Washington's Nursing Home
Resident's Bill of Rights

Each nursing home resident has the legal right to:

1. The right to safe and adequate care:

• Each resident has the right to receive safe and adequate care in a clean and comfortable environment.

2. The right to information about nursing home policies/procedures:

• Each resident must be informed both orally and in writing in a language the resident understands about the rights and rules governing resident conduct and of all services available and charges for such services.  This information must be provided before or at the time of admission and periodically during the resident's stay. 
• Each resident must be informed of any changes in nursing home policies and rules in a timely manner, and of all changes in services and related charges.
• The nursing home must inform each resident of services and charges not covered under Medicare or Medicaid or not included in the basic daily rate.
• The nursing home must post and provide both written and oral information for residents about how to apply for and use Medicaid benefits and how to receive refunds for previous private payments that Medicaid will pay retroactively.
• The nursing home must inform and provide access for residents, family members and the public to the latest written State Survey Inspection Reports and the nursing home plan of Correction.

3. The right to participate in and to determine your own plan of care:

• Each resident has the right to choose a personal attending physician.
• Each resident has a right to take their medications independently if it is determined to be safe.
• Each resident must be fully informed by a physician of their health and medical condition unless they choose not to be informed.
• Each resident is informed in advance about proposed care and treatment, about alternative choices and any changes in their health status so that the resident is able to fully direct their total care on an ongoing basis.
• Residents may refuse any treatment including the use of restraints and experimental treatment and may change their mind at any time even after signing a form, such as a Do Not Resuscitate order, living will or limited treatment form.
• Each resident has a right to request to see their records and to inspect them within 24 hours of the request.  A resident also has a right to receive a copy of their records at a reasonable cost within two days of the request.

4. The right to notice of transfer or discharge:

• Each resident may be transferred or discharged out of the facility for only:
  (a) medical reasons, (b) their welfare or the welfare of other residents, (c) nonpayment, unless prohibited by Medicaid, (d) upon the resident's request or (e) the resident no longer needs the services of the nursing home. 
• A resident cannot be discharged involuntarily from or to a Medicare-certified bed.
• The resident must be notified in writing thirty (30) days prior to a proposed transfer or discharge, except in certain specific circumstances.
• Each resident must be provided written information before leaving the nursing home about the policy for holding their bed while they are out of the nursing home and the readmission policies after a hospital stay or an extended overnight visit. 
• A resident may complain to the state about improper transfer process.  During the state investigation, the transfer/discharge proceeding will be stopped pending determination.

5. The right to exercise rights:

• Residents cannot be admitted to or detained in a nursing home against their will by a guardian or anyone else. 
• The nursing home must encourage and assist all residents to exercise their rights as a resident and citizen. 
• Each resident has the right to hire or contact a lawyer and has a right to private meetings with their lawyer. 
• The nursing home must inform all residents orally and in writing, before or upon admission and during the resident's stay, on how to voice concerns or recommendations about policies and services of the nursing home to staff and administration.

Such concerns or recommendations are to be accepted by the nursing home without interference, coercion, discrimination, or reprisal.

6. The right to manage financial affairs:

• Each resident may manage their own personal financial affairs.
• Each resident may authorize the facility, in writing, to manage any part of their personal financial affairs.
• The facility must have a system for full and complete accounting of personal funds which includes written receipts for:(a) all personal possessions and funds received by or deposited with the facility;(b) all disbursements made to or on behalf of the resident.
• The nursing home must have financial records available for resident's inspection and must provide them with a quarterly accounting of all the residents’ financial transactions.   Resident monies less than $50 are kept in a resident fund, and funds exceeding $50 must be deposited in a separate interest-bearing account in the resident's name.
• A resident may revoke any authorization to spend money from their funds.
• The nursing home must NOT charge for any item or service covered by Medicaid, including personal hygiene items and laundry services.

7. The right to be free from abuse and restraints:

• Each resident has the right to be free from verbal, sexual, physical, or mental abuse, corporal punishment and involuntary seclusion.
• Each resident has the right to be free of any chemical or physical restraints used for purposes of discipline or convince of staff.
• Restraints may be used only with the resident's informed consent and only under a physician's written order to treat medical symptoms, only for a specified time period, and only after less restrictive measures have been tried first and found to be ineffective medical treatment.
• Chemical restraints such as psychoactive drugs must be prescribed by a physician as part of a written plan of care for specific medical symptoms and for a specified time period and require the resident's informed consent.
• Restraints can be used without the resident's consent only in unanticipated, serious emergencies

8. Right to privacy and respect:

• The nursing home must treat each resident with consideration, respect, and full recognition of their dignity and individuality.
• The nursing home must provide treatment and care of personal needs in a private area, free from view to persons not involved in providing the care.
• The nursing home must treat each resident's records, including information in an automated data bank, as confidential.
• Each resident must give their written consent before information from their record is released to anyone not otherwise authorized to receive it.
• The nursing home must provide residents with private space for visiting with their spouse.

9. Right to freely associate, communicate and correspond with others in private:

• The nursing home must give married residents the opportunity to share a room if they choose.
• Each resident has the right to communicate privately by telephone or in person, with those individuals they choose. 
• Each resident has the right to send and receive personal mail unopened. 
• Each resident has the right to participate in activities such as social, religious and/or community.
• Residents have the right to privately organize in the nursing home resident groups, such as resident and family councils. 
• The nursing home must permit each resident immediate access to his/her personal physician, representatives from state regulatory agencies and LTC ombudsmen. 
• Each resident has the right to receive visits from their relatives and others of their choice.
• Each resident has the right to grant permission for the ombudsmen or other person(s) of choice to review their clinical records.
• Each resident has the opportunity, as regulations permit, for regular contact with pets.

10. Right to maintain personal possessions:

• Each resident has the right to retain and use their personal possessions as space and health regulations permit.
• The nursing home must have a system for safe-guarding residents' personal property.   (Nursing home waivers of liability for lost or stolen property are not legally enforceable.)

11. Right to not be required to work:

• No resident shall be required to perform services for the nursing home.  If "volunteer" services provided by a resident are of financial benefit to the facility, the resident must be paid prevailing wages.

12. Exercise of resident rights by others:

• The nursing home must provide to each resident, in writing, the nursing home policies and procedures for determining the resident's capacity to understand his or her rights and responsibilities. 
• Each resident has the right to formulate advance directives such as a Power of Attorney. 
• The nursing home shall write and implement policies and procedures about when and how guardianship is recommended for a resident.

13. Right to notification of change of ownership of the nursing home:

• Each resident shall be notified, in writing, at least 60 days before the effective day of any (a) change of ownership;(b) change in operating entity, or (c) change in management, except when the change is the result of a state order for receivership.

14. Right to be protected against Medicaid discrimination:

• The nursing home must establish and maintain identical policies and practices regarding admission, transfer, discharge and the provision of services required for all individuals, regardless of their source of payment.  (This means there can only be one waiting list for admission.)
• The facility may not require a third party to personally guarantee payment as a condition of admission, expedited admission, or continued stay in the facility; only the resident can be liable for the nursing home charges.