Residents' Rights: Your Life, Your Care, Your Choices

Welcome to a presentation on Residents' Rights,

brought to you by the National Ombudsman Resource Center

and the National Consumer Voice for Quality Long-Term Care.

Did you know residents of nursing homes have rights in

addition to rights as a US citizen or resident?

This additional set of rights called Residents'

Rights is legally protected by federal law.

The nursing home must protect and promote all of your rights,

and exercising your rights can help ensure you have the

quality of care and life that you want and need.

Consider this…

You like to stay up late and get up midmorning.

Staff tell you that if you want to have breakfast,

you must be in the dining room by 8 a.m.

Staff ask for your input,

but your only means of communicating is to move your head.

You have more to share but can't without proper support.

Your nursing home has a weekly church service open to all residents.

You ask the staff about inviting a rabbi to lead a service and are told "no."

Can anything be done?

Yes.

Residents' Rights gives you the power to have

your needs met and your preferences respected.

Residents' Rights have impact.

Knowing and exercising your rights enhances quality of life and care

through things like dignity,

self-determination,

choices,

information,

and communication.

Residents' rights empower you.

They put you in the driver's seat to participate and

make decisions about all aspects of your care and life.

Congress created Residents' Rights to remedy the

power and balance between residents and staff

and personalize a person's care in nursing homes.

Overview of Residents' Rights:

You have the right to exercise your rights both as a resident

of the facility and as a citizen of the United States,

and you have the right to do so without interference or retaliation.

You have the right to be treated with dignity and respect.

This includes the right to equal access to quality care;

freedom from abuse,

neglect,

and exploitation;

freedom from physical and chemical restraints;

and a safe environment.

You have the right to choices about your care,

your personal space,

and your lifestyle.

This includes things like helping to develop your own care plan,

choosing your own doctors,

and refusing medication.

You also have the right to things like a safe environment

and easy access to your belongings and your call light.

You also have the right to make choices about surrogate decision makers,

personal care,

and activities.

You have the right to be fully informed.

This means you should have access to things like

information in a language and format you understand,

facts about risks and benefits of proposed care,

your own records,

and contact information for your doctors and relevant agencies,

such as the Long-Term Care Ombudsman Program.

You have the right to access.

This means having the ability to have visitors you

want, at a time you choose; or decline visitors;

see your doctor;

or participate in social,

religious,

or community activities inside or outside the facility.

You have the right to handle your own finances.

This includes having the right to manage your own money,

receive financial statements and information about services and charges,

and have excess personal funds deposited in a separate account.

You have the right to privacy.

This includes privacy and communications, such as mail,

e-mail,

or verbal conversations

in personal,

financial,

or medical affairs,

and during treatment and care of personal needs.

You have the right to make complaints.

This includes making complaints to the facility or

to outside agencies like the state survey agency

or the Long-Term Care Ombudsman Program.

You have the right to stay in the facility unless a transfer or discharge

is necessary for your health and safety or the health and safety of others.

You have the right to receive a 30-day discharge notice, and to appeal

that notice, and to stay in the facility until the appeal is decided.

You also have the right to information about your rights to

return to the facility after a hospital stay or therapeutic leave.

If you do not need to move,

you have the right to a preparation for a safe discharge.

You can exercise your rights as long as

they don't infringe upon the rights of others.

Tips for exercising Residents' Rights:

As a general principle,

you have the right to choose aspects of your life that are important to you.

You have the right to make choices about things like your schedule,

visitors,

and medical decisions.

Think about these rights as you encounter situations

you have an issue within the facility.

For example:

You need more information or advice from a third party to make a decision.

You are not given a choice like a requirement to

see a certain doctor or required meal times and locations.

You are told there is a certain policy for all residents.

For example:

one shower per week, or no visitors after 8 p.m.

An advocate can help you with your rights.

Get to know the Long-term Care Ombudsman Program.

The Long-Term Care Ombudsman Program advocates for changes to

improve quality of life and care for residents.

If you are unsure of whether you have a right,

you can ask staff or an Ombudsman Program representative.

Invite an Ombudsman Program representative to the next Resident Council meeting.

The nursing home is required to post

information about Residents' Rights and explain them,

protect and promote the rights of each resident,

ensure residents can exercise their rights without interference or retaliation,

and treat each resident with respect and dignity,

and care for each resident in a way that maintains

or enhances quality of life, according to the resident.

In a nursing home that promotes rights,

residents,

surrogate decision makers,

and staff know residents' rights and

assist residents in exercising their rights.

Staff know residence as people,

understanding their needs,

preferences,

and natural rhythms,

and offer alternative ways to communicate when needed.

A nursing home that promotes rights will offer information and choices,

have a diversity of food and activities,

practice person-centered care,

and treat people with dignity and respect.

In a nursing home that promotes Residents' Rights,

residents and staff are happier.

Tips for surrogate decision makers:

A resident may choose a person to act on their behalf and exercise their rights.

Surrogate decision makers include a resident representative,

agents with powers of attorney,

agents with durable powers of attorney,

and guardians.

When helping a resident as a surrogate decision maker,

be sure to get input from the resident and discuss what he or she needs and prefers.

If the resident is cognitively unable to give input,

rely on your knowledge of the resident and what he or she would prefer.

Only if needs are unattainable, base your decisions

on the best interests of the person.

And remember,

whenever possible,

do what the resident would have wanted,

not what you personally would choose.

If your rights are not being protected or promoted,

speak to a trusted family member or friend,

staff member,

or an Ombudsman Program representative.

Identify which right is being violated,

and decide if and how you will address the situation.

For example,

meet with the staff person,

raise the issue at a Resident Council meeting,

or make a complaint to the state survey

agency or your Long-Term Care Ombudsman Program.

If you make a complaint to your Ombudsman Program representative,

he or she will listen to you and support you,

provide helpful information,

work with you to resolve the issue,

keep your conversation confidential,

and only act with your permission.

There are strict federal and state laws prohibiting acts

of retaliation for voicing grievances and making complaints.

Let your Ombudsman Program representative know when you have spoken up.

It's quiz time.

Answer true or false to each of the following statements,

and write down which Residents' Right pertains to the statement.

Number one:

You must follow doctor's orders.

Number 2:

When you are in a nursing home,

you must eat at the mealtime set by staff,

even if breakfast is at 8 a.m. and you would never eat that early.

Number 3:

You must communicate your input to the

facility using only written or oral communications,

even if you can only communicate through motion.

Number 4:

Your only choice of religious activity is the

weekly church service at the nursing home,

even if it is not affiliated with your religion.

And number 5:

A resident can only use the facility's grievance process to resolve a problem.

Please feel free to pause this presentation while you record your answers.

Ready for the answers.

The answer to the first statement is false.

You don't have to follow doctor's orders.

The resident has the right to be fully informed and make decisions

about all aspects of life that are important to him or her.

Residents must be informed of the risks and benefits of any care,

treatments,

or orders,

and he or she has the right to refuse.

The second statement is also false.

You can eat at your desired meal times,

even if they are different from the scheduled meal.

Residents have the right to make choices about their schedule,

including meal times.

The third statement is false.

The facility must take your input into consideration and

provide any support you need to communicate your input.

Residents have the right to information and communications

in any language and format they understand,

such as Spanish or Braille.

The fourth statement is also false.

You can practice the religion of your choosing,

regardless of the facility's scheduled religious services.

Residents have the right to freely practice their own

religion and can have visitors at any time,

including clergy.

Lastly,

the fifth statement is false.

You don't have to use the facility's grievance process to resolve a problem.

A resident has the right to choose how to get his or her problem solved.

He or she can file grievances with the facility or make a

complaint to the state survey agency or the Long-Term Care Ombudsman Program.

Some additional resources you may find helpful include the

National Long-Term Care Ombudsman Resource Center web page,

the NORC Nursing Home page,

the NORC Federal Nursing Home Regulations page,

the Long-Term Care Ombudsman Program,

and Long-Term Care Ombudsman Service advocates for quality of

life and care for people who live in long-term care facilities,

and talking to a long-term care ombudsman is free and confidential.

The National Consumer Voice for Quality Long-Term Care web page,

the Consumer Voice Nursing Home Residence page,

and the Consumer Voice Federal Nursing Home Regulations page.

You can contact the National Ombudsman Resource Center,

or NORC, through our website at www.ltcombudsman.org

or connect with us through Facebook at

the National LTC Ombudsman Resource Center or on Twitter @LTCombudcenter.

Thank you for joining us, and contact us if you have any questions.