Step 6 - After Admission

Even if you made a well-reasoned choice and selected a nursing home only after following the steps discussed in this booklet, it is possible that you may not be entirely satisfied with your choice. New nursing home residents may go through a difficult adjustment period, even if the nursing home is doing all that it can. 

Be aware that the law gives you and your relatives specific rights in the nursing home. You should be ready to hold the nursing home accountable if it is not honoring the rights of residents and family members. A summary of these rights is detailed below. 

Resident Rights in a Nursing Home 
Some people think that nursing home residents surrender the right to make medical decisions, manage funds, and control their activities when they enter a nursing home. This is not true. As a nursing home resident, you have the same rights as anyone else, and certain special protections under the law. The nursing home must post and provide new residents with a statement that details each resident's rights. New residents also have these specific rights. 

Respect 
You have the right to be treated with dignity and respect. You have the right to make your own schedule, bed-time, and select the activities you would like to attend (as long as it fits your plan of care.) A nursing home is prohibited from using physical and chemical restraints except when necessary to treat medical symptoms (see the inside cover for more information on restraints). 

Services and Fees 
The nursing home must inform you, in writing, about its services and fees before you enter the home. Most facilities charge a basic rate that covers room, meals, housekeeping, linen, general nursing care, recreation, and some personal care services. There may be extra charges for personal services, such as haircuts, flowers, and telephone. 

Managing Money 
You have the right to manage your own money or to designate someone you trust to do so. If you allow the nursing home to manage your personal funds, you must sign a written statement that authorizes the nursing home to man- age your finances, and the nursing home must allow you access to your funds. Federal law requires that the home protect your funds from any loss by having a bond or similar arrangement. 

Privacy, Property, and Living Arrangements 
You have the right to privacy. In addition, you have the right to keep and use your personal property, as long as it does not interfere with the rights, health, or safety of others. Your mail can never be opened by the home unless you allow it. The nursing home must have a system in place to keep you safe from neglect and abuse, and to protect your property from theft. If you and your spouse live in the same home, you are entitled to share a room (if you both agree to do so). 

Guardianship and Advanced Directives 
As a nursing home resident, you are responsible for making your own decisions (unless you are mentally unable). If you wish, you may designate some- one else to make health care decisions for you. You may also draw up advance directives. A Durable Power of Attorney will become your legal guardian if you ever become incapable of making your own decisions. You may also make your end of life wishes known in a living will. 

Getting Help with Legal Documents 

Depending upon your State's laws, you may need a lawyer to draw up Durable Power of Attorney orders or a living will. Check with your local Office on Aging to find out if your state has any legal assistance services that help with preparing these documents. You will find the phone number for your local Office on Aging in the Blue Pages of your phone directory. 

Visitors 
You have the right to spend private time with the visitors of your choice at any reasonable hour. You have the right to make and receive telephone calls in privacy. The nursing home must permit your family to visit you at any time. Any person who provides you with health or legal services may see you at any reasonable times. Of course, you do not have to see anyone you do not wish to see. 

Medical Care 
You have the right to be informed about your medical condition, medications, and to participate in your plan of care. You have the right to refuse medications or treatments, and to see your own doctor. 

Social Services 
The nursing home must provide each resident with social services, including counseling, mediation of disputes with other residents, assistance in contacting legal and financial professionals, and discharge planning. 

Moving Out 
Living in a nursing home is voluntary. You are free to move to another place. However, nursing home ad- mission policies usually require that you give proper notice that you are leaving. If you do not give proper notice, you may owe the nursing home money based on the home's proper notice rules. Residents whose nursing home services are covered by Medicare and Medicaid do not have to give the nursing home proper notice before moving out. 

Discharge 
The nursing home may not discharge or transfer you unless: 

Ľ it is necessary for the welfare, health, or safety of others, 
Ľ your health has declined to the point that the nursing home cannot meet your care needs, 
Ľ your health has improved to the ex- tent that nursing home care is no longer necessary, 
Ľ the nursing home has not received payment for services delivered. 
Ľ the nursing home ceases operation. If you have any concerns about the nursing home in which you live, call your local long-term care ombudsman or your State's survey agency. 

Your Rights as a Relative 
Relatives and friends have rights too. Family members and legal guardians have the right to privacy when visiting the nursing home (but only when requested by the resident). They also have the right to meet with the families of other residents. If the nursing home has a family council, you have the right to join or address this group. 

By law, nursing homes must develop a plan of care for every resident. Family members are allowed to assist in preparing the development of this care plan, with the resident's permission. In addition, relatives who have legal guardianship of nursing home residents have the right to examine all medical records concerning their loved one. If you are a resident's legal guardian, Federal law gives you the right to make important decisions on behalf of your relative. 

It is important to remember that relatives play a major role in making sure that residents are receiving good care. You can make sure your loved -one is receiving good care by visiting often, expressing your concerns whenever they arise, and being active in the nursing home's family council (or helping to start a family council if the nursing home does not have one). 

Remember that if your concerns are not being addressed by the nursing home or if you have a complaint, there are people who can help. Contact your state long- term care ombudsman or state survey agency. Their phone numbers are listed in the back of this booklet. 'Phone Lists For further information on the topics covered in this booklet, contact your area Office on Aging (listed in the Blue Pages of your phone book). You will also find some helpful phone numbers on the following pages: 

- Long-Term Care Ombudsman 
- State Survey Agency, and 
- Insurance Counseling and Assistance Program.