Current through 2024-38, September 18, 2024
10.A.
Written
Policies
Written policies shall be established by the governing body
of each facility regarding the rights and responsibilities of the
residents.
10.B.
Procedures
Procedures shall be developed and adhered to for training of
facility staff concerning these policies and procedures, and for making the
policies available to residents, to any guardians, next of kin, sponsoring
agencies or representative payees.
10.C.
Exercise of Rights
The resident has a right to a dignified existence,
self-determination, and communication with and access to persons and services
inside and outside the facility. A facility must protect and promote the rights
of each resident, including the following:
10.C.1. The resident has the right to
exercise his or her rights as a resident of the facility and as a citizen or
resident of the United States.
10.C.2. The resident has the right to be free
of interference, coercion, discrimination, or reprisal from the facility in
exercising his or her rights.
10.C.3. In the case of a resident adjudicated
incompetent under the laws of the State by a court of competent jurisdiction,
the rights of the resident are exercised by the person appointed under State
law to act on the resident's behalf.
10.C.4. The facility must inform the
resident, legal representative or family member, both orally and in writing, in
a language that he or she understands, of the resident's rights and all rules
and regulations governing resident conduct and responsibilities during the
resident's stay in the facility.
Such notification must be made prior to or upon admission and
during the resident's stay. Receipt of such information and any amendments to
it must be acknowledged in writing.
10.C.5. The resident has the right to inspect
all records pertaining to himself/herself, upon oral or written request, within
twenty-four (24) hours. Photocopies may be purchased and the facility must
provide them within two (2) working days of the request.
10.C.6. The resident has the right to be
fully informed in language that he or she can understand of his or her total
health status, including but not limited to, his or her medical
condition.
10.C.7. The resident has
the right to limit and/or refuse treatment, and to refuse to participate in
experimental research.
10.C.8. The
facility must display information and:
a.
Inform each resident how to apply for Medicaid;
b. Inform each resident who is entitled to
Medicaid benefits, in writing, at the time of admission to the nursing facility
or when the resident becomes eligible for Medicaid of:
1. The items and services that are included
in nursing facility services in the Maine Medical Assistance Manual and for
which the resident may not be charged.
2. Those other items and services that the
facility offers and for which the resident may be charged, and the amount of
charges for those services and,
c. Inform each resident when changes are made
to the items and services specified in Sections 10. C.8.b.1. and 10.
C.8.b.2.
10. C.9. Inform
each resident before, or at the time of admission, when changes occur, and
periodically during the resident's stay, of services available in the facility
and of charges for those services, including any charges for services not
covered under Medicaid/Medicare or by the facility's per diem rate.
10.C.10. The facility must furnish to each
resident, before or at the time of admission, a written description of legal
rights which includes:
a. A description of
the manner of protecting personal funds, under Section 10.E.
b. A statement that the resident may file a
complaint with the Division of Licensing and Certification, the Bureau of Elder
and Adult Services or the Long Term Care Ombudsman Program concerning resident
abuse, neglect, and/or misappropriation of resident property in the facility
and other violations of residents' rights.
c. Information regarding Advance Directives
as required by the Patient Self-Determination Act.
10.C.11. Inform each resident of the name,
specialty, and method of contacting the physician responsible for his or her
care.
10.D.
Notification of Changes
10.D.1.
Except in a medical emergency or when a resident is incompetent, a facility
must consult with the resident regarding any proposed significant changes in
treatment or plan of care. If the resident is not capable of making decisions,
facility staff must contact the designated resident representative, consistent
with his or her authority, to make any required decisions, but the resident
must still be informed of any significant changes in treatment or plan of care
and the reason for any such change. The facility must notify the resident's
physician, the resident's legal representative and, with the resident's
permission, an interested family member, when there is:
a. An accident involving the resident which
results in injury.
b. A significant
change in the resident's physical, mental, or psychosocial status.
c. A need to alter treatment significantly,
or
d. A decision to transfer or
discharge the resident from the facility.
10.D.2. The facility must also promptly
notify the resident and with the resident's permission, the resident's legal
representative or interested family member when there is:
a. A change in room or roommate
assignment
b. A change in resident
rights under Federal or State law or regulations.
10.E.
Protection of Resident
Funds
10.E.1. The resident has the
right to manage his or her financial affairs. The facility may not require
residents to deposit their personal funds with the facility.
10.E.2. The individual financial record and a
quarterly summary must be available on request to the resident or his or her
legal representative.
10.F.
Free Choice
The resident has the right to:
10.F.1. Choose a personal attending
physician.
10.F.2. Choose a
provider pharmacy.
10.F.3. Be fully
informed in advance about care and treatment that may affect the resident's
well-being.
10.F.4. Participate in
planning care and treatment or changes in care and treatment, unless
adjudicated incompetent or otherwise found to be incapacitated under the laws
of the State.
10.G.
Privacy
10.G.1. The resident has
the right to personal privacy and confidentiality of his/her personal and
clinical records.
a. Personal privacy
includes accommodations, medical treatment, written and telephone
communications, personal care, visits, and meeting of family and resident
groups, but this does not require the facility to provide a private
room.
b. Except as provided in this
section, the resident may approve or refuse the release of personal and
clinical records to any individual outside the facility.
10.G.2. The resident's right to refuse
release of personal and clinical records does not apply when:
a. The resident is transferred to another
health care institution;
b. Record
release is required by law or by third-party payment contract; or
c. Copies are requested by the
Department.
10.H.
Grievances and Complaints
A resident has the right to:
10.H.1. Voice grievances and complaints with
respect to treatment or care that is, or fails to be furnished, without
discrimination or reprisal for voicing the grievances or complaints. Such
grievances include those with respect to treatment which has been furnished, as
well as that which has not been furnished.
10.H.2. File a complaint and/or a grievance
with the State survey and certification agency, the Long Term Care Ombudsman
Program, Legal Services for the Elderly and the Bureau of Elder and Adult
Services respective to abuse, neglect and/or misappropriation of resident
property in the facility.
10.H.3.
Prompt efforts by the facility to resolve grievances and/or complaints the
resident may have, including those with respect to the behavior of other
residents.
10.H.4. A written
response to be provided whenever possible to the grievant, describing
disposition of the complaint.
10.I.
Examination of Survey
Results
A resident has the right to:
10.I.1. Examine the results of the most
recent State licensing and Federal certification survey of the facility and any
plan of correction in effect.
10.I.2. Receive information from agencies
acting as client advocates, and be afforded the opportunity to contact
agencies.
10.J.
Work
The resident has the right to:
10.J.1. Refuse to perform services for the
facility.
10.J.2. Perform services
for the facility, if he or she chooses, when:
a. The facility has documented the need or
desire for work in the plan of care.
b. The plan specifies the nature of the
services performed and whether the services performed are voluntary or
paid.
c. Compensation for paid
services is at or above prevailing rates.
d. The resident agrees to the work
arrangement described in the plan of care.
10.K.
Mail
The resident has the right to privacy in written
communications, including the right to:
10.K.1. Send and receive unopened mail
promptly.
10.K.2. Have access to
stationary, postage, and writing implements at the resident's own
expense.
10.K.3. Assistance
provided to the resident upon request.
10.L.
Access and Visitation
Rights
The resident has the right to receive visitors. The facility
must allow access to the resident for such visitors at any reasonable
hour.
10.L.1. The resident has the
right and the facility must provide immediate access to any resident by:
a. Any representative of the Secretary of the
Department of Health and Human Services.
b. Any representative of the State.
c. The resident's individual
physician.
d. A representative of
the Long Term Care Ombudsman Program or other authorized advocate(s).
e. Immediate family or other relatives of the
resident, subject to the resident's right to deny or withdraw consent at any
time.
f. 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.
10.L.2. The facility must provide 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.
10.L.3. The facility must allow
representatives of the Long Term Care Ombudsman Program to examine a resident's
clinical records with the oral or written permission of the resident or the
resident's legal representative, and consistent with State law.
10.M.
Telephone
The resident has the right to have regular access to the
private use of a telephone. Amplification shall be provided for the hearing
impaired.
10.N.
Personal Property
The resident has the right to retain and use personal
possessions including some furnishings and appropriate clothing as space
permits, unless to do so would infringe upon the rights or health and safety of
other residents. The facility must provide prior notification to the resident,
legal representative or responsible person in the event that the resident's
personal possessions must be searched in order to protect the health and safety
of the resident or other residents.
10.O.
Married Couples
The resident has the right to share a room with his/her
spouse when married residents live in the same facility and both spouses
consent to the arrangement.
10.P.
Self- Administration of
Drugs
The resident has a right to self-administer drugs when the
interdisciplinary team has determined that this practice is safe.
10.Q.
Transfer and Discharge
Rights
10.Q.1.
Definition
Transfer and discharge includes movement of a resident to a
bed outside of the certified unit, whether that bed is in the same facility or
not. Transfer and discharge does not refer to movement of a resident to a bed
within the same certified unit.
10.Q.2.
Transfer and Discharge
Requirements
The facility must permit each resident to remain in the unit
or facility, and not transfer or discharge the resident from the unit or
facility unless:
a. The transfer or
discharge is necessary for the resident's welfare and the resident's needs
cannot be met in the unit or facility.
b. The transfer or discharge is appropriate
because the resident's health and/or functional ability has improved
sufficiently so that the resident no longer needs the services provided by the
unit or facility.
c. The safety
and/or health of individuals in the facility is endangered.
d. The resident has failed, after reasonable
and appropriate notice, to pay for (or to have paid under Medicare or Medicaid)
a stay at the facility. For a resident who becomes eligible for Medicaid after
admission to a facility, the facility may charge a resident only charges
allowable under Medicaid.
e. The
facility ceases to operate.
10.Q.3.
Notice Before Transfer
Before a facility transfers or discharges a resident, the
facility must notify the resident and, if known, a family member or legal
representative of the resident, of the transfer or discharge and the
reasons.
The resident's clinical record shall contain documentation
describing the basis for the transfer or discharge.
10.Q.4.
Contents of the Notice
Each notice must be written and include, in a language and
manner understood by the resident.
a.
In order to provide for informed resident decisions, a nursing facility shall
provide lists of licensed providers of care and services for all patients prior
to discharge for whom home health care is needed.
(1) For all residents requiring home health
care, the list must include all licensed home health care providers that
request to be listed and any branch offices, including addresses and telephone
numbers, that serve the area in which the resident resides.
(2) The nursing facility shall disclose to
the resident any direct or indirect financial interest which the nursing
facility has in the home health care provider.
b. For all residents transferring to another
nursing facility, a list must be provided of all nursing facilities that
request to be listed that serve the area in which the resident resides or
wishes to reside.
c. The reason for
the transfer or discharge, including events which are the basis for such
action.
d. The effective date of
the transfer or discharge.
e. The
location to which the resident is transferred or discharged.
f. Notice of the resident's right to appeal
the transfer or discharge as set forth in the Maine Medical Assistance
Manual.
g. The location to which
the resident is transferred or discharged.
h. Notice of the resident's right to appeal
the transfer or discharge as set forth in the Maine Medical Assistance
Manual.
i. The mailing address and
telephone number of the Long Term Care Ombudsman Program.
j. In the case of residents with
developmental disabilities or mental illness, the mailing address and telephone
number of the Office of Advocate, Department of Mental Health, Mental
Retardation and Substance Abuse Services.
k. The resident's right to be represented by
himself or herself or by legal counsel, a relative, friend or other
spokesman.
10.Q.5.
Timing of the Notice
Except when specified in Section 10.Q.2.c., the notice of
transfer or discharge must be made by the facility at least:
a. Thirty (30) days before the resident is
transferred or discharged.
b. As
soon as practicable before transfer or discharge when:
1. The safety and/or health of individuals in
the facility would be endangered.
2. The resident's health improves
sufficiently to allow a more immediate transfer or discharge.
3. An immediate transfer or discharge is
required by the resident's urgent medical needs, or
4. A resident has not resided in the facility
for thirty (30) days.
10.Q.6.
Appeal of Transfer or
Discharge
The resident has the right to appeal a transfer or discharge
to the Administrative Hearings Unit of the Department.
10.Q.7.
Transfer or Discharge
Orientation
The resident has the right to receive sufficient preparation
and orientation to ensure safe and orderly transfer or discharge from the
facility. This shall be documented in the resident record.
10.R.
Physical or Chemical
Restraints
The resident has the right to be free from any physical
restraints imposed or psychoactive drug administered for purposes of punishment
for certain behaviors or to accommodate the needs of the staff, and is not
required to treat the resident's specific condition.
10.S.
Freedom From Abuse, Punishment or
Involuntary Seclusion
The resident has the right to be free from neglect, verbal,
sexual, physical or mental abuse and involuntary seclusion.
10.T. The resident has the right to:
10.T.1. Choose activities, schedules, and
health care consistent with his/her interests, assessments, and plans of
care.
10.T.2. Interact with members
of the community both inside and outside the facility.
10.T.3. Make choices that are significant to
the resident about aspects of his/her life in the facility.
10.U.
Organization and
Participation
10.U.1. A resident has
the right to organize and participate in resident groups in the
facility.
10.U.2. A resident's
family has the right to meet in the facility with the families of other
residents.
10.U.3. The facility
must provide a resident or family group, if one exists, use of private
space.
10.U.4. Staff or visitors
may attend meetings only at the group's invitation.
10.U.5. The facility must provide a
designated staff person responsible for providing assistance and responding to
written requests resulting from group meetings.
10.U.6. When a resident or family group
exists, the facility must listen to the views and act upon the grievances and
recommendations of residents and families and report back to the
group.
10.V.
Residents' Council
10.V.1.
Establishment and Composition
a.
The facility shall inform residents of their right to establish a council. This
information shall be given to all residents or a family member or designated
representative.
b. The residents
have the right to have assistance in establishing a council. The council shall
select a staff member, not related to the administrator, to assist the
residents' council.
c. If there is
no council, the facility must offer the residents, at least once a year, the
choice to establish one by majority vote.
d. Records of council meetings and decisions,
if prepared, shall be disseminated by the council and kept on file in the
facility.
e. No employee or
representative of the facility may be a member of the council or attend a
meeting, unless requested by the group.
f. Family members may sit in on the council,
at the group's invitation, but shall not be members.
g. Staff or visitors may attend meetings at
the group's invitation.
10.V.2.
Responsibilities and
Purpose
a. To review and make
recommendations to strengthen the facility's policies and procedures relating
to residents' rights.
b. To
establish procedures for informing all residents about their rights.
c. To serve as a forum for obtaining and
disseminating information, soliciting and adopting recommendations for facility
programming and improvement and early identification of and recommendation for
orderly resolution of residents' problems.
d. To inform the administrator about the
opinions and concerns of the residents.
e. To find ways of involving the families of
residents.
10.W.
Participation in Other
Activities
A resident has the right to participate in social, religious
and community activities that do not interfere with the rights of other
residents in the facility.
