As a resident of this facility, you have the right to a dignified existence and to communicate with individuals and representatives of choice. The facility will protect and promote your rights as designated below.
- You have the right and freedom to exercise your rights as a resident of this facility and as a citizen or resident of the United States without fear of discrimination, restraint, interference, coercion or reprisal.
- If you are unable to act in your own behalf, your rights are exercised by the person appointed under state law to act in your behalf.
Notice of Rights and Services
- You will be informed of your rights and of all rules and regulations governing resident conduct and responsibilities both orally and in writing.
- You have the right to inspect and purchase photocopies of your records.
- You have the right to be fully informed of your total health status.
- You have the right to refuse medication or treatment and the right to refuse to participate in experimental research.
- You have the right to formulate an advance directive in accordance with facility policy and applicable state law.
- You must be informed of Medicare and Medicaid benefits both orally and in writing, including how to receive refunds.
- You must be informed of facility services and charges and any changes to benefits or charges.
- The facility must inform you of procedures for protecting personal funds.
- You must be informed of your physician, his or her specialty, and ways of contacting him or her.
- The facility must consult with you and notify your physician and interested family member of any significant change in your condition or treatment, or of any decision to transfer or discharge.
- The facility must notify you and interested family member of a room or roommate change.
- You have the right to refuse room changes requested by the facility.
- The facility must periodically record and update the address and telephone number of your legal representative or interested family member.
- The facility must notify you and interested family member of changes to your rights.
- The facility must post the names, addresses and telephone numbers of all pertinent state client advocacy groups. If you deem necessary, you may file a complaint with the state survey and certification agency concerning resident abuse, neglect, misappropriation or resident property, and non-adherence to advance directive requirements.
Protection of Funds
- You may manage your own financial affairs. You are not required to deposit personal funds with the facility.
- The facility must manage your deposited funds with your best interests in mind. Your money must not be commingled with facility funds.
- The facility will provide you with an individualized financial report quarterly and upon your request.
- Any remaining estate will be conveyed to your named successor.
- All funds held by the facility will be protected by a security bond.
- The facility must not charge you for any items or services you do not request or which are included in your Medicare or Medicaid payment. The facility must tell you what the charges will be for any of these requested items or services.
- You may choose your own personal physician.
- You must be informed of and may participate in planning your care and treatment and any changes in your care and treatment.
- You have the right of privacy over your personal and clinical records.
- Your privacy will include: personal care, medical treatments, telephone use, visits, letters, and meetings of your family and resident groups.
- You may approve or refuse the release of your records except in the event of a transfer or legal situation.
- You may voice grievances concerning your care without fear of discrimination or reprisal.
- You may expect prompt efforts for the resolution of grievances.
Examination of Survey Results
- You may examine survey results and the plan of correction. These, or a notice of their location, will be posted in a readily accessible place.
- You may contact client advocate agencies and receive information from them.
- You have the right to perform or refuse to perform services for the facility
- All services performed must be well documented in the care plan to include nature of the work and compensation
- You have the right to send and promptly receive your mail unopened and have the access to writing supplies you have requested.
Access and Visitation Rights
- You have the right to receive or deny visitors 24 hours a day.
- You have the right and the facility must provide access to visit with any relevant agency of the state or any entity providing health, social, legal or other services.
- You have the right to use the telephone in private.
- You can retain and use personal possessions as space permits.
- A married couple may share a room.
Self-Administration of Drugs
- You may self-administer drugs if determined safe by the interdisciplinary care team.