The rights of nursing home residents are codified in both federal and state statutes with the intent of further protecting each residentís civil, religious, and human rights while they reside in a nursing facility.
1. To be treated with consideration, respect, and full recognition of personal dignity.
· It should be recognized that in an institutional setting each
and every resident cannot have complete freedom. However, individual
choices such as sleeping patterns, food likes and dislikes, flexibility
in bathing times, religious preference, clothing choices, and friendships
must be respected.
2. To receive care, treatment, and services which are adequate, and
in compliance with relevant federal and state statutes and rules.
3. To receive at the time of admission and during the stay a written statement of the services provided by the facility, including those required to be offered on an as-needed basis, and of related charges. Charges for services not covered under Medicare or Medicaid must be specified. The resident should sign as evidence that this information has been given.
· Charges not included in the facilityís basic daily rate should
be given to the resident. This may include such items as beautician
services, cosmetics, some personal care items, etc. Items covered
under Medicaid should be identified, as well as items charged directly
to the resident.
4. To have on file in the patientís record the orders of the attending physician with the proposed schedule of medical treatment. Written evidence of informed consent to participate in research must also be evident if the resident is participating in a research project.
· Each residentís diagnosis must be in the medical chart along
with an individualized plan of care for the resident. Residents and
the residentsí legal representatives must be invited to be involved in
the care planning process.
5. To receive respect and privacy in the patientís medical care program. Case discussion, consultation, and treatment shall remain confidential and shall be conducted discreetly. Personal and medical records shall be confidential, and written consent of the patient shall be obtained for their release to any individual, other than family members, except as needed in case of the patientís transfer to another health care institution or as required by law or third party payment contract.
· Generally, most facilities require written consent before the
release of confidential information such as would be found in a residentís
records. Access should be allowed to staff and consultants involved in
the residentís direct care on a ďneed to knowĒ basis.
6. To be free from mental and physical abuse and, except in emergencies, to be free from chemical and physical restraints unless authorized for a specified period of time by a physician according to clear and indicated medical need.
· Residents should always be treated courteously and professionally
by facility staff. Acts of humiliation, harassment, threats or deprivation
are examples of mental abuse.
7. To receive from the administrator of the facility a reasonable response to all requests.
· Facilities should not arbitrarily dismiss or ignore resident
requests which are not excessive and which would improve the quality of
the residentís life. On the other hand, residents should not expect that
every request will or can be granted without consideration of practicality
or potential harm to a residentís health or safety.
8. To associate and communicate privately and without restriction with persons and groups of the patientís choice on the patientís initiative or that of the persons or groups at any reasonable hour; to send and receive mail promptly and unopened, unless the patient is unable to open and read personal mail; to have access at any reasonable hour to a telephone where the patient may speak privately; and to have access to writing instruments, stationery, and postage.
· Provisions should be made for residents to visit privately
with visitors, particularly when the resident shares a semi-private room.
Reasonable hours are considered to be the normal waking hours of the day.
The facility must allow a visitor to see a resident at the residentís request,
even during odd times, should unusual circumstances warrant such flexibility,
for example, an emergency visit from out of town relatives, or a need to
relay important information to the resident.
9. To manage the patientís financial affairs unless authority has been delegated to another pursuant to a power of attorney, or written agreement, or some other person or agency has been appointed for this purpose pursuant to law. Nothing shall prevent the patient and facility from entering a written agreement for the facility to manage the patientís financial affairs. In the event that the facility manages the patientís financial affairs, it shall have an accounting available for inspection and shall furnish the patient with a quarterly statement of the patientís account. The patient shall have reasonable access to this account at reasonable hours; the patient or facility may terminate the agreement for the facility to manage the patientís financial affairs at any time upon five days notice.
10. To enjoy privacy in visits by the patientís spouse and, if both are residents of the facility, they shall be afforded the opportunity, where feasible, to share a room.
· The basic intent of this Right is to assure that there is a
method of arranging for privacy as may be necessary for visits between
spouses. In the case of semi-private rooms or wards, other special arrangements
may have to be made. There should be provisions to assure conjugal visits
and that complete privacy can be maintained at all times.
11. To enjoy privacy in the patientís room.
· Residents should expect the greatest degree of privacy that
is possible under institutional circumstances and as his condition allows.
A partially closed door or drawn curtain allows privacy from the staff
and visitors as they pass in the hallways. Resident rooms should not be
used for ingress or egress to other areas of the building. Likewise, resident
telephones and private bathrooms should not be used by unauthorized persons.
12. To present grievances and recommend changes in policies and services, personally or through other persons or in combination with others, on the patientís behalf or that of others to the facilityís staff, the community advisory committee, the administrator, the Department, or other persons or groups without fear of reprisal, restraint, interference, coercion, or discrimination.
· Each facility should have procedures in place for receiving
resident recommendations for changes within the facility.
13. To not be required to perform services for the facility without personal consent and the written approval of the attending physician.
14. To retain, to secure storage for, and to use personal clothing and possessions, where reasonable.
· Prior to admission, the facility should clearly specify in
writing any limitations on the amount and type of personal property or
clothing that will be allowed. Within reason, each resident should be able
to decorate their living space with personal pictures, small sentimental
items, and possibly a small personal chair if space permits without interfering
with another residentís space, proper nursing care, or with proper cleaning
of the room.
15. To not be transferred or discharged from a facility except for medical
reasons, the patientís own or other patientís welfare, nonpayment for the
stay, or when the transfer or discharge is mandated under Title XVIII (Medicare)
or Title XIX (Medicaid) of the Social Security Act. The patient shall be
given at least five daysí advance notice to ensure orderly transfer or
discharge, unless the attending physician orders immediate transfer, and
these actions and the reasons for them shall be documented in the patientís
medical record. (1977, c. 897,s.1; 1983, c. 775, s.1)
· All residents have the right to receive 30 days' advance written notice of intent to discharge or transfer them (unless it is an emergency discharge as outlined in federal discharge regulations). Included with the written advance notice must be information advising the resident of his right to appeal the intended discharge and a copy of the Hearing Request Form.
16. To be notified within 10 days after the facility has been issued
a provisional license because of violation of the licensure regulations
or received notice of revocation of license by the North Carolina Department
of Human Resources and the basis on which the provisional license or notice
or revocation of license was issued. The patientís responsible family member
or guardian shall also be notified.