Nursing Home and Elderly Bill of Rights

This post is part of course requirements for Dr. Farzin Madjidi, EDLT724.20, Ethics and Personal Leadership.

While searching the topic of a Bill of Rights for elderly citizens, I found this information*

Nursing Home Bill of Rights

Under Texas law, citizens over 60 years old have additional specific affordances.  The Texas Department of Disability & Aging Services regulates nursing homes and is required by law to assure that nursing homes receiving Medicaid funds implement and enforce the Rights of the Elderly.

Quality of Care rights apply to those who live in nursing homes. Nursing home facilities must provide “necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being” of its residents. Psychosocial well-being refers to the resident’s abilities to bathe, dress and groom; transfer and ambulate; use the restroom; eat; and communicate.Nursing home residents must undergo a comprehensive intake assessment with an individualized, comprehensive care program at the time of residency and at periodic intervals. These intervals for assessment must occur:(1) no later than14 days after admission
(2) after any significant change in condition
(3) at least once per year.

All residents must be treated with dignity and respect. Residents must be allowed to express their preferences regarding personal possessions, care, treatment, sleeping and waking times, Advanced Care Directives, and activity options. Components of the care program include medical, occupations, physical, mental, emotional, social, equipment, nutritional, services, and staff offered for the resident.

Abuses of care include discrimination, unequal services administration based on the ability to pay, restriction of physician visits, involuntary seclusion, restraint (unless in case of emergency or fear of self-harm), unauthorized mail handling, restricted visitation, verbal, physical, or emotional intimidation, humiliation, harassment, hitting, slapping, and verbal abuse that includes disparaging or derogatory terms. Discrimination includes unequal treatment based on race, religion, color, national origin, sex, age, handicap, marital status, or source of payment. HIPPAA confidentiality regulations regarding medical files cannot be waived in anyway.

Family members and nursing home residents have the right to participate in care-planning meetings in order to insure proper medical planning. An elderly individual may manage his personal financial affairs. If an elderly individual authorizes in writing a party to assist in managing his or her finances, that person must deposit those funds in a separate trust fund and provide the individual with a written receipt. However, if federal regulations prescribe a different procedure, those regulations prevail. An elderly person has the same rights as anyone to receive, spend,invest, save, or give away his or her money. If a family member or friend takes control of an elderly person’s money without permission, this may be a violation of the elderly person’s rights, and should prompt a call to Adult Protective Services.

Nursing home administrators must inform residents in writing of available services and applicable charges in instances where services are not covered by Medicare, Medicaid, or another form of health insurance. Service providers cannot transfer or discharge an elderly individual unless (a) the elderly individual’s medical needs require transfer; (b) The elderly individual’s health and safety or the health and safety of another individual requires transfer or discharge; (c) The elderly individual fails to pay for services, except as prohibited by federal law. An involuntary discharge may occur only under one or more of the three reasons listed above. Complaining about poor care is not grounds for a nursing home to evict a resident, nor is having a family that is outspoken regarding problems. If a resident needs to move for medical or safety reasons, if a resident is putting others at risk, or if the resident is not paying for services,then and only then may a nursing home discharge a resident involuntarily.

Except in an emergency situation, if a service provider intends to transfer or discharge an elderly individual, the service provider shall notify the individual, the responsible party for the individual,and the attending physician no later than five (5) days before the date of transfer or discharge. For example, in an emergency situation where the health or safety of other residents is jeopardized by another resident’s continued presence, that resident can be transferred to a hospital or another appropriate place for treatment without notice. Absent an emergency situation, however, all facilities must give five (5) days notice before discharge.

There is no statute of limitations on reporting of alleged abuses.

*Rasansky Law Firm

**The number of personal possessions may be limited for health and safety reasons, which should be documented in the resident’s medical record. The number of personal possessions maybe limited for the health and safety of other residents, as well.

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