RESIDENTS' BILL OF RIGHTS AND RESPONSIBILITIES This facility maintains policies, procedures, and ongoing programs to ensure that the following rights of each resident are protected by all personnel. Appendix N I have the right to: 1. Be fully informed, in writing, through the admission agreement, of all my rights and responsibilities as a resident and to receive adequate and appropriate care within the capacity of the facility. 2. Be fully informed prior to or at the time of admission of fees, method of payment and services available in the facility, and of related charges, including any charges for services not covered under Medical Assistance or Medicare, or by the facility's basic daily rate; the terms of refund of advance payments in case of transfer, death or voluntary or involuntary discharge; and the terms of holding and charge for a bed during a resident's temporary absence. If there are any changes in available services or charges during my stay, I will be informed in writing. 3. Be fully informed of my medical condition. 4. Be afforded the opportunity to participate in the planning of my medical treatment and to refuse to participate in any experimental research if any may be offered. 5. Refuse treatment, medication or participation in activities or other programs & be informed of the consequences of this action.
6. Choose my personal physician or dentist and to use the licensed, certified or registered provider of health care and pharmacist of my choice. 7. Each resident has the right to self-administer drugs unless the facility's interdisciplinary team has determined for a particular resident that this practice is unsafe. (See Appendix O) 8. Continuity of care, and may be transferred or discharged only for medical reasons, or for my welfare or that of other residents, or for nonpayment for my stay. 9. Be given reasonable advance notice of any transfer or discharge either within or outside the facility and have this documented in my medical record, and be given an explanation of the need for such transfer or discharge. The facility to which the transfer is planned must have accepted me for transfer, except in a medical emergency. 10.Be encouraged and assisted to exercise my rights as a resident and as a citizen, and to voice grievances and recommend changes in policies and services to the facility staff and/or to outside representatives of my choice, and be free from restraint, interference, coercion, discrimination or reprisal. 11. Be free from discrimination based on the source of payment for my care. 12. Not be assigned to a particular wing or distinct area of the facility for sleeping, dining or for any reason based on the source of payment for my care except in the case of Medicare certification which does not prohibit assignments to the certified part of the facility because the source of payment is Medicare. 13. Be offered an identical package of basic services as that provided all individuals regardless of the source or amount of payment.
Additional services and enhanced services will be available at identical cost to all residents willing and able to pay for them regardless of source of payment. 14. Not be required to have, be offered, or provided an identification tag or other item that discloses the source from which the facility's charges for my care are paid. 15. Manage my own financial affairs or delegate in writing a person or agent of my choice as financial manager. Authorize the nursing facility in writing to hold my personal resident account fund and to make necessary expenditures such as those for clothing, hair care, and personal grooming products at their discretion. I understand this resident account and any earnings from it would be credited to me and not mingled with any other funds or property except the funds of other residents. 16. Receive and have my guardian receive a written itemized statement of my personal account every three months or monthly upon request. 17. Be free from verbal, sexual, physical, or mental abuse, corporal punishment, and involuntary seclusion. 18. Be free from chemical and physical restraints administered for purpose of discipline or convenience, and not required to treat the resident's medical symptoms.
19. In the case of mentally retarded individuals, participate in behavior modification programs involving the use of restraints or adverse stimuli only with the informed consent of a parent or guardian. 20. Expect that all communications and records pertaining to my care will be treated as confidential. 21. Approve or refuse the release of confidential medical information to any individual outside the facility, except in case of transfer to another health care facility, or as required by law or third party payment contract, such as medical assistance. 22. Be treated with consideration, respect and full emotional privacy in treatment, living arrangements, and in caring for my personal needs. 23. Privacy concerning my healthcare. Case discussion, consultation, examination, and treatment are confidential and shall be conducted discreetly. Persons not directly involved in my care shall require my permission to be present. 24. Refuse to perform services for the facility that are not included for therapeutic purposes in my plan of care. 25. Private and unrestricted communications with my family, physician, attorney, clergy and any other person. 26. Send and receive personal mail unopened, unless otherwise indicated by my physician and documented in my medical record. Communications with public
officials or with an attorney shall not be restricted in any way. I, or my guardian, may direct in writing that specified incoming correspondence be opened, delayed or held. 27.Have reasonable access to a public telephone for private communications. 28. Meet with an participate in activities of social, religious and community groups at my discretion unless otherwise indicated by my physician and documented in my medical record. 29. Retain and use personal clothing and possessions. With my written permission, some of my clothing may be kept separately outside my room. A reasonable amount of additional storage space is available for my personal effects. 30. Privacy during visits and, if married, assured privacy for visits by my spouse. If both are residents of the facility, we have the right to share a room unless otherwise indicated and documented by our physician in our medical record. 31. The resident has the right to examine the results of the most recent survey of the facility conducted by Federal or State surveyors and any plan of correction.