Nursing Homes: Knowing Residents’ Legal Rights

Nursing Homes: Knowing Residents’ Legal Rights

There is no quicker route to a professional liability claim than violating federal regulations. Though nursing homes are not technically “hospitals” (they are instead defined as private institutions that provide food, shelter, and care for sick or aged individuals), they may be legally considered hospitals for selected purposes under some statutes, and their residents all have certain rights that cannot be violated.

Under federal regulations, there are four levels of healthcare facilities, with each one being subject to different standards. The four levels are, in ascending order of level of care, adult boarding facilities, residential care facilities, intermediate care facilities, and skilled nursing facilities. Skilled nursing facilities and intermediate care facilities are typically governed by state and federal regulations, and federal guidelines require that nursing facilities all develop and implement written policies and procedures that forbid the abuse, mistreatment, or neglect of residents. In addition to establishing requirements for nursing home procedure, these guidelines also establish the rights that all residents have.

Residents’ Legal Rights

These are the legal rights of nursing home residents, under federal guidelines:

  • Knowledge of their rights. All nursing home residents are entitled to receive both oral and written notice of their rights and the services to which they are entitled while they are residing in the facility. The facility must give said notice before or upon admission (as well as on a regular basis throughout the resident’s stay) in a language that the resident understands, and the resident must given written acknowledgment of the notice.
  • The right to visitors. Nursing home residents have the right to see family members, ombudsmen, resident advocates, physicians, service providers, and government representatives.
  • Personal possessions. Residents have the right to keep and use their personal items and clothing unless doing so would have an adverse effect on their health and safety.
  • Benefits. Residents have the right to apply for and receive Medicare and Medicaid benefits, cannot be expelled from or asked to leave a home for receiving said benefits, and must be given equal treatment to private payers. In addition, they are entitled to know which services are paid by Medicaid and Medicare and the fees for services that are not covered.
  • Autonomy. Residents have the right to choose their own personal physician, to participate in the planning of their treatment and care, to refuse treatment, and to participate in religious and social activities (as long as they do not interfere with other residents’ rights).
  • Information. Residents have the right to be fully informed of their treatment and care, to review their medical records within twenty-four hours of a request, to view the home’s most recent state inspection report, to have notice prior to a room or roommate change, to have 30 days’ notice of a proposed transfer or discharge (as well as the right to appeal), and the amount of time their bed will be in “bedhold” if they are transferred for any reason.
  • Privacy. Residents have the right to keep their clinical and personal records confidential as well as the right to privacy in their rooms, in medical treatment, and in communication, visits, and meetings with family and other groups.
  • The right to raise grievances. Residents have the right to raise grievances with the facility and have them resolved in a timely manner.
  • Humane treatment. Residents must be kept free from physical and mental abuse, and they cannot be kept apart from other residents against their will or physically or medically restrained if restraint is not a necessary part of their medical treatment.

About Caitlin Morgan

Caitlin Morgan specializes in insuring assisted living facilities and nursing homes and can assist you in providing insurance and risk management services for this niche market. Give us a call to learn more about our programs at 317.575.4440.