Rights Protected In All States Through Medicare/Medicaid

Second Subject Area: Resident Rights

Read the entire section using this link:

http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf

Rights protected in all States through Medicare/Medicaid

“F153
(Rev. 107, Issued: 04-04-14, Effective: 04-04-14, Implementation: 04-04-14)

§483.10 Resident Rights

The resident has a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility. A facility must protect and promote the rights of each resident, including each of the following rights

All residents in long term care facilities have rights guaranteed to them under Federal and State law. Requirements concerning resident rights are specified in §§483.10, 483.12, 483.13, and 483.15. Section 483.10 is intended to lay the foundation for the remaining resident’s rights requirements which cover more specific areas. These rights include the resident’s right to:

• Exercise his or her rights (§483.10(a));

• Be informed about what rights and responsibilities he or she has (§483.10(b));

• If he or she wishes, have the facility manage his personal funds (§483.10(c));

• Choose a physician and treatment and participate in decisions and care planning (§483.10(d));

• Privacy and confidentiality (§483.10(e));

• Voice grievances and have the facility respond to those grievances (§483.10(f));

• Examine survey results (§483.10(g));

• Work or not work (§483.10(h));

• Privacy in sending and receiving mail (§483.10(i));

• Visit and be visited by others from outside the facility (§483.10(j));

• Use a telephone in privacy (§483.10(k));

• Retain and use personal possessions (§483.10(1)) to the maximum extent that space and safety permit;

• Share a room with a spouse, if that is mutually agreeable (§483.10(m));

• Self-administer medication, if the interdisciplinary care planning team determines it is safe (§483.10(n)); and

• Refuse a transfer from a distinct part, within the institution (§483.10(o)).




A facility must promote the exercise of rights for each resident, including any who face barriers (such as communication problems, hearing problems and cognition limits) in the exercise of these rights. A resident, even though determined to be incompetent, should be able to assert these rights based on his or her degree of capability."

IMPORTANT:  This last statement is often a "gateway" for facilities to freely interpret the content and intent cutting corners in services and provisions for the individual and for the entire community they supervise: "A resident, even though determined to be incompetent, should be able to assert these rights based on his or her degree of capability."

FREE TO CHOOSE.  Yes, we all want and deserve that freedom. However, we must be vigilent and listen, observe and communicate with residents and families as to what is done, how it is done and where challenges exist in the daily care and offerings in a facility.

Those with cognitive challenges, who are dependent 24/7 on where they live and who cares for them are vulnerable. Sometimes their fears are unsubstantiated but sometimes they're very real. WE MUST BE VIGILENT. WE MUST LOOK, LISTEN AND SPEAK UP, SPEAK UP. For the day is coming and we do not know how close it is when we may be walking the same road, the same way.

FOR OUR FAMILY:  The facilities excuses regarding following an outside Dr's "suggestions" Mom would benefit from having more movement in her arms and legs but didn't see Physical or Occupational Therapy as needed was a "financial block" for the facility.,

There were/are no programs of individualized "motion, movement, retention of physical abilities" at many facilities. This involves staff, takes time and also costs money.


Facilities often put the $ before the human factor. Decisions are made and staff who want to retain their positions are told to follow directives.


Stretching, passing a balloon, kicking a balloon, having fun, socializing -- some facilities use these methods while others are more "clinical" and determine if it's not billable, it's not doable.

So, they OFFER with language both verbal and physical through their staff the "activity" in a way that the individual will not accept, not want and therefore not participate. VIOLA!  No need. No expense. THE RESIDENT REFUSED becomes a common entry into the individual record and the facility has maneuvered its actions safely inside the above mandates.

Is this best for our aging population? To "trick" them into submission to what the people who are responsible for providing shelter, food and care want to provide, choose to provide?

That's unfortunately more true than it is false. There are exceptions. There are great facilities. What we need to ensure is all facilities, all sizes, private businesses and not for profits, adhere to humane standards with REAL CONSEQUENCES and not just a "report", a "slap on the wrist".

Our society members advocate for the prevention of cruelty to animals. It's time we had active advocacy highly visible, easily accessible, well known and NOT connected to any agency or division of government, independent and directly focused on Senior Advocacy throughout the United States.