The American with Disability Act (ADA), signed into law in 1990, mandates that individuals with disabilities shall have access to jobs, public accommodations, government services, public transportation, and telecommunications – essentially, participation in, and full access to, all aspects of society. The law is compromised of five titles, with Titles II and III of particular importance for healthcare facilities such as nursing homes, assisted living facilities, day-care centers, ambulatory treatment or diagnostic centers, hospitals and professional offices of health care providers.
Title II of the ADA covers state and local governments, including organizations providing services on their behalf, such as state and city hospitals and clinics, regardless of the receipt of federal funding. Title III of the ADA covers all “places of public accommodation.” Places of public accommodation are places that are open to the public where an individual obtains goods and services and include, but are not limited to, private doctors’ offices, hospitals and clinics, nursing homes, irrespective of the receipt of federal funds. Federal agencies, such as the Office for Civil Rights of the Department of Health and Human Services and the Department of Justice’s Civil Rights Division, enforce these federal anti-discrimination laws as they relate to violations in health care settings.
What does this mean for a nursing home or assisted living facility? As a health care provider, the facility is required to ensure that health services are fully accessible and equally provided to individuals with disabilities. As such, an individual with a disability must have access to the same healthcare services that someone without a disability receives. Full and equal access to care can be achieved through the by removing physical barriers, providing “auxiliary aids and services,” or making reasonable changes to policies, practices, and procedures.
For example, many residents at a nursing home or assisted living facility may be ambulatory to varying degrees but will require the assistance of canes, crutches, walkers, or wheelchairs. To accommodate these residents, all spaces used by them, both inside and out, should:
- Comply with the requirements of the Americans with Disabilities, and, if federally funded or owned, the GSA’s ABA Accessibility Standards
- Be designed so that all spaces, furnishings, and equipment, including storage units and operable windows, are easily usable by residents in wheelchairs
- Be equipped with grab bars in all appropriate locations
- Be free of tripping hazards
- Be located on one floor if feasible, preferably at grade. If residents’ bedrooms must be located on more than one floor, then dining space must be apportioned among those floors, not centralized
Another example is that many elderly people in a nursing home or assisted living facility may have trouble reading signs from a distance. The ADA outlines specific standards for various elements of ADA signs for them to be specifically readable for even visually impaired people. In a nursing home environment the following elements are important for signage:
- No glare. All ADA-compliant signs must have characters and backgrounds that do not create any glare. People who have vision problems do not process these reflections very well, especially elderly people.
- High contrast. People who have vision problems have a hard time discerning dark characters on somewhat dark backgrounds, or light characters on light backgrounds. There needs to be a high level of contrast between backgrounds and characters so the signs are easily read from afar and by people who have vision problems.
- Word standards. All typefaces should be easy to read and put in sans serif or simple serif fonts with medium-weights strokes. Letters should be of an appropriate size based on the distance the reader is expected to be at when reading them.
- Sign placement. There are specific instructions as to how high signs should be mounted and how far away from doorways they should be placed.
These are but just a few examples required for healthcare facilities to ensure ADA-compliance. At Caitlin Morgan, we specialize in securing insurance programs for nursing homes and assisted living facilities in addition to providing turnkey risk management services such as compliance requirements for ADA. For detailed information about our products and services, contact us at 877.226.1027.