Nursing home residents' rights

Nursing home residents' rights are the legal and moral rights of the residents of a nursing home. Legislation exists in various jurisdictions to protect such rights. An early example of a statute protecting such rights is Florida statute 400.022, enacted in 1980, and commonly known as the Residents' Rights Act.

Specific rights protected vary greatly by jurisdiction. Types of rights protected include: dignity, medical privacy, pecuniary, dietary and visitation rights. Process rights, such as right of complaint, are also sometimes protected.

Motivations for residents' rights
In the United States, concerns about poor quality care and ineffective regulation of nursing homes date back to the 1970s. Early regulation focused on the ability of nursing homes to provide care, rather than on the quality of the care provided or the experience of the individuals receiving care. In the 1980s, particularly in response to an influential Institute of Medicine (IoM) report, the US federal government moved to address these concerns by enacting more resident-focused regulations, and among these were a number of new quality-of-life rights for residents of nursing homes. Similar concerns over quality of care motivated people in other countries to advocate for residents' rights.

Australia
Advocates for residents' rights in Australia have established a Charter of Residents' Rights and Responsibilities and the Department of Health and Ageing provides an official unit to deal with complaints. In 1987, the government introduced substantial reform and regulation which included a program to monitor standards.

Canada
Nursing home residents' rights in Canada appear to have been primarily legislated at the provincial level. In Ontario, for instance, the Long Term Care Homes Act 2007 contains a "Residents' Bill of Rights", including, inter alia, the rights to be treated with courtesy and respect; to privacy in treatment; to be informed of one's medical condition and treatment; to consent to or refuse treatment; to confidentiality of medical records and treatment; to receive visitors; and, when near death, to have family members present 24 hours a day.

New Zealand
Since 1996, New Zealand has protected residents rights' (and rights of the disabled more broadly) under the Health and Disability Commissioner's Act, including rights to respect, freedom from discrimination and coercion, dignity, communication in a language the resident can understand, information and informed consent, and right of complaint.

United Kingdom
Residents' rights in the UK appear to have been primarily legislated at the country level. In England, for instance, the Care Quality Commission, the health and social care regulator for England, describes national minimum standards under the Care Standards Act 2000 for services in care homes, including dignity and privacy rights, dietary and pecuniary rights, and the right to complain if one is unhappy with the care provided.

United States
Residents' rights in the US are protected at both the federal and state level.

Federal law
In 1980 the Civil Rights of Institutionalized Persons Act was passed to protect the civil rights of, amongst others, residents of nursing homes and similar facilities. In 1987, amendments known collectively as the Federal Nursing Home Reform Act, including a robust section on nursing home residents' rights, were attached to an Omnibus Budget Reconciliation Act of 1987 (OBRA '87) which was then enacted into law and codified at section 483 of Volume 42 of the Code of Federal Regulations and related United States Code sections. These required nursing homes to provides facilities to ensure that residents had a high quality of life, good physical and mental activities and were able to participate in the administration of the home. Appeals to an ombudsman in case of dispute were to be facilitated. However, the act's protections may or may not not apply to some nursing home residents whose nursing homes receive only state funds, and do not participate in Medicare or Medicaid.

Some rights provided by federal law as of 2010 include rights to dignity, privacy, freedom from discrimination, freedom from restraint, to be informed of medical care and treatment, pecuniary rights, visitation, rights of complaint and protection against transfer and unfair discharge. Specific rights include: choice of physician and involvement in treatment options; a right to be admitted without a third-party guaranty as a condition of admission; freedom from improper physical or chemical restraints; freedom from abuse; right to be treated with dignity; right to reasonable accommodation; right to participate in planning care and treatment and any changes in care and treatment; right to informed consent in language patient can understand; right to refuse treatment; right of family and Ombudsman to immediately access resident and have reasonable access to facility; right to privacy, confidentiality, and visitors; a right to not be transferred unless necessary to meet residents' needs, resident no longer requires care, safety of others is endangered, resident has failed to make own payments, or facility no longer operates; right to readmission; right to appeal hearings; right to have necessary care and services for highest practicable well-being; right to have adequate number of personnel; and, various rights respecting the residents' financial matters and need for proper notice and information.

State law
In California, for instance, additional rights are protected. As of 2010, these include: a contract will not require the resident to provide advance notice of voluntary discharge; arbitration agreements may not be required as a condition of admission; an arbitration agreement may be rescinded by the resident or his or her agent within 30 days of signing it; a third party guaranty of payment may not be a condition of admission; Facility may not transfer or discharge resident for switching to Medi-Cal, or while qualification for Medi-Cal is still being determined; resident has a right to be notified in writing about discharges and transfers; resident has a right to appeal discharge and transfer decisions; resident has a right to return to a facility after a temporary stay in a hospital—to the first available bed, with Medi-Cal paying for the first seven days; resident has the right to visitors, and to privacy; and, that there shall be an adequate number of personnel on staff.

There are still other protections for California residents, in part, because California incorporates federal law with respect to nursing home protections.