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RESIDENT'S
RIGHTS
In 1976, Florida enacted the Nursing Home Residents' Bill of Rights
400.022. Since enactment, these rights have been expanded and amended
to further protect nursing home residents. A nursing home resident or
resident's family members have the right to commence a legal action
free of charge, if a resident has suffered severe injury or death as
a result of nursing home abuse or neglect.
The Nursing Home Bill of Rights states the following:
1. All licensees (owners) of nursing home facilities shall adopt and
make public a statement of the rights and responsibilities of the residents
of such facilities and shall treat such residents in accordance with
the provisions of that statement. The statement shall assure each resident
the following:
The right to civil and religious liberties, including knowledge of available
choices and the right to independent personal decision, which will not
be infringed upon, and the right to encouragement and assistance from
the staff of the facility in the fullest possible exercise of these
rights.
The right to private and uncensored communication, including, but not
limited to, receiving and sending unopened correspondence, access to
a telephone, visiting with any person of the resident's choice during
visiting hours, and overnight visitation outside the facility with family
and friends in accordance with facility policies, physician orders,
and Title XVIII (Medicare) and Title XIX (Medicaid) of the Social Security
Act regulations, without the resident's losing his or her bed. Facility
visiting hours shall be flexible, taking into consideration special
circumstances such as, but not limited to, out-of-town visitors and
working relatives or friends. Unless otherwise indicated in the resident
care plan, the licensee shall, with the consent of the resident and
in accordance with policies approved by the agency, permit recognized
volunteer groups, representatives of community-based legal, social,
mental health, and leisure programs, and members of the clergy access
to the facility during visiting hours for the purpose of visiting with
and providing services to any resident.
Any entity or individual that provides health, social, legal, or other
services to a resident has the right to have reasonable access to the
resident. The resident has the right to deny or withdraw consent to
access at any time by any entity or individual. Notwithstanding the
visiting policy of the facility, the following individuals must be permitted
immediate access to the resident:
Any representative of the federal or state government, including, but
not limited to, representatives of the Department of Health and Rehabilitative
Services, the Agency for Health Care Administration, and the Department
of Elderly Affairs; any law enforcement officer; members of the state
or district ombudsman council; and the resident's individual physician.
Subject to the resident's right to deny or withdraw consent, immediate
family or other relatives of the resident.
The facility must allow representatives of the State Nursing Home and
Long-Term Care Facility Ombudsman Council to examine a resident's clinical
records with the permission of the resident or the resident's legal
representative and consistent with state law.
2. The right to present grievances on behalf of himself or herself or
others to the staff or administrator of the facility, to governmental
officials, or to any other person; to recommend changes in policies
and services to facility personnel; and to join with other residents
or individuals within or outside the facility to work for improvements
in resident care, free from restraint, interference, coercion, discrimination,
or reprisal. This right includes access to ombudsmen and advocates and
the right to be a member of, to be active in, and to associate with
advocacy or special interest groups. The right also includes the right
to prompt efforts by the facility to resolve resident grievances, including
grievances with respect to the behavior of other residents.
3. The right to organize and participate in resident groups in the facility
and the right to have the resident's family meet in the facility with
the families of other residents.
4. The right to participate in social, religious, and community activities
that do not interfere with the rights of other residents.
5. The right to examine, upon reasonable request, the results of the
most recent inspection of the facility conducted by a federal or state
agency and any plan of correction in effect with respect to the facility.
6. The right to manage his or her own financial affairs or to delegate
such responsibility to the licensee, but only to the extent of the funds
held in trust by the licensee for the resident. A quarterly accounting
of any transactions made on behalf of the resident shall be furnished
to the resident or the person responsible for the resident. The facility
may not require a resident to deposit personal funds with the facility.
7. The right to be fully informed, in writing and orally, prior to or
at the time of admission and during his or her stay, of services available
in the facility and of related charges for such services, including
any charges for services not covered under Title XVIII or Title XIX
of the Social Security Act or not covered by the basic per diem rates
and of bed reservation and refund policies of the facility.
8. The right to be adequately informed of his or her medical condition
and proposed treatment, unless the resident is determined to be unable
to provide informed consent under Florida law, or the right to be fully
informed in advance of any non-emergency changes in care or treatment
that may affect the resident's well-being; and, except with respect
to a resident adjudged incompetent, the right to participate in the
planning of all medical treatment, including the right to refuse medication
and treatment, unless otherwise indicated by the resident's physician;
and to know the consequences of such actions.
9. The right to refuse medication or treatment and to be informed of
the consequences of such decisions, unless determined unable to provide
informed consent under state law. When the resident refuses medication
or treatment, the nursing home facility must notify the resident or
the resident's legal representative of the consequences of such decision
and must document the resident's decision in his or her medical record.
The nursing home facility must continue to provide other services the
resident agrees to in accordance with the resident's care plan.
10. The right to receive adequate and appropriate health care and protective
and support services, including social services; mental health services,
if available; planned recreational activities; and therapeutic and rehabilitative
services consistent with the resident care plan, with established and
recognized practice standards within the community, and with rules as
adopted by the agency.
11. The right to have privacy in treatment and in caring for personal
needs; to close room doors and to have facility personnel knock before
entering the room, except in the case of an emergency or unless medically
contraindicated; and to security in storing and using personal possessions.
Privacy of the resident's body shall be maintained during, but not limited
to, toileting, bathing, and other activities of personal hygiene, except
as needed for resident safety or assistance. Residents' personal and
medical records shall be confidential and exempt from the provisions
of s. 119.07(1).
12. The right to be treated courteously, fairly, and with the fullest
measure of dignity and to receive a written statement and an oral explanation
of the services provided by the licensee, including those required to
be offered on an as-needed basis.
13. The right to be free from mental and physical abuse, corporal punishment,
extended involuntary seclusion, and from physical and chemical restraints,
except those restraints authorized in writing by a physician for a specified
and limited period of time or as are necessitated by an emergency. In
case of an emergency, restraint may be applied only by a qualified licensed
nurse who shall set forth in writing the circumstances requiring the
use of restraint, and, in the case of use of a chemical restraint, a
physician shall be consulted immediately thereafter. Restraints may
not be used in lieu of staff supervision or merely for staff convenience,
for punishment, or for reasons other than resident protection or safety.
14. The right to be transferred or discharged only for medical reasons
or for the welfare of other residents, and the right to be given reasonable
advance notice of no less than 30 days of any involuntary transfer or
discharge, except in the case of an emergency as determined by a licensed
professional on the staff of the nursing home, or in the case of conflicting
rules and regulations which govern Title XVIII or Title XIX of the Social
Security Act. For nonpayment of a bill for care received, the resident
shall be given 30 days' advance notice. A licensee certified to provide
services under Title XIX of the Social Security Act may not transfer
or discharge a resident solely because the source of payment for care
changes. Admission to a nursing home facility operated by a licensee
certified to provide services under Title XIX of the Social Security
Act may not be conditioned upon a waiver of such right, and any document
or provision in a document which purports to waive or preclude such
right is void and unenforceable. Any licensee certified to provide services
under Title XIX of the Social Security Act that obtains or attempts
to obtain such a waiver from a resident or potential resident shall
be construed to have violated the resident's rights as established herein
and is subject to disciplinary action as provided in subsection (3).
The resident and the family or representative of the resident shall
be consulted in choosing another facility.
15. The right to freedom of choice in selecting a personal physician;
to obtain pharmaceutical supplies and services from a pharmacy of the
resident's choice, at the resident's own expense or through Title XIX
of the Social Security Act; and to obtain information about, and to
participate in, community-based activities programs, unless medically
contraindicated as documented by a physician in the resident's medical
record. If a resident chooses to use a community pharmacy and the facility
in which the resident resides uses a unit-dose system, the pharmacy
selected by the resident shall be one that provides a compatible unit-dose
system, provides service delivery, and stocks the drugs normally used
by long-term care residents. If a resident chooses to use a community
pharmacy and the facility in which the resident resides does not use
a unit-dose system, the pharmacy selected by the resident shall be one
that provides service delivery and stocks the drugs normally used by
long-term care residents.
16. The right to retain and use personal clothing and possessions as
space permits, unless to do so would infringe upon the rights of other
residents or unless medically contraindicated as documented in the resident's
medical record by a physician. If clothing is provided to the resident
by the licensee, it shall be of reasonable fit.
17. The right to have copies of the rules and regulations of the facility
and an explanation of the responsibility of the resident to obey all
reasonable rules and regulations of the facility and to respect the
personal rights and private property of the other residents.
18. The right to receive notice before the room of the resident in the
facility is changed.
19. The right to be informed of the bed reservation policy for a hospitalization.
The nursing home shall inform a private-pay resident and his or her
responsible party that his or her bed will be reserved for any single
hospitalization for a period up to 30 days provided the nursing home
receives reimbursement. Any resident who is a recipient of assistance
under Title XIX of the Social Security Act, or the resident's designee
or legal representative, shall be informed by the licensee that his
or her bed will be reserved for any single hospitalization for the length
of time for which Title XIX reimbursement is available, up to 15 days;
but that the bed will not be reserved if it is medically determined
by the agency that the resident will not need it or will not be able
to return to the nursing home, or if the agency determines that the
nursing home's occupancy rate ensures the availability of a bed for
the resident. Notice shall be provided within 24 hours of the hospitalization.
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