Based on a rash of recent questions and requests from our readers about residents’ rights in nursing facilities, we have summarized some of the pertinent provisions of the Nursing Home Reform Act, a federal law applicable to all facilities participating in either the Medicare or Medicaid programs. While many resident rights guaranteed by the NHRA and state law deal with admission and discharge, the following cover other protected areas that are important to quality of life in a facility:

Right To Equal Access to Quality Care: Regardless of how a resident’s care is paid for (that is, by private pay, insurance, Medicare, or Medicaid), a nursing facility must establish and maintain identical policies and practices regarding the transfer, discharge, and provision of services required under the state plan for all residents.

Right To Freedom of Choice: Nursing home residents have rights involving decisions that affect their care and who will provide their care. For example, each resident has the right to choose a personal attending physician. However, because of economics and practicality, most choose to use the facility physician. Residents also have the right to be fully informed in advance about their care and treatment and changes in their plan of care and treatment.

Right To Privacy and Confidentiality: Each resident has the right to privacy regarding their accommodations, medical treatment, written and telephonic communications, visits, and meetings with family and resident groups. Each also has a right to confidentiality of their personal and clinical records. Facility personnel should not only arrange for adequate privacy when administering treatment, but should not discuss a resident’s care or treatment with other residents or unauthorized persons.

Right To Accommodation of Needs: Each resident has the right to receive individualized services with regard to his or her individual needs unless the health and safety of the resident or other residents would be endangered.

Right To Participation in Resident and Family Groups: Each nursing home is obligated to protect and promote the right of the residents to organize and participate in resident groups, and the right of the resident's family to meet in the facility with families of other residents in the facility. No facility may interfere with a resident’s religious, social, and community activities that do not interfere with the rights of others.

Right To Access and Visitation: A nursing facility must permit immediate access to any resident by any representative of the U.S Department of Health and Human Services, any representative of the state, or the resident's individual physician. And, subject to the resident’s consent, each facility must allow immediate access by his or her immediate family or other relatives and by others, subject to reasonable restrictions.

Right to Inspect Survey Results: Each resident has the right to examine, upon reasonable request, the results of the most recent survey of the facility conducted by a federal or state agency having jurisdiction over the facility.

Right To Freedom From Abuse and Restraints: Each resident has the right to be free from physical or mental abuse, corporal punishment, involuntary seclusion, and any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the residents symptoms. Physical restraints can be used only to ensure the physical safety of the resident or other residents and must be prescribed by a physician. The order must specify how long and circumstances under which the restraints are to be used. Similarly, drugs that have an altering effect on the mind can only be administered on the order of a physician as a part of a written drug plan of each resident receiving such drugs.

Right To Make Grievances: Each resident has the right to voice grievances regarding his or her care or treatment without fear of discrimination or reprisal along with prompt efforts by the facility to resolve the complaints. Should grievances not be resolvable internally, the facility must provide written information about State agencies which can make resolution.

The Rights of Incompetent Residents: The rights of incapacitated and incompetent resident may be exercised by guardians, conservators, or attorneys in fact under durable powers of attorney.