors have any recourse to be sure that they are treated with dignity and their basic needs are being met?
They do — and it helps to know the rights of your senior loved one as a resident of a long term care facility!
Bill of Rights for Residents
Under the 1987 Nursing Home Reform Law, all nursing homes are required by law to provide a specific level of care that promotes quality of life to residents living in a nursing home/long term care facility.
A Nursing Home Residents’ Bill of Rights, which describes the rights of the residents, is mandated for all facilities regulated by CMS.
Nursing homes are required by law to make these policies available to any resident who requests them.
The Nursing Home Residents’ Bill of Rights should include and define (but not be limited to) the following rights:
- The Right to be Informed of Your Rights and the Policies of the Home
- The Right to be Informed about the Facility’s Services and Charges
- The Right to be Informed about Your Medical Condition and Treatment
- The Right to Participate in Planning Your Care and Medical Treatment
- The Right to Choose Your Own Physician
- The Right to Manage Personal Finances
- The Right to Privacy, Dignity, and Respect
- The Right to Personal Possessions
- The Right to be Free from Abuse and Restraints
- The Right to Voice Grievance without Retaliation
- The Right to be Discharged or Transferred Only for Medical Reasons
- Rights of Access
- The Right to be Informed of Your Rights and the Policies of the Home
The nursing home must have written policies about your senior’s rights and responsibilities as a resident.
The responsible party (this could be the senior or the person holding the senior’s healthcare power of attorney) must sign a statement saying that they have received and understood these rights and the rules of the nursing home when your senior is admitted.
As a resident, you have the right to be fully informed before or at admission of your rights and responsibilities as a resident and to be notified of any changes or amendments to those rights and responsibilities.
Right to be Informed about the Facility’s Services and Charges
Every resident has the right to be fully informed of the services available in the facility and of the charges related to those services. These charges include services not covered under Medicare or Medicaid and charges that are not covered in the facility’s basic rate.
Right to be Informed about Your Medical Condition and Treatment
Every resident has the right to receive medical care, nursing care, rehabilitative and restorative therapies, and personal hygiene in a safe, clean environment. Also, every resident has the right to be fully informed of his/her medical condition unless the physician indicates in the medical records that it is not in the best interest of the patient to be told.
Residents have the right to be advised by a physician or appropriate professional staff of alternative courses of care and treatments and their consequences.
Right to Participate in Planning Your Care and Medical Treatment
Residents must be given the opportunity to participate in the planning of their medical treatment. Residents have the right to refuse treatment and to refuse to participate in experimental research.
Right to Choose Your Own Physician
Every resident has the right to choose his/her own physician and pharmacy. Residents do not have to use the nursing home’s physician or pharmacy.
Right to Manage Personal Finances
Residents have the option to manage their funds or to authorize someone else to manage them. If someone else is authorized to handle a resident’s funds, the resident has the right to: know where the funds are and the account number(s); receive a written accounting statement every 3 months; receive a receipt for any funds spent; and, have access to his/her funds within 7 business days.
Right to Privacy, Dignity, and Respect
Every resident has the right to be treated with consideration, respect, and dignity in full recognition of his/her individuality. This includes privacy during medical treatment and care of personal needs.
People not involved in the care of the resident should not be present during examinations and treatment without consent from the resident.
Right to Personal Possessions
Every resident has the right to retain and use his/her personal clothing and possessions as space permits, unless doing so infringes upon the rights of other residents or constitutes a safety hazard.
Right to be Free from Abuse and Restraints
Residents have the rights to be free from mental (humiliation, harassment, and threats of punishment or deprivation) and physical (corporal punishment and the use of restraints as punishment) abuse.
Residents also have the right to be free from chemical and physical restraints unless authorized in writing by a physician for a specified and limited time period or when necessary to protect the patient from injury to him/herself or to others.
Right to Voice Grievance without Retaliation
Every resident should be encouraged and assisted to exercise his/her right to voice grievances and recommend changes in policies and services to facility staff and/or outside representatives of his/her choice without fear of coercion, discrimination, or reprisal.
Right to be Discharged or Transferred Only for Medical Reasons
A resident may only be discharged or transferred for medical reasons or for his/her welfare or that of other residents. Residents must be provided with a written notice 30 days prior to transfer or discharge.
The law provides residents the right to appeal discharge or transfer.
Rights of Access
Residents may receive any visitor of their choice and may refuse visitors to enter their room or may end a visit at any time. Residents have the right to immediate access by family and reasonable access to others. Visiting hours must be at least 8 hours per day and be posted in a public place.
Members of community organizations and legal services may enter any nursing home during visiting hours. Communication between the resident and visitors are confidential. Visitors may talk to all residents and offer them personal, social, and legal services. Visitors may help residents claim their rights and benefits through individual assistance, counseling, organizational activity, legal action, or other forms of representation.
Source: National Long Term Care Ombudsman Resource Center
Attention by Family Caregivers Needed
As with other aspects of life, the existence of rights is not the same as assurance those rights will be protected when nobody is looking.
Our senior loved ones still need the protection of the eyes and ears of the family caregivers who visit.
That means we need to understand the rights of our senior loved ones and what actions to take if needed.
First off let me say I have longtime reader, first time commenter. I figured I should probably say thanks for posting this piece (and all your others), and I’ll be back!
I really liked this post. You describe this topic very well. I really love your blog and I will definetly bookmark it! Keep up the great posts! 🙂
I thought the nursing home reform act of 1987 allowed immediate family to visit any time of night or day. Does this conflict with what you say about visiting hours?
Hello Tim,
That may be true, but from an operational viewpoint and to protect the rights of roommates and all residents, many facilities have established visiting hours.
If you want to visit at midnight, you would likely be allowed to do so but you would have to meet in a common area away from sleeping residents.
A facility will not deny you access to your loved one, but they may need to have a plan for how best to accomplish your visit for the benefit of everyone.
We appreciate your question!
I can’t find any rights relating to food and nutrition. Meals are extremely important to long term care residents. Mealtime is a high point of many resident’ day and also an important part of a healthy living plan. Residents should have rights to a choice of food, snacks and access to facility refrigerators, foods prepared for specific nutritional needs, and input into menu creation.
In long term care facilities, the state usually establishes guidelines about resident’s rights in term of regulations the facility must meet. Food concerns often deal with dignity rights. Menus are deemed nutritionally adequate but may not be pleasing to all residents. Most quality LTC facilities allow resident input in the menu through resident’s council. Remember, you can’t make a menu that each person will love 100% of the time. Families often need to provide enhancements if needed such as occasional favorite meals or snack foods from home. Most of the items you mention Kathy are provided by a quality facility for patient satisfaction but may not be ‘regulated’ to be included. For reasons you point out, choosing an appropriate facility that best meets the needs of your particular senior are important from the beginning. Dietitians are vital team members in LTC to protect the nutritional health of seniors, but not regulated to be in facility full-time or even weekly. Perhaps more discussion about the topic will focus on the need for improvements. Thanks for your comments!
I have a close friend who is concern about his mother who is a resident in a nursing,two of the siblings are the executive of her medical well being,thy never visit nor call,and when my friend which is her son reports to them her well being and care has not been attended to nothing is being down,he is a truckdriver and he make his way to see her as least once a week,he has loads state to state,as the black sheep in the family what rights do he have? if he complains to the staff he will not be allowed to see her,she has bed sores,she can’t speak due to her disability,and she cries when he comes to see her,like she want to say something,please help.
Theresa, that is a difficult story and one with which I am sure this son is struggling greatly. Hopefully he can get someone in his corner to be sure his mother is being cared for adequately. If he feels there is not proper care being provided in the facility, has he contacted a third party to check it out? In the US there are government agencies that check facilities for appropriate care that he could access. Without legal standing and conflicts with siblings, I hope he can get results for the best interest of his mother. Good luck!
My father is in a assisted living care home and my sister at the moment is POA of financials for my father and nothing eles when I go to visit my father to take him to go get something to eat they claim he cannot leave.He has said he does want to leave with me but they say they have a document stating he can only leave with my evil sister They have never produced said document and according to the employees there is no such document and never has been They(owner of care home and evil sister) are abusing my fathers civil rights!!!!
Sorry to hear about your situation Lori. If your father is in a US nursing home, you have the option of talking with an Ombudsman to advocate the rights of your father. Good luck to your family.
Nursing home in Arizona. We have all the legal POA’s for my mother in-law, including a income-only trust required by the state, she has been accepted medically for ALTCHS and state aid she is 92 years young. The long term care facility which we would like for her to be admitted says there is a federal law that states she has to self-admit and she can self-check out.
All I can find on line is that a doctor has to write a script for her to be admitted.
I cannot find the laws. In need of help.
Thank you
Richard E. Bulman
Right of resideance
Chris, in the US there is a process if a regulated facility wishes to evict a resident. There must be 30 days notice and a reason for their action such as smoking in a nonsmoking facility. If you are in the US, if you feel your senior is being treated unfairly by a facility, you can contact the Ombudsman to advocate on your senior’s behalf. The Ombudsman is a great resource that can help families and seniors! Thanks for your comment!