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Resident Rights

The Federal 1987 Nursing Home Reform Act (OBRA ’87) dramatically impacted the standards of care in long-term care facilities and created an emphasis on the quality of life, as well as the quality of care. Under OBRA ‘87, guidelines for Resident Rights were created, reinforcing that long-term care residents should be given the same value, respect, and opportunities – the same rights - that an individual enjoys in the larger community. Nursing homes must meet federal Resident Rights requirements if they participate in Medicare or Medicaid. Additionally, Massachusetts laws require that long-term care facilities uphold Resident Rights.

 

Resident Rights are protected throughout OBRA, and the information below is a summary of these sections: resident rights (483.10), admission, transfer, and discharge rights (483.12), resident behavior and facility practices (483.13), quality of life (483.15), and quality of care (483.25). For the full text of federal and Massachusetts laws, please refer to Laws & Regulations.

 

Links to the following categories:
Dignity, Respect, and Freedom
Discharge/Transfers
Grievances
Information
Medical Care
Privacy
Quality of Care/Quality of Life
Records
Resident and Family Councils

 

• Be free from mental and physical abuse, corporal punishment, involuntary seclusion, and physical and chemical restraints. The use of restraints will never be implemented for purpose of staff convenience, whether it be chemical or physical.
• Receive treatment with dignity and respect.
• Choose activities, schedules, and health care consistent with personal interests and plans of care; to interact with members of the community; and to make choices about aspects of his/her life in the facility that are significant to the resident.
• Share a room with his/her spouse upon mutual consent.
• Use personal possessions, including some furnishings, without infringing on health and safety of others.
• Manage personal financial affairs with protection for funds on deposit with the facility.
• Be free of interference, coercion, discrimination, and reprisal from the facility in exercising his or her rights.

 

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• The facility must permit each resident to remain in the facility, and not transfer or discharge the resident unless:
  1. it is necessary to meet the resident’s welfare;
  2. it is appropriate because the resident’s health has improved and the resident no longer requires nursing home care;
  3. it is necessary to protect the health and safety of other residents or staff;
  4. the resident cannot pay for his/her stay after sufficient notice; or
  5. the facility closes.
• Thirty (30) days advance notice prior to a discharge or transfer must be given in writing to the resident and if known, a family member or legal representative of the resident. The notice must include the reason for the change, the date of the transfer, the exact location to which the resident will be moved, the right of the individual to appeal the change, and the contact information for the state ombudsmen and protection/advocacy agencies for mental ill or disabled residents.
• Notification of bed-hold policy and readmission must be provided.

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• Access to the ombudsmen program and contact information for all pertinent State client advocacy groups.
• File a complaint with the ombudsman program and/or state survey and certification agency.
• Complaints may be made without fear of retaliation or discrimination.

 

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• Receive notices in a language/format understood by the resident.
• Receive written notice of resident rights upon admission.
• Upon admission or eligibility for Medicaid, informed in writing of items and services for which the resident may be not be charged, as well as the services he/she will be charged and the amount of the charge.
• Receive written information on the application process for Medicaid and Medicare benefits.
• Receive notice of any roommate changes prior to change (notice also must be provided to the resident’s legal representative or interested family member).
• Examine federal or state surveys and plans to correct deficiencies. The facility must make the results available for examination in a place readily accessible to residents, and must post a notice of their availability.

 

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• Be evaluated and informed as to his/her medical condition.li>
• Receive care by a physician of the resident’s own choosing, and to be an active participant in treatment, including care planning, treatment, and discharge.
• Self-administer drugs upon approval of interdisciplinary team.
• Refuse participation in research activities..
• Refuse medication and treatment.
• A facility must immediately notify the resident and legal representative or interested family member if:
  • an accident involving the resident has potential for requiring medical attention;
  • a significant change in the resident’s physical, mental or psychosocial status occurs;
  • it is necessary to significantly alter treatment i.e. cease a current treatment or begin a new treatment;
  • a decision has been made to transfer or discharge an individual from the facility (see Rights During Discharge/Transfers above for further information).

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• Includes personal privacy and confidentiality for medical treatment, personal care, and written and telephone communications (including sending and receiving mail unopened).
• Accommodations may be shared, however privacy must be maintained.
• Receive visitations in private with any individual (subject to reasonable restrictions) with the ability to deny or withdraw visitation consent at any time. There is immediate and unlimited access by family members, the long-term care Ombudsman, government agency representatives, and the resident’s physician.

 

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• Receive services with reasonable accommodation of individual needs and preferences, except when the health or safety of the individual or other residents would be endangered.
• Receive the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care.
• A facility must promote care for residents in a manner and in an environment that maintains or enhances each resident's dignity and respect in full recognition of his or her individuality.
• A facility must care for its residents in a manner and in an environment that promotes maintenance or enhancement of each resident's quality of life.

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Rights of resident or legal representative:

• Obtain for inspection, a copy of records to be provided within 24 hours of written or verbal request (excluding weekends and holidays).
• Purchase copies of such documents at a price not to exceed current community photocopying costs (facility must be provided two working days advance notice).

 

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See Family-Run Council Legislation for full text.

 

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