Nursing Home Surveyors Look At Nursing Home Resident Rights
Nursing Home residents have guaranteed rights. These rights are spelled out in the Code of Federal Regulations at 483.10, 483.12, 483.13, and 483.15. The nursing home must actively promote these rights for all residents, regardless of any barriers the resident may face (such as communication issues or hearing/vision problems, etc.) This also includes residents who may not be competent, for whatever reason, to act upon or decide issues for him/herself.
These rights include the resident’s right to:
- Exercise his or her rights; (Exercising rights means that residents have autonomy and choice, to the maximum extent possible, about how they wish to live their everyday lives and receive care, subject to the facility’s rules, as long as those rules do not violate a regulatory requirement) The facility must not hamper, compel, treat differentially, or retaliate against a resident for exercising his/her rights.
- Be informed about what rights and responsibilities he or she has;
- If he or she wishes, have the facility manage his personal funds;
- Choose a physician and treatment and participate in decisions and care planning;
- Privacy and confidentiality;
- Voice grievances and have the facility respond to those grievances;
- Examine survey results;
- Work or not work;
- Privacy in sending and receiving mail;
- Visit and be visited by others from outside the facility;
- Use a telephone in privacy;
- Retain and use personal possessions to the maximum extent that space and safety permit;
- Share a room with a spouse, if that is mutually agreeable;
- Self-administer medication, if the facility’s interdisciplinary care planning team determines it is safe; and
- Refuse a transfer from a distinct part, within the institution. (A distinct part is a part of another institution such as a hospital which is used as a nursing facility or skilled nursing facility - surveyors will often refer to this as a D/P SNF [distinct part skilled nursing facility].
- Have access to current and old clinical records pertaining to him/her and at the community rate for copies.
- Be fully informed in a language the resident can understand of his/her total health status
- To be informed in advance of treatments & changes in care
- To refuse treatment and make an advanced directive (Some state laws will also state that a resident who has the capacity to make a health care decision and who withholds consent to treatment or makes an explicit refusal of treatment either directly or through an advance directive, may not be treated against his/her wishes. In these cases a facility may not transfer or discharge a resident for refusing treatment unless the criteria for transfer or discharge are met. Refusal of treatment does not absolve the facility from providing care. The facility should make a care plan to address the residents refusal and try to address the reasons for the refusal.)
There are circumstances when a surrogate decision maker needs to be involved. But even when a surrogate decision maker is involved if the resident can understand the situation and express a preference, the resident should be informed and his/her wishes respected as much as possible. Remember, though, that the involvement of a surrogate or representative does not automatically relieve a facility of its duty to protect and promote the resident’s interests. For instance, a surrogate decision maker does not have the right to insist that a treatment be performed that is not medically appropriate. Also, state laws may also restrict the right of a surrogate to reject treatment or care for the resident.
This has been a quick review/summary of the information from the regulations related to Residents Rights. These are under F-tags 151 & 154.
Be informed, be safe!
JL
Filed Under Nursing Homes, Regulations, Resident Rights |
Tagged With Code of Federal Regulations, F-Tags, Nursing Homes, Regulations, Resident Rights
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