1. You have the right to "equal access" to quality care
regardless of your color, creed, race, sex, or financial status.
2. You have the right to be respected and treated as an individual,
to have your dignity maintained and to have full possession of
all your social and civil rights.
You are encouraged to vote for the issues and candidates of your
choice at election times and perform other civic responsibilities
of your choosing. Please request assistance from Social Services,
the Recreation Department or the facility Ombudsman in these matters
or for any other concerns you may have.
3. Upon admission you have the right to receive both the Attorney
General's regulations and any written policies regarding your
rights and responsibilities. This information must:
a. be provided orally and in writing;
b. be typed in a clear and conspicuous format;
c. be provided in a language you can understand;
d. be made available to you and your legal representative
or next of kin; through annual updates.
4. You have the right to make choices in your daily routine and
the facility must ensure a reasonable accommodation to your individual
needs. You are allowed to follow the same - if not similar -
routine you had before entering the nursing facility.
5. The nursing facility must provide written information to you,
upon admission, regarding your right to make your own health care
decisions.
6. You are entitled to good medical services, and you have the
right to choose or change your physician at any time. Upon admission,
you will be given the name, specialty and telephone number of
your physician.
7. You have the right to be seen by your physician of record within
48 hours following your admission, and at regular intervals throughout
your stay.
8. You are entitled to have your health care needs met by a sufficient
number of properly trained personnel at all levels. This may
include registered and licensed practical nurses, responsible
for both distributing medication and performing specialized treatments
ordered by your physician. The nursing staff also provides supervision
and direction to every certified nursing assistant.
9. You have the right to receive care from a nursing assistant
who is properly trained to serve you, and this training should
be obvious.
10. If you feel that a nursing assistant or any staff member is
not properly trained, you have the right to discuss your concern
with the Head Nurse, Nursing Supervisor, the Director of Nursing,
the Administrator, or Ombudsman.
11. The nursing staff must try to answer your questions about
the effects of drugs or treatment that you receive. You have
the right to refuse drugs or treatment and, if you do so, the
staff must make a prompt and good faith effort to obtain information
from qualified sources about the likely consequences of how refusing
drugs or treatment may affect you.
12. You have the right to receive routine progress reports from
the nursing staff, and the facility must respond promptly to reasonable
requests that you make for specific services.
You have the right to be fully informed in advance of any changes
in your care or treatment that may affect your well being.
13. You have the right to refuse to participate in experimental
research.
14. You have the right to regular dental care.
15. You have the right to self-administer your own medications
unless your attending physician and the interdisciplinary team
responsible for your care and well being determines that this
practice may be unsafe.
16. You have the right to attend Resident Care Planning Conferences.
This meeting is attended by representatives of the facility's
care team, who are continually involved in developing and reviewing
an individual plan of care appropriate for you. Together with
your input, long and short-term goals are discussed and set.
Your discharge plans may also be reviewed using this forum. You
may invite family members or someone significant to you to attend.
17. You have the right to manage your personal financial affairs
and we encourage you to do so. However, if you are unable and/or
do not have a responsible person to care for your personal money,
you may deposit it with the Business Office for safekeeping and
withdraw it for your personal use as needed.
Accounting of your funds is maintained through an itemized statement
of deposits and disbursements. Funds under $50 will either be
placed into a non-interest bearing account or kept in a petty
cash fund. Funds over $50 are placed in a separate interest-bearing
account. The Business Office can supply you the name of the bank
and account number where your funds have been deposited. Each
quarter, a balance statement will be given to you by the Business
Office upon your request.
18. You have the right to be informed of any billing changes in
services available or cost-related to your stay at least 30 days
prior to the effective date of increase. If you are a private
resident, an increase in the basic per diem rate must be preceded
by 60 days prior written notice to you and/or your legal representative.
You are encouraged to discuss your views about rates and their
changes with members of the administrative staff.
19. You have the right to retain and use personal clothing and
possessions as space permits, unless to do so would infringe upon
the rights and safety of other residents. A private closet will
be provided for you to store your personal clothing and belongings.
While you reside here, you should always feel that your personal
belongings are safe. If anything of yours is lost or stolen,
you should report this loss to a member of the administrative
staff.
20. You have the right to purchase prescription medications from
a pharmacy of your choice, provided that the prescription complies
with all relevant regulations governing pharmacy labeling. If
you prefer, the facility will choose a pharmacy they are familiar
with.
21. You have the right to receive information regarding benefits
under and Medicaid. This information is available from
the administration and is also displayed on the Resident Information
Bulletin Board. Items, services, and charges for services that
are not included in the per diem rate will be explained to you
upon admission and periodically during your stay.
21a. If your spouse is not living in a facility or institution,
you and your spouse have the right to request an assessment of
your nonexempt resources at the time you enter the nursing facility.
This assessment will assist you in determining your eligibility
for Medical Assistance.
22. You have the right not to be discriminated against for being
a Medicaid recipient or person eligible or soon-to-be eligible
to receive Medicaid benefits. The facility cannot discriminate
against your admission to the facility based on your current or
anticipated source of payment.
23. You have the right to adequate and secure storage space for
your personal property which is accessible to you and may include
a private, individually locked drawer or box to which you will
have sole control of the key.
24. You are entitled to use assistive devices which will have
a positive impact on your quality of life, such as special eating
utensils, walkers, canes, wheelchairs, etc.
25. You have the right to adequate lighting throughout the facility
and also by your bed to enable you to read comfortably.
26. You are entitled to a safe environment. If you feel there
is a condition that may cause injury, you have the right to report
it to the staff of the facility so that the obstacle can be removed
for your safety.
Fire drills are conducted on a routine basis on all shifts to
promote your safety in the event of fire.
27. You have the right to clean bed linens and comfortable sound
and temperature levels. You should be able to have quiet when
you want it, and the facility must maintain a temperature range
of 71 - 81 degrees, Fahrenheit.
28. You have the right to be free from mental, verbal, and physical
abuse, physical restraints, and/or psychoactive drugs that are
not required to treat your medical conditions. The nursing facility
can not fail or refuse to effectuate the right of any resident
to be free from mental, verbal, sexual, and physical abuse, corporal
punishment or involuntary seclusion.
A restraint may only be used upon the written order of a physician
that specifies the duration and circumstances under which the
restraint is to be used, except in emergency circumstances specified
by the nursing facility until a physician's order can reasonably
be obtained.
If a restraint is used it may only be used to ensure your own
physical safety or that of other residents.
29. You have the right to notify any member of the facility's
administrative staff - without fear, reprisal, discrimination,
discharge, or reprimand - if at any time you feel that you are
not being treated fairly or you feel an employee has mistreated
you in any way.
30. Each member of the facility's staff must ensure that all alleged
violations involving mistreatment, neglect or abuse (including
injury of unknown source and misappropriation of resident property)
are immediately reported to the administration and /or other officials
in accordance with State law through established procedures.
31. While you are a resident here, your personal and medical records
are kept confidential and are used only by authorized individuals
involved in your care. You may approve in writing, or refuse,
to release records to anyone outside the facility. If you are
incapable of giving the required approval in writing, or refusal,
to the individual outside the facility requesting to see your
medical records, he/she may request permission from your legal
guardian. If you have no legal guardian, one must petition the
court for permission to see your records.
32. You have the right to purchase a photocopy of your medical
records at any time with a 24-hour notice to the administration.
All requests by those outside the facility to see or obtain a
photocopy of medical records require 24 hours notice and should
be referred to the administration.
33. You have the right of privacy within the limits of safety.
Except during emergency situations or when you have requested
their assistance, all staff members must ask for permission to
enter your room. The delivery of your total health care needs
will be provided to you with privacy so that you may maintain
your dignity as an individual. Persons not directly involved
in examination or treatment of your body may not be present without
your consent. Your privacy will also be maintained during your
toileting, bathing, dressing, and other activities of personal
hygiene, except when assistance is needed for your safety and
well being.
34. The nursing facility may obtain necessary information from
your physician or from another qualified source only with your
expressed permission.
35. The facility must assure privacy to a married resident during
visits by his/her spouse if it is requested.
36. You have the right to ample fluids, nutritional meals, and
a snack at bedtime. If you do not like the meal being offered,
you have the right to be offered an alternative meal. If you
are on a special diet, that diet will be provided for you.
37. You have the right to participate in activities of your choice.
This facility is responsible for providing an ongoing program
of activities. The activities are designed to meet your interests
and to maintain your physical, mental, and psychosocial well being.
We encourage you to participate in this program unless your attendance
is contraindicated by your physician. In addition, you have the
freedom to join community activities provided for you outside
of the facility.
38. You are not required to perform services for the facility
except in situations where services are deemed for therapeutic
purposes in your plan of care. You may perform voluntary service(s)
in the facility for reasonable consideration when:
a. the facility has documented the need or desire for
work in your plan of care;
b. the plan specifies the nature of the services performed
and whether the services are voluntary or paid;
c. if paid, compensation is at or above prevailing rates;
and
d. you agree to the work arrangement described in the
plan of care.
39. You have the right to freedom of religious practice.
40. You have the right to receive and send mail in unopened envelopes.
Stationery, postage, and writing materials will be made available
to you upon request, at your expense.
41. You may privately communicate and visit with persons of your
choice.
These visits may include and are not limited to:
a. your spouse;
b. physician;
c. attorney or legal representative;
d. clergy
e. a representative of the Secretary of the U.S. Dept.
of Health & Human Services;
f. the Ombudsman; and
g. any representative of a State agency responsible for
maintaining your health, safety, and well being.
42. You have the right to receive or refuse to see visitors at
any given time. Although a facility may have visiting hours,
these hours are only posted as a request in order to ensure that
your needs are provided for on a timely basis.
43. You have the right to make and receive private telephone calls.
To ensure this right, a public pay phone is available at a convenient
location. The phone is accessible to wheelchair residents and
equipped with an audible device for those with hearing difficulties.
You may be assisted, if necessary, by a staff member in making
calls. If you prefer, a private phone may be installed in your
room upon request, at your own expense.
44. At the time of your admission, your room is selected according
to your total care needs as determined by the facility's Admission
Committee. If, for any reason, your room or your roommate must
be changed, you will be given no less than 48 hours notice of
these changes. You will be consulted in this decision, and the
administrative staff will give every possible consideration to
your desires if and when a transfer becomes necessary.
The facility may not move you to different living quarters within
the facility if it is contrary to your wishes.
45. You have the right to 30-days written notice of transfer or
discharge. The only circumstances in which you may not receive
30 days notice of discharge from the facility or transfer from
one certified unit to another unit includes:
a. if the facility is no longer able to meet your medical
needs and requirements;
b. if your health has improved such that our services are
no longer needed;
c. if transfer or discharge is required for your health
or safety or the health or safety of other residents of the facility;
or
d. if you have failed, after reasonable notice, to pay
charges which are properly due, except as prohibited by Title
XVIII and XIX of the Social Security Act.
This notice will include the name, address, and telephone number
of the State Long-Term Care Ombudsman and, if applicable to you,
the same information pertaining to the agency responsible for
the protection and advocacy of the developmentally disabled as
established under Part C of the Developmental Disabilities Assistance
and Bill or Rights Act and/or the agency responsible for the protection
and advocacy of mentally ill individuals as established under
the Protection and Advocacy for Mentally Ill Individuals Act.
The facility will make every effort to alert you of a transfer
or discharge if providing you less than 30 days notice is indicated
and this, too, will be in writing.
46. The facility must not fail to consult you and your family
or legal representative in choosing another facility if a transfer
is indicated. Responsible steps must be taken to implement your
choice of an alternate facility.
47. If you are in the facility for rehabilitative purposes, the
facility will provide you with ample written notice of your discharge
or transfer. Family meetings or discharge planning conferences
are coordinated for this reason. At this meeting, a careful transitional
plan will be developed with you, your social worker and members
of the nursing and rehabilitative care staff. A family member
may also attend so that planning may be discussed and implemented
before you return home or to a new environment.
You have the right to refuse a transfer to another room within
the facility if the purpose of the transfer is based upon your
eligibility or ineligibility for coverage. You have
the right to not be transferred from a room in one distinct part
of a facility to a room in another part of the facility without
medical justification. Should you choose to exercise your right
to refuse a transfer, this will not affect your eligibility for
or entitlement to or Medical Assistance benefits.
48. Written notice of discharge or transfer must also include:
a. the date of the discharge or transfer;
b. the location to which you will be discharged or transferred;
c. notification of your right to request a hearing before
the Division of Medical Assistance;
d. the name, address and phone number of the local legal
services office; and
e. information about the resources coordinated and mutually
agreed upon that will provide support in the community.
f. If you are disabled, you have the right to request
that the Division accommodate your disability to ensure your access
to the fair hearing.
49. You have the right to occupy the same room as your spouse
if you are both residents of this facility. If proper room accommodations
are not possible at the time of admission, new arrangements will
be made at the earliest possible date. If available, a room may
be used for private visits by your spouse unless medically contraindicated
and so documented by your physician.
50. Before you are transferred to a hospital, you have the right
to be provided with written notification that explains the State
Bed-Hold Policy and the facility's responsibility for your re-admission
under this plan.
51. You have the right to request and have access to any representative
of the State Ombudsman's Office. The Ombudsman's function is
to visit the facility on a weekly or biweekly basis. Their role
is to assist you with any concerns, questions or complaints you
may have. The goal of the Ombudsman is to ensure that your voice
is heard and your quality of life is as it should be. Please,
feel free to speak with the Ombudsman.
52. You have the right to attend meetings of the Resident Council,
which meets monthly. At these meetings, you may voice grievances
(without fear of reprisal or discrimination) with respect to your
care or treatment or the behavior of other residents. These grievances
will be presented to the administrative staff for investigation
and assessment. Every effort will be made for prompt resolution
of these issues and you will be informed of these efforts and
the results.
53. You should not be reprimanded for complaining about any concern
you have. Retaliation is not permitted. If you feel you are
being reprimanded for complaining about anything, you should speak
immediately with a member of the staff, the Social Worker or the
Ombudsman.
The nursing facility must permit you to complain about conditions,
treatment or care to others inside or outside the facility. (For
example, to the Departments of Public Health or Public Welfare;
the Secretary of Elder Affairs; the Attorney General's Office;
or to any other government official.)
54. The facility must post in a conspicuous place in each unit
a copy of the Attorney General's regulations and a copy of the
facility's policies relating to your rights and responsibilities.
55. You have the right to be informed of any changes in this statement
of Resident's Rights; to be informed of any changes in services
available at least one month prior to the effective date of the
change; and to be informed of issues pending decisions that affect
you in order to give your views.
56. You have the right to be informed when the facility is being
surveyed by a Federal or State agency and to be permitted to speak
with the surveyor if you so desire.
57. You have the right to examine the results of the most recent
survey conducted by the Federal or State agency with the accompanying
facility plan of corrective action. These survey documents will
be displayed on the Resident Information Bulletin Board.