It happens every day; unfortunate and often unexpected circumstances require loved ones to enter skilled care facilities. Everyone has heard the nursing home “horror stories” and this fear can leave individuals paralyzed about how to ensure that their loved one is treated right. The first step in moving forward is to eliminate your hesitation by educating yourself on your rights. In 1987, the Federal Government solidified a skilled care facility resident’s rights in the Omnibus Budget Reconciliation Act. Here are the essentials:
- Each resident must receive, and the facility must provide, the necessary care and services to attain or maintain the highest practicable physical, mental and psychological well-being, in accordance with the comprehensive assessment and plan of care. 42 CFR Sect 483.25
- Resident, resident’s family, facilities’ personnel, and legal personnel all have the right to participate in developing the resident’s plan of care. The facility must complete a full assessment of resident’s condition within 14 days after admission and thereafter at least once every 12 months and after a significant change in the resident’s condition.
- Nursing home “must establish and maintain identical policies and practices regarding the transfer, discharge and provisions of services required under the State Medicaid plan for all individuals regardless of source of payment” 42 CFR 483.12(c)(1). Summary: Medicaid eligible residents are entitled to the same level of services that are provided to any other resident.
- Use of physical or chemical restraints on a resident can only be used to treat a medical condition or symptoms and not as a form of discipline or convenience to facility workers.
- Responsible Party Provisions in Admission Agreements: Facilities are prohibited from requiring a family member, friend or other third party to become financially liable for resident’s nursing home expenses. Signatures of a family member or friend can only be required if acting as agent of Nursing home resident, not as a guarantor. Therefore, during a loved one’s admission to a facility, the only individuals who should be signing the documents are those who have been appointed the power of attorney for the resident. The signature should include the agent’s name, followed by “as power of attorney for [principal’s name]”.
- Evictions from facilities: Only 6 Legitimate Reasons for Evicting a Resident [42 USC 483.12(a)]:
- Failure to Pay.
- Medicaid is a form of payment and a facility cannot discriminate against Medicaid eligible residents.
- A loss of Need for Skilled Nursing Level of Care
- Facility is Incapable of Meeting Resident’s Care Needs.
- The Resident’s Stay Endangers Others’ Health and Safety.
- The Facility Goes Out of Business.
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