Resident's Rights
By Alice Ahart
 A resident receives treatment in the hallway of a nursing home; a resident is told to take the medication the doctor prescribed despite the resident’s protests; dentures are lost after a resident is admitted to a nursing home and replacements are not provided; a resident is told she will be discharged because her family is too demanding; a resident is awakened at 6:30 a.m. to be assisted with dressing for the day.
All of these events described could occur without recourse, were it not for the 1987 Nursing Home Reform Law that requires nursing homes to promote and protect the rights of each resident. Nursing homes must meet residents’ rights requirements if they participate in Medicare or Medicaid. Under this law a resident has the right to choose activities, schedules, and health care consistent with his or her interests, assessments and plans of care; interact with members of the community both inside and outside the facility; and make choices about aspects of his or her life that are significant to the resident.
The purpose of residents’ rights is to safeguard and promote dignity, choice, and self determination of nursing home residents and to protect civil, personal and privacy rights, and the right to information, rights related to health care, due process and life in the nursing home, transfer and discharge rights, the handling of personal finances, and the right to be free from abuse and restraints.
Residents’ ability to participate in decisions affecting their daily lives and to exercise control over their lives is critical to their well-being. This means residents have the right to voice concerns and seek changes without fear of reprisal. Prior to the enactment of this law, several residents’ rights could be limited or denied because the resident’s physician documented that the exercise of that right was medically contra-indicated. This provision gave the physician the power to restrict resident’s rights. Now residents have the right to refuse treatment or medication and to select their own physician and to be fully informed in advance about care and treatment.
Management of personal funds is at the discretion of the resident. A facility may not require residents to deposit their personal funds with the facility, but if the facility receives written authorization to deposit resident funds with the facility then the facility must maintain strict records and provide the resident with an accounting of his/her funds.
The law also specifies permissible reasons for transfer and discharge, and the nursing home must send a letter with reasons for intended discharge at least 30 days in advance except in certain circumstances. The letter of discharge must tell the resident that he/she has the right to appeal the intended discharge and the addresses of the Director of the Office of Long-term Care and State Ombudsman must be included.
Restraints may not be used as a means of retaliation, staff shortages or in lieu of alternatives such as a safe area for wanderers. Strict regulations dictate under what circumstance restraints may be used. Chemical restraints include any medication given to control mood, mental status, or behavior. Physical restraints are any manual method or physical or mechanical device, material, or equipment attached to the resident’s body that the resident can’t remove himself. Residents have a right to dignity, respect and freedom which means they have the right to be treated with the fullest measure of consideration, respect and dignity and to be free from mental and physical abuse, and corporal punishment.
The list of rights is lengthy, but these rights are meaningless unless there is a methodology in place to assure residents and their families are informed regarding all their rights. When resident feels his rights have been restricted, abridged or denied what recourse are there for the resident? A complaint may be made by the resident, family member or friend to the Office of Long –term Care for investigation. If a nursing home is found to have violated resident rights they will be cited for this deficiency, and a plan of correction will be required.
Even though the rights of residents are posted in nursing home facilities, that is not enough. The nursing home community, which includes the resident, nursing home staff, Ombudsmen, family, friends, neighborhood churches, legislators, and civic organizations have an obligation to assure that nursing home resident’s rights are protected. This is done through participation in family council meetings, consistent visitation to the nursing home to observe first hand how residents are treated, and becoming educated about the Nursing Home Reform Law. Regional Ombudsmen who are regular visitors to long-term care facilities are available to talk with community groups, family and resident councils and to others who want additional information. They can be contacted in your region’s Area Agency on Aging.
October is the month designated to highlight nursing home residents’ rights. It is a great time to become active in your community’s nursing home. As Americans we take our constitutional rights seriously enough to have fought a war in order to retain them. Now it is time to battle indifference, staff shortages, and lack of respect on behalf of our nursing home friends.
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