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Tip Sheets
Residents of nursing homes in Minnesota have rights
State and Federal laws protect the rights of residents of licensed nursing facilities and licensed board-and-care facilities.
Any guardian, conservator, or interested person may seek enforcement of these rights on behalf of a resident.
Your rights include:
- Accommodation of needs
A nursing home resident has the right to reasonable accommodation of individual needs and preferences. Resident rooms, toilets, bath facilities, common areas, and other areas must have adaptations that help residents maintain independence, i.e., readable clocks, calendars, grab bars, elevated toilet seats, wheelchair accessible telephones.
- Appropriate medical and personal care
The resident has the right to appropriate medical and personal care based on individual needs and preferences.
- A care plan is developed with the resident to set reasonable goals to achieve their highest physical and mental ability and meet their individual needs and preferences.
- Facility staff must ensure that a resident's physical and mental abilities do not diminish except for medical reasons.
- The plan must utilize residents' skills, talents and mental ability.
- Right to participate
The resident has the right to choose activities, schedules, food and health care according to his or her interests, assessments and plans of care, and to make choices about life in the facility. Choices may include when to get up, go to bed, arrange his or her room, choice of table partner at meals, style of grooming and dressing, or activity or food preference.
- Right to associate
The resident has the right to associate with persons of his or her own choice inside and outside the facility. Residents shall be given the opportunity to authorize disclosure of their presence to callers and visitors.
- Residents may participate in community groups or political parties of their own choosing.
- Residents have the right to participate in cultural and religious events that promote their well being.
- The resident may choose to have their name posted on the resident roster list.
- Right to dignity
The facility must promote the resident's dignity. Facility staff must respect the resident by speaking respectfully, listening carefully and showing respect for the resident's private space and property.
- Staff must not change radio station or television setting or utilize any property without the resident's permission.
- Facility staff shall knock and seek consent before entering a resident's room except in an emergency.
- Room and roommate change
The resident has the right to receive notice before the resident's room or roommate in the facility is changed.
Residents have the right to personal privacy and confidentiality of his or her personal and clinical records. The resident must consent to have their name posted on a resident roster. If you wish to keep your presence in the nursing home private you may ask the facility not to publish your name.
- Records
The Resident may approve or refuse the release of personal and clinical records to anyone outside the facility.
A resident's approval is not required when the records are required by law or third party payment.
- Medical and personal care
Privacy must be assured during medical treatment, personal care and visits with family, friends and groups.
- Nursing home staff shall knock before entering a resident's room.
- A resident will have privacy while bathing, toileting and performing other personal grooming tasks.
- The resident has the right to privacy with whomever he or she wishes.
- Private mail and telephone
Residents have the right to receive mail unopened, and to have access to stationery, postage and pens at his or her own expense.
- Mail must be delivered within twenty-four (24) hours of post office delivery.
- Residents should have reasonable access to a telephone where calls can be made without being overheard.
- Personal possessions and clothing
Residents have the right to have their own possessions and clothing as space permits.
- Regardless of their apparent value to others, individual possessions must be treated with respect.
- There should be reasonable preventative measures for lost or damaged personal property. (For example, labeling belongings, investigating incidents of loss, etc.)
- The facility must maintain a central locked depository or locked storage area in which residents may store their valuables.
- Married couples
Married couples have the right to share a room if both consent. Residents shall be assured privacy for visits by their spouses.
- Work
Residents may choose to work for the facility. The facility must document a resident's need or desire to work in the care plan, describe the nature of the work, and state whether the work is voluntary or paid. Paid services are at the prevailing rate, and the resident must agree to the work arrangement.
- Communication privacy
Upon admission to a facility, the resident or his/her legal guardian or shall be given the opportunity to authorize disclosure of the resident's presence in the facility to callers and visitors who may seek to communicate with the resident.
- Right to manage finances
The resident has the right to manage his or her own financial affairs. The facility can't require a resident to deposit funds with the facility.
- Protection of funds
If requested, the facility must manage a resident's funds. When the facility accepts written responsibility for residents' funds, the facility must:
- keep funds over $50 in an interest-bearing account, separate from the facility account;
- keep other funds available in a separate account, petty cash or interest-bearing account;
- keep a complete and separate accounting of each resident's funds with a written record of all transactions; the record shall be available for review by residents and their representatives on a quarterly basis;
- notify Medicaid residents when their balance comes within $200 of the Medicaid limit and the effect of this on their eligibility;
- upon a resident's death, turn the funds over to a private pay resident's trustee or, if the resident has MA, to the county; and give a financial accounting within thirty (30) days;
- not charge a resident for any item or service covered by Medicaid including routine personal hygiene items and services.
- Financial liability
A person other than the resident may assume financial responsibility for the resident, if they so desire. They must inform the facility of this decision.
- The person assuming financial responsibility must sign the admission contract.
- If the person misspends the resident's assets for the purpose of obtaining medical assistance, the person is personally liable only for the resident's income or asset that was misapplied.
- Receiving visitors
The resident has the right to receive visitors. The facility must provide access to resident. The nursing home must permit:
- immediate visits by the resident's personal physician or by representatives from the health department and the ombudsman program;
- immediate visits by a resident's relatives, as long as the resident consents;
- visits "subject to reasonable restriction" for others who visit with the resident's consent; and
- reasonable visits by organizations or individuals providing health, social, legal, or other services, subject to a resident's consent.
- Disclosure of identity
Upon admission to a facility the resident or legal guardian or conservator of the resident shall be given the opportunity to authorize disclosure of the resident's presence in the facility to callers and visitors who may seek to communicate with the resident.
- Advance information
The resident has the right to be informed in a language she or he can understand of health status, care, treatment, and charges; also, the resident has the right to participate in planning care and treatment.
- The facility will discuss with the resident, his/her family or legal representative, treatment options and alternatives; the resident has the right to select and approve of the plan before it is begun. This includes physical and chemical restraints, do-not-resuscitate orders and tube feedings.
- Residents suffering from any form of breast cancer shall be of alternatives, effective treatment and risk of those treatments. Residents shall be informed prior to or at the time of admission and during the stay.
- Rights to notice and information
Residents must receive notice of their rights and facility policies both orally and in writing at the time of admission and throughout their stay.
Accommodation will be made for those who have difficulties in hearing and seeing and those who speak a language other than English.
- Survey results
Residents have the right to examine survey results. Results must be available in a place accessible to all residents. The name, address and phone number of the survey agency must be posted.
- Changes in resident's status
The resident or family member or legal representative and the physician must be notified immediately when there is a change in resident status, such as:
- an accident resulting in injury that has potential for physician intervention;
- a change in physical, mental or social condition;
- a need to alter treatment significantly;
- a plan to transfer or discharge;
- a change of room or roommate; and
- a change in resident's rights.
- Services, charges, Medicare and Medicaid
The facility must inform a resident of medical assistance covered services, and other charges.
- The facility must inform residents in writing at admission and throughout their stay of the services available under the basic rate and of any extra changes for special services, including a list of services covered by Medicaid and those for special charges;
- The facility must prominently display and provide written and oral information for residents about how to apply for and use Medical Assistance and Medicare benefits and how to receive a refund for previous private payments that MA will pay for retroactively;
- The resident has the right to request an asset assessment, which determines the community spouse's share of financial resources and the exempt resources for medical assistance purposes.
- Records and copies
The resident, his/her guardian or his/her conservator has the right to inspect all records pertaining to the resident, within twenty-four (24) hours and purchase copies, at the going rate, within two (2) working days with advance notice. The resident may give family member, friend or ombudsman, permission to inspect records.
- Posting of agency names and information
The facility must post names, addresses and phone numbers of the following agencies:
- Office of Ombudsman for Long-Term Care 651-296-0382 or 1-800-657-0538
- Office of Health Facility Complaints 651-201-4201 or 1-800-369-7994
- Minnesota Department of Health 651-643-2120
- Medicaid Fraud Unit
- Disability Law Center
The facility must also POST survey results, their grievance process and how to apply for Medicaid and Medicare.
- Reasons for discharge
The facility must permit each resident to remain in the facility and the facility cannot discharge a resident without full compliance with resident's rights. Residents may not be discharged except for the following reasons:
- the residents' medical needs and welfare cannot be met in the facility;
- the residents' health has improved so that the services are no longer needed;
- the safety or health of individuals in the facility is endangered; or
- the resident has failed after reasonable and appropriate notice to pay for a stay at the facility.
- Time frame, notices and appeal rights
Before a resident may be transferred or discharged, the facility must provide a thirty (30) day written notice to the resident and his/her family member or legal representative. The written notice must include:
- the reason for the discharge,
- the effective date of discharge,
- the location where the resident is to be transferred,
- a statement that the resident has the right to appeal the action to a State agency within the (30) thirty days of notice, and
- the name, address and telephone number of the State and Regional long term care ombudsman. For residents with developmental disabilities or mental illness, the name, mailing address and telephone numbers of the agency responsible for protection and advocacy.
The facility must provide sufficient preparation and orientation to the resident to insure safe discharge from the facility. If discharge or transfer is necessary to meet the residents' welfare the facility must document their efforts to meet the residents' needs and the outcome of those efforts.
Thirty-day notice is not required for an urgent medical problem requiring transfer to a hospital or when the health or safety of either the resident or other residents is endangered.
- Bed hold policy and readmission
Before a facility transfers a resident to a hospital, or for therapeutic leave, the facility must provide written information to the resident and his/her family member or legal representative. The document must specify the duration of the bed-hold policy. Regardless of source of payment, the facility must provide the policy regarding bed-hold days at admission and at the time of transfer.
- A facility must establish and follow a written policy under which a Medical Assistance (MA) resident whose hospital stay or therapeutic leave exceeds the bed-hold period is re-admitted to the facility immediately to the first available bed in a semi-private room.
- MA residents are allowed 18 bed hold days for every hospital admission
- MA residents are allowed 36 therapeutic leave days per year
- Medicare or private pay residents must pay for hospital or therapeutic leave days.
A facility cannot discharge a resident by first transferring them to a hospital.
- Discharge plans
Facilities must provide sufficient preparation and orientation to residents to assure safe and orderly discharge. For residents discharged to home, to another facility or to a lower level of care, a facility must:
- prepare a discharge summary that recaps the residents' stay and specifies needs and preferences; and
- develop a post-discharge plan of care with input from the resident and family to assist in adjustment to the new living arrangement.
- Maltreatment: Abuse, neglect or financial exploitation
A resident has the right to be free from maltreatment as defined by law, which is:
- Abuse is the intentional act to produce pain or injury to a resident or sexual contact between staff and the resident.
- Neglect is reckless, careless or unprofessional disregard for a resident's physical, mental or emotional well being or negligently failing to supply the resident with reasonable food, clothing, health care or supervision.
- Financial exploitation is knowingly permitting conditions which result in financial hardship for the resident or allowing the mismanagement of resident's funds.
- The resident has the right to be free from verbal, sexual, physical, or mental abuse, corporal punishment and involuntary seclusion.
- Freedom from restraints
The resident has the right to be free from chemical and physical restraints. This includes:
- to be free from mental abuse, physical restraints or psychoactive drugs not required for medical symptoms;
- to be free of restraints used for the convenience of staff rather than the well-being of residents; (convenience means controlling behavior with least amount of effort by staff and not in the residents best interest);
- to have restraints used only under written physician's recommendation and with written and informed consent of residents or family representatives, to treat a resident's medical symptoms and ensure his/her safety and the safety of others; and
- to be given psychopharmacological medication only as recommended by a doctor as part of a written plan of care for a specific medical symptom, with written and informed consent of the resident or family representative.
- 'Informed consent' means knowledge of risks, benefits and alternatives.
- Identical discharge policies
The facility must establish and maintain identical policies and practices regarding discharge of residents and the provision of services required under Medicaid for all individuals regardless of source of payment.
- Right to medical assistance information
The facility must not require residents to waive their rights to Medicaid, and must provide written information about how to apply for Medicaid; and display this information within the facility.
- Admission policy
People seeking admission to a facility may not be denied admission based on race, age, color, nationality, diagnosis (including dementia) or facility preference. If the facility can meet the medical needs of the applicant, admission must be granted.
- The facility may not require a third party to guarantee personal financial liability as a condition of admission or continued
stay
- The facility cannot require you to waive your rights to Medicare or Medicaid.
- Upon admission to a facility, the resident or his/her legal guardian or conservator shall be given the opportunity to authorize disclosure of the resident's presence in the facility to callers and visitors who may seek to communicate with the resident.
- Preconditions for continued stay
The facility may not "charge, solicit, accept or receive" gifts, money, donations or "other consideration" as a precondition for continued stay for persons eligible for Medicaid.
- Posting of fraud phone number
The Medical Assistance Fraud Unit phone number must be posted.
- Covered services
The resident must be informed of services in the daily rate. These include personal hygiene items, incontinence products, over-the-counter drugs, moisturizing lotion, appropriately sized wheelchair, etc.
Other services such as a private telephone, cosmetics, cable television, private room, smoking materials and other personal items must be offered to all residents without discrimination.
The facility must provide residents with information about whether Medical Assistance will pay for any or all of the services.
Information numbers
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Office of Ombudsman for Long-Term Care 651-431-2555 or 1-800-657-3591.
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Office of Health Facility Complaints 651-201-4201 or 1-800-369-7994.
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Minnesota Department of Health 651-215-8700.
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Disability Law Center 612-332-1441 or 1-800-292-4150.
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Board of Medical Practice 612-617-2130.
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Board of Social Work 612-617-2100.
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Board of Nursing Home Administrators 612-617-2117.
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Board of Psychology 612-617-2230.
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Office of Mental Health Practice 612-282-5621 or 1-800-657-3957.
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Board of Nursing 612-617-2270.
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