Resident Rights in Skilled Nursing Facilities

A Summary of Nursing Home Residents’ Rights

Nursing Home residents still retain their civil rights and are still entitled to their basic human rights.

  • The nursing home must provide each resident safe and adequate care in a clean and comfortable environment.  The resident must be free from verbal, sexual, physical or mental abuse.
  •  A nursing facility must have the same policies and practices for transfer, discharge, and for the provision of services for all individuals regardless of their source of payment.
  • The facility shall not require a third party to guarantee payment as a condition of admission, expedited admission or continued stay in the facility.
  • Residents must be informed of their legal rights, services available in the facility and of related charges for such services during their stay at the facility.  This information must be provided orally and in writing, at the time of admission to the facility and periodically during the resident’s stay.
  • Residents who are entitled to Medi-Cal assistance must be informed of the items and services that are included in basic services under Medi-Cal.  The resident must not be charged for these items.

A nursing facility must protect and promote the rights of each resident. These rights are:

  • The right to be fully informed in advance about their care and to be informed before any changes are made in their care that may affect their well-being. They have the right to fully participate in planning their care on an ongoing basis.
  • Each resident must be given an opportunity to refuse treatment (which must be documented in the record).
  • The right to be free from physical or mental abuse, corporal punishment, and involuntary seclusion.  They have the right to be free from any physical or chemical restraints that are not required to treat the resident’s medical symptoms.  They may not be restrained for purposes of discipline or convenience of staff.
  • Physical and chemical restraints may be used to ensure the physical safety of the resident or other residents.  These restraints may be used only with a doctor’s written order and should be the treatment of last resort.  The orders must be written into the care plan.  The order must specify the duration and circumstances under which the restraints are to be used.
  • The right to privacy concerning accommodations, medical treatment, written and verbal communications, visits, and meetings of family and of resident groups.
  • The right to voice concerns or recommendations about care that is (or fails to be) given, without discrimination or reprisal for voicing those concerns.  The facility will promptly attempt to resolve the concerns of the resident.  Such concerns or recommendations are to be submitted free from interference, coercion, discrimination, or reprisal.
  • The right to confidentiality of personal and clinical records.
  • The right to inspect his/her records.
  • The right to receive notice before the room or roommate of the resident is changed.
  • The right of the resident to organize and participate in resident groups in the facility and to participate in social, religious, and community activities that do not interfere with the rights of other residents in the facility.
  • The right of the resident’s family to meet in the facility with the families of other residents in the facility.
  • The right to examine, upon reasonable request, the results of the most recent survey of the facility and any plan of correction in effect with respect to the facility.
  • The right to file a complaint with a State survey and certification agency about resident abuse and neglect and misappropriation of resident property in the facility.
  • The right to immediate access to the Long-Term Care Ombudsman.
  • The right to visit with family or others, subject to the resident’s right to deny or withdraw consent at any time.

Transfer and discharge rights

A nursing facility must permit each resident to remain in the facility and must not transfer or discharge the resident from the facility unless:

  • Medical reasons (beyond the level of care);
  • His/her welfare or welfare of other residents;
  • The safety or health of individuals in the facility is endangered;
  • The resident has failed to pay an allowable charge imposed by the facility for an item or services requested by the resident.

The basis for the transfer or discharge must be documented in the resident’s clinical record.  The documentation must be made by the resident’s physician, and the facility.  A nursing facility must provide sufficient preparation and orientation to the resident to ensure safe and orderly transfer or discharge from the facility.

Before transferring or discharging of a resident, a nursing facility must:

  • Notify the resident (and, if known, an immediate family member of the resident or legal representative) of the transfer or discharge and the reasons for this discharge;
  • The notice must be made at least thirty (30) days in advance of the resident’s transfer or discharge except in emergency situations, license suspension, revocation or decertification;
  • Each notice must inform the resident of the resident’s right to appeal the transfer or discharge.  The notice must include the name, mailing address, and telephone number of the long-term care ombudsman.

Notice about bed-hold policy and readmission

Before and at the time of transfer for hospitalization, a nursing facility must provide written information to the resident and an immediate family member or legal representative concerning the bed-hold policies of the facility.

A nursing facility must establish and follow a written policy regarding bed holds for residents who are eligible for Medi-Cal and who are transferred from the facility to the acute hospital.  This policy will also permit residents to be readmitted to the facility if the hospitalization exceeds the period paid for the bed hold.  The resident will be afforded the first available bed in a semiprivate room, if at the time of re-admission, the resident requires the services provided by the facility.

For more copies of this summary or for a complete copy of the law, 42 U.S.C. Section 1396r©, please contact the Sonoma County Ombudsman Program at 707-526-4108.