In every healthcare sector, the concept of patient rights influences every aspect of care delivery. For nursing homes and long-term care facilities, residents are afforded specific rights that are governed by local, state, and federal regulations.
Because the residents of nursing homes are considered at-risk populations, numerous protections for them have been adopted across the country. Nursing home resident rights cannot be overlooked, as to do so may create devastating risk exposures for facilities and their management teams. Risk management must go beyond nursing home insurance coverage, and must also include strategies for honoring and protecting resident rights.
Nursing Home Residents’ Bill of Rights
Faced with growing concerns about unfair or inadequate health care in the nursing home sector, an organization called the Institute of Medicine proposed sweeping reforms aimed at strengthening the regulations governing long-term care facilities. The result was the passage of the Nursing Home Reform Act, which itself was a part of the Omnibus Budget Reconciliation Act of 1987. In addition to setting minimum standards and guidelines nursing homes must meet in their operation, the Act also established the Nursing Home Residents’ Bill of Rights. These rights include:
- The right to freedom from abuse, mistreatment, and neglect;
- The right to privacy;
- The right to be treated with dignity;
- The right to participate in review of one’s care plan and to be informed in advance about any changes in status of the facility and in individual care and treatment;
- The right to suitable accommodations of medical, physical, psychological, and social needs;
- The right to freedom from physical restraints; and
- The right to voice grievances without reprisal or discrimination.
The full Bill of Rights can be viewed by visiting the Nursing Home Alert website.
More Rights Under State and Federal Regulations
In addition to the sweeping reforms implemented in the passage of the Nursing Home Reform Act in 1987, nursing home residents are also afforded protections by the United States Constitution, just like every other U.S. citizen. In simple terms, nursing home residents have the right to be free of discrimination, interference, and reprisal in exercising the rights set out for them.
Numerous states followed suit, adding enhanced protections for nursing home residents by passing state regulations. Among the states that took protecting at-risk seniors in nursing homes seriously was the state of Texas, which implemented a statewide code. Under Title 40, Part 1 of the Texas Administrative Code, Chapter 19, Subchapter E Resident Rights, state legislators built on the framework of the federal Nursing Home Residents’ Bill of Rights. The Texas Health and Human Services Commission has the full text of resident rights on its website.
Protecting Nursing Home Resident Rights: Managing Facility Risk Exposures
It is important for nursing homes to provide compassionate and accurate care for residents. It is also imperative that these facilities understand residents’ rights completely and to do everything in their power to protect these rights. Failure to do so can create harmful risk exposures. Even though nursing home insurance is designed to protect against a wide range of risks, facility managers and owners may still face significant challenges if resident rights are violated.
Violations of established resident risks may result in steep financial penalties, loss of accreditation or licensure, or complete shuttering of facilities. The Centers for Medicare and Medicaid Services (CMS) governs the operation of program-eligible nursing homes, and if resident rights violations occur, this agency may withhold financial reimbursement for services.
Residents and their family members may also file lawsuits against such a facility; these legal claims can quickly overwhelm even the most financially stable nursing home.
Education & Accountability
Protecting resident rights is a vital part of the healthcare delivery system for nursing homes. To begin with, residents must have access to information about their rights. Many facilities provide resident rights education for new residents first moving into facilities, while others will provide resident rights posters and pamphlets in the facility.
Staff members and managers must also be trained on resident rights. Implementing reporting systems to allow residents and staff to notify managers of potential rights violations is another important addition, and these reporting mechanisms must be free of the fear of reprisal or discrimination as set out in the Residents’ Bill of Rights.
Finally, nursing homes must ensure that their insurance coverage is sufficient to protect against the risks they face in their operations; many insurers also offer risk management programs and services to help clients remain in compliance with applicable standards and regulations.