Current through Register Vol. 50, No. 9, September 20, 2024
A. In accordance with
R.S.
40:2010.6 et seq., all nursing facilities
shall adopt and make public a statement of the rights and responsibilities of
the residents residing therein and shall treat such residents in accordance
with the provisions of the statement. The statement shall assure each resident
the following:
1. the right to civil and
religious liberties, including but not limited to:
a. knowledge of available choices;
b. the right to independent personal
decision; and
c. the right to
encouragement and assistance from the staff of the nursing facility in the
fullest possible exercise of these civil and religious rights;
2. the right to private and
uncensored communications, including but not limited to:
a. receiving and sending unopened
correspondence;
b. access to a
telephone;
c. visitation with any
person of the resident's choice; and
d. overnight visitation outside the nursing
facility with family and friends in accordance with nursing facility policies,
and physician orders without the loss of his bed:
i. nursing facility visiting hours shall be
flexible, taking into consideration special circumstances such as out of town
visitors and working relatives or friends;
ii. with the consent of the resident and in
accordance with the policies approved by the Department of Health, the facility
shall permit recognized volunteer groups, representatives of community based
legal, social, mental health, and leisure and planning 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;
3. the right to be granted
immediate access to the following:
a. any
representative of the secretary of the United States Department of Health and
Human Services;
b. any
representative of the state acting pursuant to his duties and responsibilities
under state or federal law;
c. the
resident's individual physician;
d.
the state long term care ombudsman;
e. the agency responsible for the protection
and the advocacy system for individuals with developmental
disabilities;
f. the agency
responsible for the protection and the advocacy system for individuals with
mental illness;
g. immediate family
members, other relatives of the resident, and the resident's clergy subject to
the resident's right to deny or withdraw consent at any time;
h. others who are visiting with the consent
of the resident, subject to reasonable restrictions and the resident's right to
deny or withdraw consent at any time;
i. reasonable access to any resident by any
entity or individual that provides health, social, legal, or other services to
the resident, subject to the resident's right to deny or withdraw consent at
any time; and
j. reasonable
restrictions imposed by the nursing facility, Department of Public Safety and
Corrections, or the court that protect the welfare and safety of all the
nursing facility's residents. The nursing facility may change the location of
visits to assist care giving or protect the privacy of other
residents;
4. the right
to present grievances on behalf of himself or others to the nursing facility's
staff or administrator, to governmental officials, or to any other person; to
recommend changes in policies and services to nursing 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 the
resident's sponsor and the Department of Health; and the right to be a member
of, to be active in, and to associate with advocacy or special interest
groups;
5. the right to be fully
informed, in writing and orally, prior to or at time of admission and during
his stay, of services not covered by the basic per diem rates and of bed
reservation and refund policies of the facility;
6. the right to be fully informed, in a
language that he or she can understand, of his or her total health status,
including but not limited to, his or her medical conditions and proposed
treatment, to participate in the planning of all medical treatment, including
the right to refuse medication and treatment, and to be informed of the
consequences of such actions;
7.
the right to receive adequate and appropriate health care and protective and
support services, including services consistent with the resident care plan,
with established and recognized practice standards within the community, and
with rules promulgated by LDH;
8.
the right to refuse treatment and to refuse to participate in experimental
research;
9. the right to formulate
an advanced directive and to address life-sustaining procedures, the purpose of
which is to assure that all residents have the fundamental right to control the
decisions relating to their own medical care, including the decision to have
life-sustaining procedures withheld or withdrawn in instances where such
persons are diagnosed as having a terminal and irreversible condition. This
purpose may be fulfilled by the following, non-exclusive means:
a. an advance directive executed pursuant to
the provisions of
R.S.
40:1151 et seq., defined as a declaration by
a resident which instructs his/her physician to withhold or withdraw
life-sustaining procedures or designates another to make the treatment decision
and to make such a declaration for him;
b. Louisiana physician order for scope of
treatment (LaPOST), executed pursuant to the provisions of
R.S.
40:1155.1 et seq., which documents the wishes
of a qualified patient in a physician order; or
c. any other means of documenting written
instructions or directives, including but not limited to, a living will,
durable power of attorney for health care, a medical power of attorney, a
pre-existing medical order for do not resuscitate (DNR) or another document
that directs the residents health care choices related to life-sustaining
treatments;
NOTE: A residents choice to document wishes relative to
withholding or withdrawal of medical treatment or life-sustaining procedures is
voluntary and the provisions herein shall not be construed to compel a resident
to do so and shall not be a condition of admission to a nursing
facility.
10. the
right to have privacy in treatment and in caring for personal needs:
a. to have closed room doors, and to have
nursing facility personnel knock before entering the room, except in case of an
emergency;
b. to have
confidentiality in the treatment of personal and medical records;
c. to be secure in storing and using personal
possessions, subject to applicable state and federal health and safety
regulations and the rights of other residents; and
d. the right to privacy of the resident's
body during, but not limited to toileting, bathing, and other activities of
personal hygiene, except as needed for resident safety or assistance;
11. the right to be treated
courteously, fairly, and with the fullest measure of dignity and to receive a
written statement and oral explanations of the services provided by the
facility, including statements and explanations required to be offered on an as
needed basis;
12. the right to be
free from mental and physical abuse; and the right to be free from any physical
or chemical restraint imposed for the purposes of discipline or convenience,
and not required to treat the residents medical symptoms:
a. in case of an emergency, restraint may
only be applied by a qualified licensed nurse, who shall set forth in writing
the circumstances requiring the use of the restraint, and, in case of a
chemical restraint, the attending physician shall be consulted immediately
thereafter;
b. restraints shall not
be used in lieu of staff supervision or merely for staff convenience or
resident punishment, or for any reason other than resident protection or
safety;
13. the right of
the resident or his or her legal representative:
a. upon an oral or written request, to access
all records pertaining to himself or herself including current clinical records
within 24 hours (excluding weekends and holidays); and
b. after receipt of his or her records for
inspection, to purchase at a cost not to exceed the community standard,
photocopies of the records or any portions of them upon request and two working
days advance notice to the nursing facility;
14. the right to select 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 XVIII or
title XIX of the Social Security Act; and to obtain information about, and to
participate in, community based activities and programs, unless such
participation would violate infection control or quarantine laws or
regulations;
15. 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 health and safety.
Clothing need not be provided to the resident by the facility except in
emergency situations. If provided, it shall be of reasonable fit;
16. the right to have copies of the nursing
facility's rules and regulations and an explanation of the resident's
responsibility to obey all reasonable rules and regulations of the nursing
facility and of his responsibility to respect the personal rights and private
property of other residents;
17.
the right to be informed of the bed reservation policy for a hospitalization:
a. the nursing facility shall inform a
private pay resident and his sponsor that his bed shall be reserved for any
single hospitalization for a period up to 30 days, provided the nursing
facility receives reimbursement;
b.
notice shall be provided within 24 hours of the hospitalization;
18. the right to receive a prompt
response to all reasonable requests and inquiries;
19. the right to refuse to serve as a medical
research subject without jeopardizing access to appropriate medical
care;
20. the right to use tobacco
at his own expense under the facility's safety rules and under applicable laws
and rules of the state, unless the nursing facility's written policies preclude
smoking in designated areas;
21.
the right to consume a reasonable amount of alcoholic beverages at his own
expense, unless:
a. not medically advisable
as documented in his medical record by the attending physician;
b. alcohol is contraindicated with any of the
medications in the resident's current regime; or
c. expressly prohibited by published rules
and regulations of a nursing facility owned and operated by a religious
denomination which has abstinence from the consumption of alcoholic beverages
as a part of its religious belief;
22. the right to retire and rise in
accordance with the residents personal preference; and
23. the right to have any significant change
in health status immediately reported to the resident and his/her legal
representative or interested family member, if known and available, as soon as
such a change is known to the facility's staff.
C. Each nursing facility shall provide a copy
of the statement required by
R.S.
40:2010.8(A) to each
resident and sponsor upon or before the resident's admission to the facility
and to each staff member of the facility. The statement shall also advise the
resident and his sponsor that the nursing facility is not responsible for the
actions or inactions of other persons or entities not employed by the nursing
facility, such as the resident's treating physician, pharmacists, sitter, or
other such persons or entities employed or selected by the resident or his
sponsor. Each facility shall prepare a written plan and provide appropriate
staff training to implement the provisions of
R.S.
40:2010.6 et seq., including, but not limited
to, an explanation of the following:
1. the
residents' rights and the staff's responsibilities in the implementation of
those rights; and
2. the staff's
obligation to provide all residents who have similar needs with comparable
services as required by state licensing standards.
I. Any
violations of the residents rights set forth in
R.S.
40:2010.6 et seq., shall constitute grounds
for appropriate action by the Department of Health.
1. Residents shall have a private right of
action to enforce these rights, as set forth in
R.S.
40:2010.9. The state courts shall have
jurisdiction to enjoin a violation of residents rights and to assess fines for
violations not to exceed 100 dollars per individual violation.
2. In order to determine whether a facility
is adequately protecting residents' rights, inspection of the facility by LDH
shall include private, informal conversations with a sample of residents to
discuss residents' experiences within the facility with respect to the rights
specified in
R.S.
40:2010.6 et seq., and with respect to
compliance with departmental standards.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
40:2009.1-2116.
