Different standards apply to nursing homes depending on how the institution is classified. In order from those providing the lowest to the highest level of nursing care, these classifications are “adult boarding”, “residential care”, “intermediate care”, and “skilled nursing” facilities. Federal and state governments regulate intermediate and skilled nursing facilities, especially with respect to their involvement with Medicare and Medicaid. National standards for “extended care” facilities are outlined in the Federal Medicare Health Insurance Program for the Aged.
Federal and state laws govern facilities participating in Medicaid or Medicare, whereas only state laws apply to those that do not. Under federal guidelines, nursing homes must provide written policies and procedures with respect to mistreatment, abuse and neglect of residents. Residents are entitled to receive written and verbal notice of the services and rights to which they are entitled and they must acknowledge receipt of such notice.
Nursing home residents have the right to see representatives of the state and federal government, family members, physicians, service providers, and ombudsmen or other resident advocates. An ombudsman investigates and helps resolve resident complaints. Ombudsmen do not charge for their services and do not regulate the facility.
A resident can only be removed from a facility if the resident no longer needs the nursing home’s services, if it is necessary for the resident’s welfare or for the safety of others, the resident fails to make payments after reasonable notice, or if the facility closes. The nursing home must provide 30 days’ notice of a discharge or proposed transfer, and the resident has the right to appeal.
Facilities that participate in the Medicaid program are required to supply written notice of the state bed hold policy to a resident and family member before transferring the resident for therapy or hospitalization. A bed hold period is the length of time a resident’s bed will be held open for their return. Residents who return after the bed hold period expires have the right to be readmitted when a semi-private bed becomes available.
Other rights nursing home residents are entitled to include:
* Keeping their personal possessions
* Applying for Medicare and Medicaid benefits without being discriminated against for receiving such benefits
* Being treated the same as other residents
* Confidentiality of their clinical and personal records
* A listing of services paid by Medicare and Medicaid and all additional fees and services
* A choice in their own physician
* Full information and participation in the planning with regard to their medical care
* Refusal of any treatment
* Not being kept apart from other residents against their will
* Not to be restrained if not necessary
* To raise grievances and to have them resolved expeditiously
* To participate in religious, social and community activities
* Not to be required to deposit their personal funds with the nursing home
* To privacy, including that with regard to medical treatment, visits, communications, and meetings with resident groups and family
* To review the most recent state inspection report
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