50-10.2-02. Residents' rights - Implementation
1. All facilities shall, upon a resident's admission, provide in hand to the resident and a
member of the resident's immediate family or the resident representative a statement
of the resident's rights during the admission process and while living in the facility.
Within thirty days after admission, the statement must be orally explained to the
resident and, if the resident is unable to understand, to the resident's immediate family
member and the resident representative, and thereafter annually so long as the
resident remains in the facility. The statement must include rights, responsibilities of
both the resident and the facility, and the facility rules governing resident conduct. A
facility shall treat a resident in accordance with provisions of the statement. The
statement must include provisions ensuring each resident the following minimum
rights:
a. The right to civil and religious liberties, including knowledge of available choices,
the right to independent personal decisions without infringement, and the right to
encouragement and assistance from the staff of the facility to promote the fullest
possible exercise of these rights.
b. The right to have private meetings, associations, and communications with any
person of the resident's choice within the facility.
c. The right to participate in the community.
d. The right of each resident, the resident's immediate family, the
resident representative, friends, facility staff, and other persons to present
complaints on the behalf of the resident to the facility's staff, the facility's
administrator, governmental officials, or to any other person, without fear of
reprisal, interference, coercion, discrimination, or restraint.
e. The right to send and receive unopened personal mail and electronic mail and the
right of access to and use of telephones and electronic devices for private
conversations.
f. The right to assured private visits, subject to restrictions to protect the health or
safety of the resident, by one's spouse, partner, or significant other, or if both are
residents of the same facility, the right to share a room, within the capacity of the
facility, unless sharing a room is not medically advisable as documented in the
medical records by the attending physician.
g. The right to manage one's own financial affairs if not under legal guardianship, or
to delegate the responsibility in writing to the administrator or manager of the
facility, but only to the extent of funds held in trust by the facility for the resident.
h. The right to be fully informed in writing prior to or at the time of admission and
during one's stay, of services provided and the charges for those services,
including ancillary charges.
i. The right to be adequately informed of one's medical condition and proposed
treatment and to participate in the planning of all medical treatment, including the
right to refuse medication and treatment, to be discharged from the facility upon
written request, and to be notified by the resident's attending physician of the
medical consequences of any such actions.
j. The right to have privacy in treatment and in caring for personal needs and to
have confidentiality in the treatment of personal and medical records.
k. The right to keep and use personal possessions, including furnishings and
clothing as space permits, unless keeping or using the personal possession
would infringe upon the rights, health, or safety of another resident.
l. The right to be treated courteously, fairly, and with the fullest measure of dignity.
m. The right to be free from mental and physical abuse, neglect, and financial
exploitation, and the right to be free from physical or chemical restraint except in
documented emergencies or when necessary to protect the resident from injury
to self or to others.
n. The right not to be transferred or discharged except for:
(1) Medical reasons;
(2) The resident's welfare or the safety of an individual in the facility who is
endangered due to the clinical or behavioral status of the resident;
(3) Nonpayment of one's rent or fees;
(4) A temporary transfer during times of remodeling; or
(5) The facility ceases to operate.
o. The right to receive at least a thirty-day written advance notice of any transfer or
discharge when the resident is being discharged to another facility or the
resident's own home, or when the resident is being transferred or discharged
because of a change in the resident's level of care; however, advance notice of
transfer or discharge may be less than thirty days if the resident has urgent
medical needs that require a more immediate transfer or discharge, or a more
immediate transfer or discharge is required to protect the health and safety of
residents and staff within the facility.
p. The right to refuse to perform services on behalf of the facility, unless agreed to
by the resident or legal guardian and established in the plan of care.
q. The right to a claim for relief against a facility for any violation of rights
guaranteed under this chapter.
r. The right to have each facility display a notice that the following information is
available for public review and make the information available on request:
(1) A complete copy of every inspection report, deficiency report, and plan of
correction the facility received during the previous three years.
(2) The facility's grievance process.
(3) A copy of the statement of ownership, board membership, and partners.
(4) A statement of ownership setting forth any conflict of interest in the
operation of the facility.
s. The right to a pharmacist of the resident's choice irrespective of the type of
medication distribution system used by the facility, and to not be charged a fee or
receive a financial incentive or disincentive for choosing a pharmacy other than
the facility's preferred pharmacy. The resident may not be charged for
repackaging if that cost can be included on the facility cost report.
t. The right to not be discriminated against by a facility in the admissions process or
in the provision of appropriate care on the basis of the resident's source of
payment to the facility.
u. The right of residents and their families to organize, maintain, and participate in
resident advisory and family councils.
v. The right of residents receiving services performed by a provider from outside the
facility to be informed, on request, of the identity of the provider.
2. If there is a change in the resident rights, laws, or regulations, the facility shall
promptly notify the resident, and, if the resident is unable to understand, a member of
the resident's immediate family or the resident representative.
3. For involuntary transfer and discharge actions taken by a facility, the written transfer or
discharge notice issued by the facility must include:
a. The reason for the transfer or discharge.
b. The effective date of transfer or discharge.
c. The location the resident is to be transferred or discharged to.
d. The name, mailing and electronic mail address, and telephone number of the
office of the state long-term care ombudsman.
4. The facility shall protect the resident from retaliation. The facility shall adopt a
grievance process and make the process known to each resident, the resident's
immediate family member, and the resident representative. A person making a
complaint in good faith is immune from any civil liability that otherwise might result
from making the complaint.
5. If a trust is established by the facility to hold the resident's funds, the facility shall
provide to the resident, resident representative, or an agent under a power of attorney
for financial decisions a written quarterly accounting of transactions made on behalf of
the resident, including an explanation of the transactions by the facility. The facility
shall pay out in full:
a. A resident's personal funds deposited with the facility or refunds due to the
resident upon discharge or eviction within thirty days, and provide a final
accounting of those funds to the resident, or in the case of death, in accordance
with state law.
b. Refunds due as a result of an overpayment to the facility within thirty days from
the date the overpayment is discovered.
c. Other refunds due to the resident upon discharge, eviction, or death within thirty
days from the resident's date of discharge from the facility.
6. The facility shall inform a resident, resident representative, an agent under a power of
attorney for financial decisions, or immediate family member, at least thirty days before
any change in the costs or availability of the services. A facility may not demand or
receive advance payment or gratuity to assure admission or for the resident to be
placed on a waiting list for admission.
7. A resident and the resident representative may view and authorize release of any
personal or medical records.
8. The use of a physical or chemical restraint in an emergency or if necessary to protect
the resident from injury to self or others must be authorized and documented by a
physician, nurse practitioner, or physician's assistant for a limited period of time. A
chemical restraint must be administered by a licensed nurse, physician, nurse
practitioner, or physician's assistant. Except as provided in this subsection, a drug or
physical restraint may not be used or threatened to be used for the purpose of
punishment, for the convenience of staff, for behavior conditioning, as a substitute for
rehabilitation or treatment, or for any other purpose not included in an approved
treatment plan.
9. Upon request, a facility shall provide an applicant for admission to a facility who is
denied admission the reason for the denial in writing. The facility shall note in the
written denial if the denial is based on the special characteristics or service limitations
of the facility.
10. A facility shall ensure a resident council meeting is attended by residents only or at the
invitation of a resident.
11. Waiver of any of the rights guaranteed by this chapter may not be made a condition of
admission to a facility or ongoing residence.
12. Each facility shall prepare a written plan and provide staff training to implement this
chapter.
13. The department shall develop and coordinate with the facility licensing and regulatory
agencies a relocation plan in the event a facility is decertified or unlicensed.
