After Admission

Respect
Restraints
Managing Money
Privacy, Property, and Living Arrangements
Guardianship and Advance Directives
Visitors
Medical Care
Social Services
Moving Out
Discharge and Transfer
Rights for Families and Friends

New nursing home residents may go through a difficult adjustment period, even if the nursing home is doing all that it can. The adjustment can be made easier with the support of family and friends. The adjustment also can be made easier by knowing about your resident rights and some special protections under the law.

Respect
Nursing home residents have the right to be treated with dignity and respect. As long as it fits your plan of care, you have the right to make your own schedule, including when you go to bed, rise in the morning, and eat your meals. You have the right to select the activities you would like to attend. You also may have the right to leave the facility with relatives or friends after notifying he staff.

Restraints
It is against the law for a nursing home to use physical and chemical restraints, except when necessary, to treat medical symptoms. Restraints may not be used for discipline or for the convenience of the nursing home staff.

Restrained residents may have decreased functional ability, lower self-esteem and feel depressed or angry. Restraints do not provide security or safety. Residents also are likely to be seriously injured if they fall with a restraint on. A physician must provide medical orders for any use of restraints and give the reason why they are needed except in certain emergency circumstances.

Managing Money
You have the right to manage your own money or to pick someone you trust to do so. If you request the nursing home to manage your personal funds, you must sign a written statement that authorizes the nursing home to do this for you. However, the nursing home must allow you access to your bank accounts, cash, and other financial records. The nursing home must protect your funds from any loss by purchasing a bond or providing other similar assurances.

Privacy, Property, and Living Arrangements
You have the right to privacy. In addition, you have the right to keep and use  your personal property, as long as it does not interfere with the rights, health or safety of others. Your mail should never be opened by the home unless you allow it. The nursing home must have a system in place to keep you safe from neglect and abuse, and to protect your property from theft. See if there is a safe in the facility or cupboards with locked doors in resident rooms. If you and your spouse live in the same home, you are entitled to share a room (if you both agree to do so).

Guardianship and Advance Directives
As a nursing home resident, you are responsible for making  your own decisions (unless you are mentally unable or have made legal arrangements for help). You may also draw up a document called an Advance Directive. This sometimes is called a living will because it becomes effective while you are still alive. It is a legal document that says what type of treatment you want or don't want in case you cannot speak for yourself.

If you wish, you may designate someone else to make health-care decisions for you. This is called a Durable Power of Attorney for health care. The person you name will become your legal guardian if you ever become incapable of making your own decisions. Depending upon your State's laws, you may need a lawyer to draw up a Durable Power of Attorney order or a living will. Although the nursing home should be able to help you with this, other help is available.

Check with your State Health Insurance Assistance Program (SHIP) or with the local Office on Aging to find out if your State has any legal assistance services that help with preparing these documents. You will find the phone number for your local Office on Aging in the blue pages of your phone directory.

Visitors
You have the right to spend private time with visitors at any reasonable hour. You have the right to make and receive telephone calls in privacy. The nursing home must permit your family to visit you at any time, as long as you wish to see them. You do not have to see any visitor you do not wish to see. Any person who provides you with health or legal services may see you at any reasonable times.

Medical Care
You have the right to be informed about your medical condition, medications, and to participate in developing your Plan of Care. You have the right to examine your medical records and reports upon request. You have the right to refuse medications or treatments, and to see your own doctor.

Social Services
The nursing home must provide each resident with any needed social services, including counseling, mediation of disputes with other residents, assistance in contacting legal and financial professionals, and discharge planning.

Moving Out
Living in a nursing home is voluntary. You are free to move to another place. However, nursing home admission policies usually require that you give proper notice, you may owe the nursing home money based on the home's proper notice rules. If you are going to another nursing home, make sure the home has a bed for you.

Discharge and Transfer
Whether leaving a room or the nursing home, change can be very traumatic for residents. Nursing homes cannot discharge you unless:

It is necessary for the welfare, health, or safety of you or others;

• Your health has declined to the point that the nursing home cannot meet your care needs;

• Your health has improved to the point that nursing home care is no longer necessary;

• The nursing home has not been paid for services you received; or

• The nursing home is closing.

Except in emergencies, the facility must give a 30 day written notice of discharge or transfer. Residents have the right to appeal a transfer to another facility.

Rights for Families and Friends
Relatives and friends have rights too. Family members and legal guardians have the right to privacy when visiting the nursing home when the resident asks. They also have the right to meet with the families of other residents and to join or address family councils.

By law, nursing homes must develop a plan of care for every resident. Family members are allowed to participate in the development of the care plan with the resident's permission. Relatives who have legal guardianship of nursing home residents have the right to examine all medical records concerning their loved one and the right to make important decisions on his or her behalf.

Family and friends can make sure the resident receives good care. They should visit often, know the nursing home's staff and procedures, express concerns to the right staff member, and be active in the nursing home's family council.

Although there are people in the nursing home who may be able to help, if the home does not address your concerns or complaints, call the State's inspection agency or the Long-Term Care Ombudsman.

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