Nursing home residents' rights

Last updated
Rights
HumanRightsLogo.svg
Theoretical distinctions
Human rights
Rights by beneficiary
Other groups of rights

Nursing home residents' rights are the legal and moral rights of the residents of a nursing home. [1] Legislation exists in various jurisdictions to protect such rights. An early example of a statute protecting such rights is Florida statute 400.022, enacted in 1980, and commonly known as the Residents' Rights Act. [2]

Contents

Specific rights protected vary greatly by jurisdiction. Types of rights protected include: dignity, medical privacy, pecuniary, dietary and visitation rights. Process rights, such as right of complaint, are also sometimes protected. [3]

Motivations for residents' rights

In the United States, concerns about poor quality care and ineffective regulation of nursing homes date back to the 1970s. Early regulation focused on the ability of nursing homes to provide care, rather than on the quality of the care provided or the experience of the individuals receiving care. In the 1980s, particularly in response to an influential Institute of Medicine (IoM) report, the US federal government moved to address these concerns by enacting more resident-focused regulations, and among these were a number of new quality-of-life rights for residents of nursing homes. [4] [5] Similar concerns over quality of care motivated people in other countries to advocate for residents' rights. [6] [7]

Australia

Advocates for residents' rights in Australia have established a Charter of Residents' Rights and Responsibilities and the Department of Health and Ageing provides an official unit to deal with complaints. In 1987, the government introduced substantial reform and regulation which included a program to monitor standards. [8]

Canada

Nursing home residents' rights in Canada appear to have been primarily legislated at the provincial level. In Ontario, for instance, [9] the Long Term Care Homes Act 2007 contains a "Residents' Bill of Rights", including, inter alia, the rights to be treated with courtesy and respect; to privacy in treatment; to be informed of one's medical condition and treatment; to consent to or refuse treatment; to confidentiality of medical records and treatment; to receive visitors; and, when near death, to have family members present 24 hours a day. [10]

New Zealand

Since 1994, New Zealand has protected residents rights' (and rights of disabled people more broadly) under the Health and Disability Commissioner Act, including rights to respect, freedom from discrimination and coercion, dignity, communication in a language the resident can understand, information and informed consent, and right of complaint. [11] [12]

United Kingdom

Residents' rights in the UK appear to have been primarily legislated at the country level. In England, for instance, [9] the Care Quality Commission, the health and social care regulator for England, describes national minimum standards under the Care Standards Act 2000 for services in care homes, including dignity and privacy rights, dietary and pecuniary rights, and the right to complain if one is unhappy with the care provided. [13]

United States

Residents' rights in the US are protected at both the federal and state level. However, the legal rights of nursing home residents are currently controversial, as delegation clauses used in many nursing home contracts have been blamed for effectively permitting the rape of residents. [14]

Federal law

In 1980 the Civil Rights of Institutionalized Persons Act was passed to protect the civil rights of, amongst others, residents of nursing homes and similar facilities. In 1987, amendments known collectively as the Federal Nursing Home Reform Act, including a robust section on nursing home residents' rights, were attached to an Omnibus Budget Reconciliation Act of 1987 (OBRA '87) which was then enacted into law and codified at section 483 of Volume 42 of the Code of Federal Regulations and related United States Code sections. [15] [16] [17] These required nursing homes to provide facilities to ensure that residents had a high quality of life, good physical and mental activities, and were able to participate in the administration of the home. Appeals to an ombudsman in case of dispute were to be facilitated. [18] However, the act's protections may or may not apply to some nursing home residents whose nursing homes receive only state funds, and do not participate in Medicare or Medicaid. [19]

Some rights provided by federal law as of 2010 include rights to dignity, privacy, freedom from discrimination, freedom from restraint, to be informed of medical care and treatment, pecuniary rights, visitation, rights of complaint and protection against transfer and unfair discharge. [20] Specific rights include: choice of physician and involvement in treatment options; a right to be admitted without a third-party guarantee as a condition of admission; freedom from improper physical or chemical restraints; freedom from abuse; right to be treated with dignity; right to reasonable accommodation; right to participate in planning care and treatment and any changes in care and treatment; right to informed consent in language patient can understand; right to refuse treatment; right of family and Ombudsman to immediately access resident and have reasonable access to facility; right to privacy, confidentiality, and visitors; a right to not be transferred unless necessary to meet residents' needs, resident no longer requires care, safety of others is endangered, resident has failed to make own payments, or facility no longer operates; right to readmission; right to appeal hearings; right to have necessary care and services for highest practicable well-being; right to have adequate number of personnel; and, various rights respecting the residents' financial matters and need for proper notice and information. [21]

State law

In addition to the rights required by federal law and regulation, additional rights and protections may be extended to residents of long-term care facilities under state law. [22]

California

In California, [9] certain rights are protected. As of 2010, these include: a contract will not require the resident to provide advance notice of voluntary discharge; arbitration agreements may not be required as a condition of admission; an arbitration agreement may be rescinded by the resident or his or her agent within 30 days of signing it; a third party guaranty of payment may not be a condition of admission; Facility may not transfer or discharge resident for switching to Medi-Cal, or while qualification for Medi-Cal is still being determined; resident has a right to be notified in writing about discharges and transfers; resident has a right to appeal discharge and transfer decisions; resident has a right to return to a facility after a temporary stay in a hospital—to the first available bed, with Medi-Cal paying for the first seven days; resident has the right to visitors, and to privacy; and, that there shall be an adequate number of personnel on staff. [21] [23]

There are still other protections for California residents, in part, because California incorporates federal law with respect to nursing home protections. [24] [25]

Florida

Florida enacted nursing home reform in 2016 through its Chapter 400 Residents' Rights legislation. [26] The legislation allows for civil lawsuits brought on behalf of the victim or the victim's survivors, to enforce the resident's rights. This allowed nursing home corporations to be held accountable by juries, thereby creating a financial disincentive to bad nursing home care. [2]

Illinois

In Illinois, residents in nursing homes have the right to be fully informed of available services and the charges of each service. They have the right to be informed of all facility rules and regulations, including a written copy of all residents rights. Illinois nursing home residents have the right to receive information in a language they understand: English, Spanish, Braille, or any other language they wish to receive it in.

Residents have the right to complain to the staff or any other person without the fear of reprisal and are able to file a complaint with the state survey and certification agency. They have the right to participate in one's own care which includes receiving adequate and appropriate care. And are also able to participate in their own assessment, care-planning, treatment and discharge. Residents are able to refuse any medication or treatments and is always able to review one's medical record. Residents have the right to privacy and confidentiality regarding all medical, personal, or financial affairs.

Residents also have the rights to make independent choices, these include: Making personal decisions such as what to wear and how to spend free time, choose their own physician, participate in community activities that are both inside and outside of the nursing home, organize and participate in a resident council, and manage one's own financial affairs. [27]

Wisconsin

In Wisconsin, residents have the right to dignity. This means they have the right to be valued as an individual, to maintain and enhance their self-worth, to be treated with courtesy, respect and dignity, free from humiliation, harassment or threats. They have the right to privacy. They have the right to personal privacy during care and treatment, the right to confidentiality concerning their personal and medical information as well as the privacy to send and receive mail without interference. Residents have the right to access quality care for all residents, and to be told in advance about care and treatment, including all risks and benefits.

Residents have the right to remain in the facility unless there is a valid, legal reason for transfer or discharge and the resident will receive a 30-day written notice with the reason for the transfer or discharge, including appeal rights and information. Nursing home residents have the right to be offered choices and allowed to make decisions, and can expect that the facility will accommodate the individuals needs and preferences. Residents have the right to accept or refuse care and treatment, and are able to choose their own health care providers including their doctor and pharmacy of choice. [28]

See also

Related Research Articles

A patient's bill of rights is a list of guarantees for those receiving medical care. It may take the form of a law or a non-binding declaration. Typically a patient's bill of rights guarantees patients information, fair treatment, and autonomy over medical decisions, among other rights.

<span class="mw-page-title-main">Home care in the United States</span>

Home care is supportive care provided in the home. Care may be provided by licensed healthcare professionals who provide medical treatment needs or by professional caregivers who provide daily assistance to ensure the activities of daily living (ADLs) are met. In-home medical care is often and more accurately referred to as home health care or formal care. Home health care is different non-medical care, custodial care, or private-duty care which refers to assistance and services provided by persons who are not nurses, doctors, or other licensed medical personnel. For patients recovering from surgery or illness, home care may include rehabilitative therapies. For terminally ill patients, home care may include hospice care.

Medical privacy, or health privacy, is the practice of maintaining the security and confidentiality of patient records. It involves both the conversational discretion of health care providers and the security of medical records. The terms can also refer to the physical privacy of patients from other patients and providers while in a medical facility, and to modesty in medical settings. Modern concerns include the degree of disclosure to insurance companies, employers, and other third parties. The advent of electronic medical records (EMR) and patient care management systems (PCMS) have raised new concerns about privacy, balanced with efforts to reduce duplication of services and medical errors.

<span class="mw-page-title-main">Health Insurance Portability and Accountability Act</span> United States federal law concerning health information

The Health Insurance Portability and Accountability Act of 1996 is a United States Act of Congress enacted by the 104th United States Congress and signed into law by President Bill Clinton on August 21, 1996. It modernized the flow of healthcare information, stipulates how personally identifiable information maintained by the healthcare and healthcare insurance industries should be protected from fraud and theft, and addressed some limitations on healthcare insurance coverage. It generally prohibits healthcare providers and healthcare businesses, called covered entities, from disclosing protected information to anyone other than a patient and the patient's authorized representatives without their consent. With limited exceptions, it does not restrict patients from receiving information about themselves. It does not prohibit patients from voluntarily sharing their health information however they choose, nor does it require confidentiality where a patient discloses medical information to family members, friends, or other individuals not a part of a covered entity.

<span class="mw-page-title-main">Nursing home</span> Type of residential care

A nursing home is a facility for the residential care of elderly or disabled people. Nursing homes may also be referred to as care homes, skilled nursing facilities (SNF) or long-term care facilities. Often, these terms have slightly different meanings to indicate whether the institutions are public or private, and whether they provide mostly assisted living, or nursing care and emergency medical care. Nursing homes are used by people who do not need to be in a hospital, but cannot be cared for at home. The nursing home facility nurses have the responsibilities of caring for the patients' medical needs and also the responsibility of being in charge of other employees, depending on their ranks. Most nursing homes have nursing aides and skilled nurses on hand 24 hours a day.

A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health care provider.

An assisted living residence or assisted living facility (ALF) is a housing facility for people with disabilities or for adults who cannot or who choose not to live independently. The term is popular in the United States, but the setting is similar to a retirement home, in the sense that facilities provide a group living environment and typically cater to an older adult population. There is also Caribbean assisted living, which offers a similar service in a resort-like environment.

<span class="mw-page-title-main">Medical record</span> Medical term

The terms medical record, health record and medical chart are used somewhat interchangeably to describe the systematic documentation of a single patient's medical history and care across time within one particular health care provider's jurisdiction. A medical record includes a variety of types of "notes" entered over time by healthcare professionals, recording observations and administration of drugs and therapies, orders for the administration of drugs and therapies, test results, x-rays, reports, etc. The maintenance of complete and accurate medical records is a requirement of health care providers and is generally enforced as a licensing or certification prerequisite.

The Patient Self-Determination Act (PSDA) was passed by the United States Congress in 1990 as an amendment to the Omnibus Budget Reconciliation Act of 1990. Effective on December 1, 1991, this legislation required many hospitals, nursing homes, home health agencies, hospice providers, health maintenance organizations (HMOs), and other health care institutions to provide information about advance health care directives to adult patients upon their admission to the healthcare facility. This law does not apply to individual physicians.

The American Health Care Association (AHCA) is a non-profit federation of affiliated state health organizations that represents more than 14,000 non-profit and for-profit nursing homes, assisted living communities, and facilities for individuals with disabilities. The organization's president and CEO is Mark Parkinson, a former governor of Kansas. The National Center for Assisted Living (NCAL) is a part of the AHCA.

Patient advocacy is a process in health care concerned with advocacy for patients, survivors, and caregivers. The patient advocate may be an individual or an organization, concerned with healthcare standards or with one specific group of disorders. The terms patient advocate and patient advocacy can refer both to individual advocates providing services that organizations also provide, and to organizations whose functions extend to individual patients. Some patient advocates are independent and some work for the organizations that are directly responsible for the patient's care.

<span class="mw-page-title-main">Patient dumping</span> Inappropriately releasing homeless or indigent patients

Patient dumping or homeless dumping is the practice of hospitals and emergency services inappropriately releasing homeless or indigent patients to public hospitals or on the streets instead of placing them with a homeless shelter or retaining them, especially when they may require expensive medical care with minimal government reimbursement from Medicaid or Medicare. The term homeless dumping has been used since the late 19th century and resurfaced throughout the 20th century alongside legislation and policy changes aimed at addressing the issue. Studies of the issue have indicated mixed results from the United States' policy interventions and have proposed varying ideas to remedy the problem.

<span class="mw-page-title-main">Philosophy of healthcare</span>

The philosophy of healthcare is the study of the ethics, processes, and people which constitute the maintenance of health for human beings. For the most part, however, the philosophy of healthcare is best approached as an indelible component of human social structures. That is, the societal institution of healthcare can be seen as a necessary phenomenon of human civilization whereby an individual continually seeks to improve, mend, and alter the overall nature and quality of their life. This perennial concern is especially prominent in modern political liberalism, wherein health has been understood as the foundational good necessary for public life.

<span class="mw-page-title-main">Health and Disability Commissioner Act 1994</span> Act of Parliament in New Zealand

The Health and Disability Commissioner Act is an Act of Parliament passed in New Zealand in 1994. Thus, since 1994, New Zealand has protected the rights of the disabled under the Act including rights to respect, freedom from discrimination and coercion, dignity, communication in a language the resident can understand, information and informed consent, and right of complaint.

<span class="mw-page-title-main">Civil Rights of Institutionalized Persons Act</span>

The Civil Rights of Institutionalized Persons Act (CRIPA) of 1980 is a United States federal law intended to protect the rights of people in state or local correctional facilities, nursing homes, mental health facilities, group homes and institutions for people with intellectual and developmental disabilities.

<i>Personal Health Information Protection Act</i> Ontario legislation established in 2004

The Personal Health Information Protection Act, also known as PHIPA ('pee-hip-ah'), is Ontario legislation established in November 2004. PHIPA is one of two components of the Health Information Protection Act 2004. The Health Information Protection Act, also established in 2004, comprises two schedules: PHIPA and the Quality of Care Information Protection Act. The PHIPA replaced the Health Cards and Numbers Control Act.

Sidney Katz, MD was a pioneering American physician, scientist, educator, author, and public servant who developed the Index of Independence of Activities for Daily Living (ADLs) in a career spanning more than sixty years. He made several other advances in geriatric care, including the U.S. Nursing Home Reform Act of 1987, which established basic rights for nursing home residents. Katz received several public and private awards, including the Maxwell A. Pollak Award (1993) and the American Geriatrics Society’s (AGS) Foundation for Health in Aging (2001). The AGS award was also won by former US President Jimmy Carter and poet Maya Angelou.

As of 2017, approximately 1.4 million Americans live in a nursing home, two-thirds of whom rely on Medicaid to pay for their care. Residential nursing facilities receive Medicaid federal funding and approvals through a state health department. These facilities may be overseen by various types of state agency.

Elder rights are the rights of older adults, who in various countries are not recognized as a constitutionally protected class, yet face discrimination across many aspects of society due to their age.

The authority for patient rights in New Zealand comes from the Health and Disability Commissioner Act 1994, the specific rules come from Health and Disability Commissioner Regulations 1996. This code improves the quality of healthcare in New Zealand and ensures that there is a consistent expectation for all consumers.

References

  1. ↑ Nevins, A.; Girling-Zanger, C. (1988), "Nursing Home Residents' Rights", The Gerontologist, 28 (6): 842–843, doi:10.1093/geront/28.6.842a, archived from the original on 29 January 2011
  2. 1 2 "Residents' Rights". Florida's Long-Term Care Ombudsman Program. State of Florida, Department of Elder Affairs. Retrieved 9 March 2018.
  3. ↑ This paragraph summarizes material in the body; details and citations are found below. For examples of dignity and privacy rights, see #United Kingdom and #Canada. For pecuniary rights and rights of complaint, see #United States and #United Kingdom. See #Canada and #United States for rights of visitation.
  4. ↑ Improving the quality of care in nursing homes. Committee on Nursing Home regulation, Institute of Medicine (U.S.). 1986. ISBN   978-0-309-03646-7.
  5. ↑ Joshua M. Wiener; Marc P. Frieman; David Brown (December 2007). "Nursing Home Care Quality: Twenty Years After the Omnibus Budget Reconciliation Act of 1987" (PDF). Kaiser Family Foundation. pp. 3–8. Retrieved 19 July 2010.
  6. ↑ Luciani, Tracy (3 September 1986). "Nursing-home laws a 'disgrace,' group says". Toronto Star. Canada. Retrieved 19 July 2010. All of these homes, including the one here, are operating within the law, and the major thing that needs changing ... is the Ontario Nursing Home Act.
  7. ↑ Nicole Kershen & Marie Mercat-Bruns (June 1993). "Towards reform of long-term care in France". Ageing International. 20 (2): 20–26. doi:10.1007/BF03032492. S2CID   144710441. Other issues not fully addressed by the reports are residents' rights in institutions ...
  8. ↑ Diane Gibson; Gavin Turrell; Anne Jenkins (March 1993), "Regulation and Reform: Promoting Residents' Rights in Australian Nursing Homes", Journal of Sociology, 29 (1): 73–91, doi:10.1177/144078339302900105, S2CID   144342447
  9. 1 2 3 The sub-jurisdictional examples within nations are currently drawn from the largest sub-divisions by population. One can imagine adding examples based on other criteria, such as degrees of protection of rights.
  10. ↑ "Seniors' Care: Maintaining Standards of Care in Long-Term Care Homes". Ministry of Health and Long-Term Care (Ontario). Archived from the original on 10 July 2010. Retrieved 18 July 2010.
  11. ↑ "Health and Disability Commissioner". New Zealand: Health and Disability Commissioner. Retrieved 25 July 2010.
  12. ↑ "Health and Disability Commissioner (Code of Health and Disability Services Consumers' Rights) Regulations 1996 (SR 1996/78)". New Zealand: Parliamentary Counsel Office. 10 June 2004. Retrieved 25 July 2010.
  13. ↑ "Your rights". Care Quality Commission. Archived from the original on 24 March 2010. Retrieved 18 July 2010.
  14. ↑ An 87-Year-Old Nun Said She Was Raped in Her Nursing Home. Here's Why She Couldn't Sue, Haley Sweetland Edwards Time Magazine. 16 November 2017
  15. ↑ "OBRA '87 Summary" (PDF). Alliance for Health care reform. Archived from the original (PDF) on 17 June 2010. Retrieved 20 July 2010.
  16. ↑ "42 US § 1396r". Cornell University Law School. Retrieved 20 July 2010.
  17. ↑ "Title 42, PART 483—REQUIREMENTS FOR STATES AND LONG TERM CARE FACILITIES". US Government Printing Office. Retrieved 20 July 2010.
  18. ↑ Geriatric education for emergency medical services, American Geriatrics Society, 2003, ISBN   9780763720865
  19. ↑ "History of Nursing Homes". eJustice. Retrieved 20 July 2010.
  20. ↑ "Guide to Choosing a Nursing Home" (PDF). Centers for Medicare & Medicaid Services. pp. 49–54. Archived from the original (PDF) on 17 June 2010. Retrieved 19 July 2010.
  21. 1 2 "Outline of Nursing Home Residents' Rights". California Advocates for Nursing Home Reform. Retrieved 19 July 2010.
  22. ↑ "Nursing Home Residents' Rights" (PDF). The National Long-Term Care Ombudsman Resource Center. National Consumer Voice. Retrieved 9 March 2018.
  23. ↑ "Nursing Home Residents Rights". California Department of Public health. Retrieved 19 July 2010.
  24. ↑ "California Advocates for Nursing Home Reform". CANHR. Retrieved 20 July 2010.
  25. ↑ "Senate Bill 1248". Senator Alquist. Retrieved 20 July 2010.
  26. ↑ "2016 Florida Statutes: Title XXIX: Public Health. Chapter 400: Nursing Homes and Related Health Care Facilities". State of Florida. 2016. Retrieved 7 July 2017.
  27. ↑ "Residents' Rights". ltcombudsman.org. National Consumer Voice.
  28. ↑ "You Have Rights". state.wi.us. State of Wisconsin Board on Aging and Long-Term Care. Retrieved 25 October 2013.

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.