Nursing Home Abuse Attorneys


Important information for those considering a nursing home for an elderly loved one. Patient rights, nursing home responsiblities, patient care and how to report elder abuse and nursing home neglect.

Sonoma County Nursing Home Care, Guidelines, Neglect & Elder Abuse Lawsuits

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What Standard Of Care Should I Expect In A Nursing Home?


The formal standards of care expected from a nursing home are spelled out in necessarily general terms by California state law. In participating in the Medicare or Medi-Cal programs, nursing homes agree to:

• help every resident achieve the highest possible levels of physical, mental, and psychosocial well-being
• ensure that residents’ conditions do not decline (unless such a situation is medically unavoidable)
• use care, treatment, and therapy to maintain and improve residents’ health, to the degree possible and subject to the residents’ wishes.
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Those are pretty general guidelines that only detail expectations, not quality of care. So here’s what you need to know about the standards of care that you are entitled to expect from a nursing home or other long-term eldercare facility.

Nursing Home Accident Prevention

• Facilities must keep the resident environment as free from accident hazards as possible.
• Facilities must adequately supervise residents to prevent accidents.
• Facilities must use assistive devices (e.g., handrails) that help improve residents’ safety.

Accommodation of residents’ needs

• Residents have the right to reside in the nursing home to which they have been admitted.
• Residents have the right to receive care and treatment with reasonable accommodation of individual needs and preferences.
• The facility should make a reasonable attempt to adapt event schedules, staff assignments, room arrangements, and other schedules to accommodate residents’ preferences, desires, and needs.
• The facility is required to arrange for language interpreters or other measures to ensure clear and accurate communication between residents and staff.

Care planning

• The facility must establish and communicate a comprehensive, individualized treatment and care plan for every resident. This plan must spell out residents’ needs and how they will be met.

Feeding tubes

• If a resident is able to swallow food and thereby obtain proper nutrition, no feeding tube should be used.
• Feeding tubes may only be used with the consent of the resident AND with adequate medical justification.
• Residents fed by tube must receive appropriate treatment and services to prevent aspiration pneumonia, diarrhea, vomiting, dehydration, and other complications.
• If a resident requires a feeding tube, staff must take all possible measures to help the resident take food by mouth again as soon as possible.
• Dementia is not an adequate reason for the use of a feeding tube.

Food and nutrition

• The facility must provide each resident with a nourishing, palatable, well-balanced diet that meets daily nutritional and special dietary needs.
• Facilities must serve at least three meals a day, at regular times, with no more than a 14-hour span between the evening meal and breakfast the next morning.
• Facilities must offer snacks at bedtime.
• Facilities must make reasonable accommodations for residents’ food and mealtime preferences.
• Facilities must offer food substitutes of similar nutritional value if a resident refuses food.
• Facilities must serve food attractively, and at the proper temperature, and in a manner that meets individual needs.
• Facilities must prepare food that meets national dietary standards.
• Facilities must plan menus with regard for residents’ cultural backgrounds and food habits.
• Facilities must post the current week’s and subsequent week’s menus for regular and special diets.
• Facilities must prepare food using methods that conserve nutritional value, flavor, and appearance.
• Facilities must provide therapeutic diets to residents with special nutritional needs, subject to physician orders.
• Facilities must ensure that residents’ ability to eat does not diminish, unless medically unavoidable.
• Facilities must provide special eating utensils to those who need them.
• Facilities must provide table service to all residents who desire it, served at tables of appropriate height.
• Facilities must store, prepare, distribute, and serve food under sanitary conditions.
• If a resident’s ability to eat is compromised, the facility must design an individualized care plan to assist the resident with eating and nutrition.
• Facilities must immediately notify a resident’s physician of any signs of malnutrition. Facilities are urged (but not technically required by federal law) to reassess residents’ nutritional status in the event of undesired or unplanned weight loss.

Hydration

• Facilities must provide residents with sufficient fluids to maintain proper hydration and health. Every resident should receive plentiful, fresh water and/or other beverages, and be given any needed assistance or encouragement to drink fluids.

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Incontinence

• Any resident who has bladder or bowel control problems must have their condition assessed and treated promptly so that the condition may be alleviated.
• Catheters may not be used without valid medical justification. If a catheter is used, the facility must provide appropriate treatment to prevent urinary tract infections and restore normal bladder function.
• Nursing home staff must help residents use the toilet as often as the residents require.

Infection control

Facilities must have an organized infection-control program. Within this program, at minimum, facilities must: • Investigate, control, and prevent infections in the facility
• Screen residents and staff for tuberculosis
• Decide on infection procedures for individual residents
• Isolate residents only to the degree needed to contain infecting organisms
• Require staff to wash their hands after every direct contact with residents
• Prohibit staff with communicable diseases or conditions from directly contacting residents or their food
• Handle, store, process, and transport linens so as to prevent the spread of infection
• Clean and disinfect contaminated articles and surfaces
• Maintain records of infections and the actions taken to control and correct them
• Report cases of reportable communicable, infectious, or parasitic diseases or infestations to local and state health officials
• Provide details of their infection-control program upon request

Medications

• Facilities must properly order, record, store, administer, and monitor residents’ medications.
• Residents have the right to consent to or refuse any treatment, including medical treatment.
• Physicians must seek consent before ordering or changing medications.
• Residents have the right to choose their own pharmacy.
• Facilities must have 24-hour arrangements with at least one pharmacy.
• Medications must be provided in a timely manner. Doses must be administered within one hour of the time specified by the prescriber.
• Facilities may not administer drugs in excessive amounts, over an excessive period of time, without adequate monitoring, without adequate justification, or in the presence of adverse consequences under which doses should be adjusted or discontinued.
• Facilities may only use sedatives, tranquilizers, and similar drugs in the event of a clear medical need for them. Facilities may not use such medications to cover up symptoms caused by environmental conditions (e.g., temperature, crowding), psychosocial problems (e.g., abuse, taunting), or treatable medical conditions (e.g., diabetes).
• Residents may not be given antipsychotic drugs unless they are medically necessary. If a resident must take antipsychotic drugs, facilities must try to discontinue their use via behavioral interventions and/or gradual dosage reductions, unless clinically contraindicated.
• Residents may not be chemically restrained except in the event of an emergency.
• Residents’ medications must be administered by licensed nurses or medical personnel. Unlicensed personnel may administer only certain laxatives, non-prescription lotions, and medicinal shampoos and baths, subject to specific training, supervision, and demonstrated competence.
• Facilities must record the dosages of drugs and the dates and times of their administration for every resident.
• Facilities must keep their medication error rate under 5 percent.
• Facilities may not give medications to anyone other than the resident for whom it has been prescribed.
• Facilities must contract with a licensed pharmacist to assess its program of drug administration. The pharmacist is required to report any irregularities with the program to the director of nursing, who must act on such reports.


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Personal Care

old man in wheelchair sonoma county nursing home
What is Personal Care?

• Facilities must assist residents with bathing, dressing, eating, using the toilet, walking, communicating, getting into and out of beds and chairs, and other personal needs.
• Facilities must help residents maintain clean, dry skin.
• Facilities must change linens, clothing, and other items so that residents’ skin is free at all times from contact with urine and feces.
• Facilities must provide necessary hygienic services, including bathing, shampooing, hair grooming, oral hygiene, shaving and/or beard trimming, and cleaning and cutting fingernails.
• Facilities must keep residents free of offensive odors.
• Facilities must answer call signals promptly.
• Facilities must ensure privacy during treatments and personal care.

Physician services

• Physicians must see and evaluate residents at least once every 30 days, and more frequently if necessary. Physicians must have face-to-face contact with residents in their care, and review their medical history and treatment plan.
• Physicians must participate in residents’ assessment and care planning.
• Physicians must monitor changes in residents’ medical status.
• Physicians must review residents’ total care program at each visit.
• Physicians must prescribe new treatments and therapies as needed.
• Physicians must order residents’ transfers to a hospital when needed.
• Physicians must supervise nurse practitioners and/or physician assistants who attend to their patients.
• Physicians must provide consultation or treatment when called by the facility.
• Physicians must record residents’ progress or problems in residents’ health status.
• Residents’ care must be supervised by physicians chosen by the residents and/or their representatives.
• Facilities may not interfere in any way with residents’ choosing their physicians.
• If residents need assistance in choosing a physician, the facility must assist them in so doing.
• Facilities must provide medical services, medication management, therapy, nursing care, nutritional interventions, social work, and activity services.
• Facilities must carry out physicians’ orders and make all necessary diagnostic and therapeutic arrangements.
• Facilities must arrange for transportation if a resident requires off-site medical treatment.
• Facilities must have arrangements with substitute physicians for occasions when residents’ physicians are unavailable.
• Facilities must notify residents’ physicians in the event of:
• sudden, marked, or adverse changes in symptoms or behavior
• unusual medical occurrences
• changes of weight of 5 pounds of more within a 30-day period
• inappropriate responses to a medication or treatment
• a life-threatening medical or treatment error
• a threat to a resident’s health caused by a failure to administer drugs, treatment, supplies, or services in a timely manner

Pressure sores

• Facilities must ensure that pressure sores (aka bedsores) do not develop, taking all preventative measures possible, including keeping residents’ skin clean and dry, maintaining residents’ good nutrition, helping residents change position as often as necessary, and ensuring that pressure is kept off of vulnerable parts of residents’ bodies.
• Facilities must provide any necessary pads and mattresses for the relief of pressure sores.
• Facilities must ensure that residents who do develop pressure sores receive appropriate, timely treatment for them.
• Facilities must notify residents’ physicians immediately if residents develop pressure sores.

Special services

Facilities must ensure that residents receive proper care and treatment for the following special services:
• injections
• IV fluids
• colostomy, ureterostomy, ileostomy
• tracheostomy
• tracheal suctioning
• respiratory care
• foot care
• prostheses
These services must be provided, whether or not they are covered by Medicare or Medi-Cal.
• Facilities must assist residents in attaining any other necessary special services.

Staffing

• The facility must have, at all times, sufficient nurses and other staff members to meet the needs of every resident.
• California requires every facility to provide a minimum of 3.2 hours of nursing care per resident per day. If this minimum is unachievable, the facility must hire more staff.
• The facility must post, in a clearly visible place, the number of licensed and unlicensed staff members who are responsible for resident care.

Therapy services

• Facilities must provide therapy services for strokes, broken bones, and other conditions, regardless of how a resident’s care is paid for. Facilities must make all necessary arrangements for such services as (but not limited to) physical therapy, occupational therapy, speech-language pathology, and mental health rehabilitative services.
• Facilities must work with physicians to develop therapy plans for residents, and must follow the physician’s plan of care expressly.
• Facilities may not halt therapy care if/when a resident’s Medicare or Medi-Cal service expires.
• When therapy services end, facilities must set up a care plan that continues necessary exercises and other services.
• Facilities must ensure than residents do not lose range of motion in their extremities, and must work with therapists to design an exercise program that ensures a full range of motion, especially post-therapy.

Vision, dental, and hearing care

• Residents’ care plans must address their vision, dental, and hearing needs.
• Facilities must assist residents in obtaining routine dental care (annual exams) and emergency dental care.
• Facilities may have an arrangement with a dentist to care for residents.
• If a resident’s dentures are lost or damaged, the facility must assist the resident in referring them to a dentist and/or obtaining replacement dentures.
• Facilities must assist residents in obtaining vision and hearing services and care, including making appointments and arranging for transportation for off-site care.
• Facilities must assist residents in their use of necessary assistive devices, such as corrective lenses and hearing aids.
• Residents may have to pay for dental, hearing, and/or vision services themselves. Such services are not always covered by Medi-Cal.


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Attorney Jeremy Fietz

The Elderly who cannot care for themselves deserve to be cared for in clean, safe and caring enviroment.

Sonoma County Attorney Jeremy Fietz has represented many local residents who couldn't stand up for themselves. Jeremy makes sure those who are guilty of elder abuse and neglect pay for their neglect!

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Elder Abuse Act

The California Elder Abuse Act is an important piece of legislation because it provides a great deal of legal protection for the state’s senior citizens, who had been, under previous laws, vulnerable to financial, medical, and legal exploitation.

Anyone who has a loved one in a California nursing home should know about the history of elder care law in California, and should understand the protections afforded by the California Elder Care Act. Nursing home neglect lawsuits are becoming more frequent as care for the elderly is neglected in many nursing homes.

What is the California Elder Abuse Act?

The California Elder Abuse Act is the shorter, more familiar name of the California Elder and Dependent Adult Civil Protection Act, which was passed by the state legislature in 1982. The objective of this law was to require that certain people with privileged information of known or suspected abuse report that abuse; to encourage others to report known or suspected abuse; and to offer protection to those who report abuse.

The Elder Abuse Act, of course, is also intended to reduce and minimize the occurrence of elder abuse by penalizing those who take advantage of senior citizens, who are particularly vulnerable to exploitation.

The Elder Abuse Act was intended as a corrective measure to previous state laws, which insufficiently criminalized the act of elder abuse and insufficiently punished those who committed it.

Why is the California Elder Abuse Act considered to be necessary legislation?

The Elder Abuse Act replaced (well, actually, augmented; see below) the Medical Injury Compensation Reform Act of 1975. This law is commonly known as MICRA.

The stated intent of MICRA was to lower medical malpractice liability insurance premiums for healthcare providers. The law accomplished this goal largely by setting a $250,000 cap on providers’ tort liability.

In other words, under MICRA, healthcare providers were not liable for any malpractice claims that exceeded $250,000, even in cases when the pain and suffering endured by a plaintiff far exceeded $250,000.

In this context, such claims are called “non-economic damages,” which are designed to compensate for injuries that do not relate specifically to economic losses. Such damages can include everything from loss of limbs to loss of sight or hearing to pain and suffering In many cases, severe injuries such as these would seem to be “worth” more than $250,000.

Only two other states – Kansas and Montana – set caps on non-economic damages as low as California. 21 states and the District of Columbia have no such caps. Additionally, the $250,000 cap established by MICRA has never been adjusted for inflation, even though $250,000 in 1975 is worth nearly $1.2 million in 2017.

Because this cap was set so low, and because MICRA also established caps on the fees that lawyers could receive, lawyers were at a disincentive to take on cases of elder abuse or other serious injury, because they stood to gain very little from cases with a $250,000 maximum award.

In short, MICRA served to benefit the healthcare industry, not individual citizens. Though still on the books as a law, has been repeatedly challenged on grounds of constitutionality.

The California Elder Abuse Act did not “erase” MICRA. MICRA is still law in California, but the Elder Abuse Act has established additional laws that effectively render MICRA meaningless.

The Elder Abuse Act recognizes that MICRA benefits large, for-profit healthcare organizations, which have little trouble paying $250,000 awards, even on a semi-regular basis.

Under the Elder Abuse Act, elders or their families and/or legal representatives may seek “pre-death pain and suffering” damages. This element of the law allows no-financial-limit lawsuits to be filed on the basis of the pain and suffering endured by an elder between the time that the alleged abuse began and the time of the elder’s death.

As well, since the Elder Abuse Act raises the financial ceiling on damage awards and includes specific provisions for the awarding of attorneys’ fees, it incentivizes lawyers to take up elder abuse cases.

Compared to the time when MICRA was the sole law of the land, the Elder Abuse Act creates more – and fairer – opportunities for the victims and elder abuse to seek moral and financial justice.

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What are the most important terms and definitions within the California Elder Abuse Act?

Under this law, an “elder” or “senior” is defined as someone 65 years of age or older.

According to the law, “elder abuse” can take one or more of several forms, including but not limited to:
• physical abuse of elders
• neglect of elders
• financial abuse or exploitation of elders
• abandonment or isolation of elders
• abduction of elders
• any treatment that results in physical and/or psychological harm to elders
“Neglect” itself is a complex term that encompasses, according to the law, several components, including but not limited to:

• failure to assist in personal hygiene
• failure to provide food, clothing, and/or shelter
• failure to provide necessary care for physical health
• failure to provide necessary care for mental health
• failure to protect from health and safety hazards
• failure to prevent malnutrition and/or dehydration

Who may be punished under the California Elder Abuse Act?

The California Elder Abuse Act is intended to punish those who use their positions in nursing home and rehabilitation facilities to take advantage of elders.

What are the criteria for finding someone liable for elder abuse under the California Elder Abuse Act?

The Elder Abuse Act requires the plaintiff (the person filing the lawsuit) to find clear and convincing evidence of abuse in order to invoke this law. This is the highest standard of proof in a civil case in the state of California.

What this means is that anyone invoking this law must provide, at minimum, clear and convincing evidence that the defendant: • was the person or agency responsible for providing necessary nutrition, hydration, hygiene care, and/or medical care for an elder or dependent adult, AND
• was aware of the conditions that prevented the elder from supplying himself or herself with these necessities, AND
• denied or withheld the goods and/or services required to supply those necessities, AND
• knew or was substantially certain that those deprivations would cause injury, or possessed a conscious disregard of the likelihood that those deprivations would cause injury to an elder.
Additionally, the plaintiff must provide clear and convincing evidence that the elder in question suffered from physical pain and/or mental anguish.

If you believe that a loved one has suffered from abuse at the hands of the caretakers at a nursing home, elder care facility, or rehab facility, you may be entitled to file a lawsuit under the California Elder Abuse Act.

The attorneys at Adams Fietz are experts in elder law in general, and in the California Elder Abuse Act in particular. We have handled cases of elder abuse and nursing home abuse for years, and are proud of the victories we have secured for our clients.

Attorney Ben Adams

Ben Adams is an award winning attorney who is able to practice law in multiple countries and jurisdictions and has almost 20 years of experience successfully representing his many satisfied clients.

His primary focus at the current time is meeting with fire survivors from the wildfire that recently devastated Sonoma County.

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How Do I Report Elder Abuse?

Who Can Report Elder Abuse?

Anyone can report elder abuse. Certain people – known as “mandated reporters” – are obligated to report it.

Who and what are mandated reporters?

Certain people are under legal obligation to report nursing home abuse if they witness it or see convincing evidence of it. These people are usually those who have a supervisory role in elders’ health. Mandated reporters include:
• the staff of a public or private nursing home, eldercare facility, or rehabilitation facility, including:
• all administrators
• all supervisors
• all licensed staff
• eldercare or dependent adult care custodians
• health practitioners
• members of the clergy
• employees of a local, county, state, or federal adult protective services agency
• members of any law enforcement agency
• anyone who has been legally granted full-time or part-time care or custody of an elder, regardless of whether the person is compensated for doing so
As well, officers and employees of financial institutions are mandated reporters of the financial abuse of elders.

What is reported in cases of elder abuse?

In reporting elder abuse, mandated reporters (or any concerned citizen) should report on:
• actual or suspected physical abuse or neglect
• actual or suspected financial abuse
• actual or suspected sexual abuse
• abandonment
• isolation
• neglect of any kind that is observed, evident, or described

When should elder abuse be reported?

Short answer: as soon as possible. Actual or suspected abuse should be reported as soon as possible by telephone. That call should be followed up within two (2) working days by a written or online report.

If the abuse or suspected abuse is physical abuse, and it takes place in a long-term care facility, the report should be submitted to the facility’s ombudsman, as well as to local law enforcement.

If the abuse involves grievous bodily injury, the report must be made to local law enforcement within two hours of the incident, and must be made to the relevant ombudsman within 24 hours.

If the abuse or suspected abuse is physical or sexual in nature, but does not involve grievous injury, the report must be made to the relevant ombudsman and to local law enforcement within 24 hours.

What happens if abuse – actual or suspected – is not reported?

The failure to report elder abuse carries with it a fine of $1000 and a term of six months in county jail.

If a mandated reporter fails to report elder abuse, that person will receive a fine of $5000 and a one-year term in county jail.

If an officer or employee of a financial institution fails to report financial abuse, that person will receive a fine of $1000 if the failure to report is unintentional or circumstantial, and a fine of $5000 if the failure to report is intentional.

“Failure to report” can mean a literal failure to report abuse or suspect abuse of any kind, and can also mean impeding or obstructing an abuse report of any kind.

To whom, or to which agency, should elder abuse be reported? How can I find the forms that I need to report elder abuse?

If you are not a mandated reporter and you wish to report elder abuse, you can and should call 911 or your local law enforcement agency.

If you are a mandated reporter, below is a list of the California agencies to which elder abuse can and should be reported, along with links to the relevant documents.

Mandated reporters should submit elder care abuse reports to EACH of the following agencies, using the forms and/or phone numbers listed.

NURSING HOME ABUSE

• Certified Nurse Assistant / Home Health Aide / Certified Hemodialysis Technicians Report of Misconduct Form: www.cdph.ca.gov/pubsforms/forms/CtrldForms/cdph318.pdf

• California Department of Public Health (DPH) Elder Abuse Report Form: www.cdph.ca.gov/certlic/facilities/Pages/LCDistrictOffices.aspx

• Local law enforcement Contact your local police department or sheriff’s office, as well as your county district attorney’s office

• California Long-Term Care Ombudsman Program Elder Abuse Report Form: www.aging.ca.gov/programs/LTCOP Phone: 1-800-231-4024

• Office of the California State Attorney General, Bureau of Medi-Cal Fraud and Elder Abuse (BMFEA) Elder Abuse Report Form: ag.ca.gov/bmfea/reporting.php Phone: 1-800-722-0432

For general reference about filing a nursing home complaint in the state of California, CANHR (California Advocates for Nursing Home Reform) has a useful fact sheet. www.canhr.org/factsheets/nh_fs/html/fs_NH_complaint.htm

ABUSE IN RESIDENTIAL CARE FACILITIES (ASSISTED LIVING)

• Community Care Licensing, Department of Social Services: www.ccld.ca.gov

• Local law enforcement Contact your local police department or sheriff’s office, as well as your county district attorney’s office

• Long-term Care Ombudsman Program www.aging.ca.gov/programs/LTCOP Phone: 1-800-231-4024

HEALTH-RELATED ABUSE

• Fraudulent Medi-Cal Practices: Contact the Office of Attorney General, Bureau of Medi-Cal Fraud and Elder Abuse 1-800-722-0432 or www.ag.ca.gov/bmfea/reporting.php

• Fraudulent Medicare Practices: Contact the Health Insurance Counseling and Advocacy Program (HICAP) 1-800-434-0222 or www.medicare.gov/FraudAbuse/Overview.asp or California Senior Medicare Patrol: (714) 560-0309.

For additional information on how to report and identify abuse call 1-800-447-8477 or visit www.cahealthadvocates.org/fraud

ABUSE IN COMMUNITY SETTINGS

If abuse occurs in your home, or the home of a family or friend, mandated reporters must make a report to each of the following agencies:

• Adult Protective Services (APS) Find the contact information for APS in your county by referring to the California Department of Social Services’ site www.cdss.ca.gov/agedblinddisabled/PG1298.htm

• Local law enforcement Contact your local police department or sheriff’s office, as well as your county district attorney’s office

ELDER FINANCIAL ABUSE

Consumer scams: • Contact your county district attorney’s office • Contact the Consumer Financial Protection Bureau (CFPB) at www.consumerfinance.gov/complaint

Questionable Annuity or Insurance Practices: Contact the State Insurance Commissioner’s Office at 1-800-927-4347 or www.insurance.ca.gov/0300-fraud/index.cfm If an attorney sold the annuity, file a complaint with the California State Bar Association at 1-800-843-9053 or www.calbar.ca.gov/Attorneys/LawyerRegulation/FilingaComplaint.aspx

Reverse Mortgage Scams: File a complaint with the Federal Trade Commission at 1–877–FTC–HELP or www.yourhome.ca.gov/filing-complaint.shtml

If you have any questions about the information on this page, or about elder abuse in general, please do not hesitate to call the attorneys at Adams Fietz.


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Nursing Homes, Resident Rights, Staff Conduct & FAQ's

What are the rights of nursing home residents?

Moving into a nursing home doesn’t mean sacrificing any fundamental rights. In fact, nursing home residents’ rights are further protected by the federal Nursing Home Reform Law of 1987, which is designed to protect the dignity of every individual.

If you’re considering moving a loved one to a nursing home, here are some things that you need to know.

If your loved one is in a nursing home, and you believe that any of the rights listed below are being violated, contact the attorneys at Adams Fietz immediately. The health and safety of your loved one could be at risk.

Guaranteed Quality of Life

Under the 1987 Nursing Home Reform Law, every nursing home must care for its residents in a way that promotes and enhances their quality of life. Every nursing home must promote:
• dignity
• choice
• self-determination.
The health of a nursing home resident should NEVER decline as a result of the care provided by the facility.

The Right to Dignity, Respect, and Freedom

All nursing home residents have the right:
• To be treated with consideration, respect, and dignity.
• To self-determination.
• To be free from physical and mental abuse, corporal punishment, involuntary seclusion or isolation, and physical or chemical restraints.
• To the security of his or her possessions.

The Right to Make Independent Choices

All nursing home residents have the right to:
• Make personal decisions, such as those concerning clothing and leisure time.
• Reasonable accommodation of their needs and preferences.
• Choose their own physicians.
• Participate in community activities within and outside the nursing home.
• Organize and participate in a Resident Council.
• Manage their own financial affairs.

The Right to Full Disclosure

All nursing home residents are entitled to be fully informed, in a language they understand, about:
• All services provided by the facility, and the costs thereof.
• All rules and regulations of the facility, including a written copy of residents’ rights.
• Contact information for any state and/or federal agencies that govern nursing homes.
• All state nursing home survey reports, and the facility’s plans to respond to them.
• Any plans to change rooms or roommates.
• All available assistance options for sensory impairments (e.g., blindness, deafness).

The Right to Privacy and Confidentiality

All nursing home residents have the right to:
• Communicate privately and without restriction with anyone they wish.
• Receive care and treatment in private.
• Discuss their medical, personal, and/or financial affairs in private.

The Right to Visitations

All nursing home residents have the right to visitations by:
• Relatives, friends, and anyone of their choosing.
• Their personal physicians.
• Representatives of state nursing home survey agencies and ombudsman programs.
• Individuals or representatives of organizations that provide health, social, legal, financial, or other services.
• Residents also have the right to refuse visitors.

The Right to Complain

All nursing home residents have the right to:
• Present grievances to any staff member or resident, without fear of reprisal; residents are entitled to prompt responses from the staff about the resolution of those grievances.
• Complain to the facility’s ombudsman.
• File complaints with the state nursing home agency.

The Right to Participate in One’s Own Care

All nursing home residents have the right to:
• Receive adequate and appropriate care.
• Be informed about all changes in their medical condition(s).
• Participate in planning and assisting in their own care; participate in their own treatment and discharge.
• Refuse any medication or treatment.
• Refuse any chemical or physical restraints.
• Review their own medical records.
• Receive services covered by Medicare or Medicaid at no charge.

Transfer and Discharge Rights

All nursing home residents have the right to remain in their facility, unless a transfer or discharge:
• Is necessary to preserve the resident’s welfare.
• Is appropriate because the resident’s health has improved to the point at which he or she no longer requires nursing home care.
• Is necessary for the protection of the health and safety of other residents or staff.
• Is deemed necessary because the resident has failed to pay, within a reasonable time, for a service or item that the resident has requested.
• Residents have the right to receive 30 days’ notice of a transfer or discharge, and that notice must contain:
• the reason for the transfer or discharge,
• the effective date of the transfer or discharge,
• the location to which the resident will be transferred or discharged,
• information about how to appeal the transfer or discharge, including the name, address, and telephone number of the state long-term care ombudsman.

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