Long-Term Care Ombudsman Program - Nursing Home Resident Rights

Nursing Home Resident Rights (from the Maryland Health Care Commission)

Under the authority of Section19-343 of the Health General Article, regulations were adopted to provide Maryland nursing home residents with the following basic rights. The regulation can be found in COMAR (Code of Maryland Regulation)
A. A nursing facility shall provide care for residents in a manner and in an environment that maintains or enhances each resident's dignity and respect, and in full recognition of the resident's individuality.
B. A nursing facility may not interfere with a resident's exercise of rights guaranteed under the Constitution or laws of the United States and Maryland.
C. A resident has the right to:
  1. Reside and receive services in a nursing facility with reasonable accommodations of individual needs and preferences, except when accommodations would endanger the health or safety of the resident or other residents;
  2. Receive treatment, care, and services that are in an environment that promotes maintenance or enhancement of each resident's quality of life;
  3. A dignified existence, self-determination, and communication with and access to individuals and services inside and outside the nursing facility;
  4. Be free of interference, coercion, discrimination, or reprisal from the nursing facility when exercising the resident's rights;
  5. Be free from:
    1. (a) Physical abuse;
    2. (b) Verbal abuse;
    3. (c) Sexual abuse;
    4. (d) Physical or chemical restraints imposed for purposes of discipline or convenience;
    5. (e) Mental abuse; and
    6. (f) Involuntary seclusion;
  6. Choose an attending physician, if the physician agrees to abide by nursing facility policies and procedures, and the regulations in this chapter;
  7. Choose a pharmacy to obtain medications as set forth in COMAR and D(3);
  8. Be fully informed in advance about care and treatment, and of proposed changes in that care or treatment;
  9. Participate in planning care and treatment, or changes in care or treatment;
  10. Seek advice from the resident care advisory committee concerning the options for medical care and treatment for an individual with a life-threatening condition in accordance with Health-General Article, §19-370 et seq., Annotated Code of Maryland; 
  11. Consent to or refuse treatment, including the right to accept or reject artificially administered sustenance in accordance with State law;
  12. Self-administer drugs if the interdisciplinary team determines that the practice is safe;
  13. Access the resident's records within 24 hours, excluding weekends and holidays, upon an oral or written request;
  14. Purchase copies of all or part of the resident's records upon request by giving two working days advance notice to the nursing facility;
  15. Approve or refuse the release of personal and clinical records to an individual outside the nursing facility unless:
    1. Otherwise provided by Health-General Article, §4-301 et seq., Annotated Code of Maryland; or
    2. The release is required by law;
  16. Personal privacy, including:
    1. Confidentiality of personal records; and
    2. Privacy in:
      1. Medical treatment, and
      2. Personal care; 
  17. Privacy in the resident's room, including the right to have nursing facility staff knock before entering the resident's room; 
  18. Privacy in written communication, including the right to:
    1. Send and receive mail promptly without it being opened by anyone other than the resident, except when the resident requests assistance; and 
    2. Have access to stationery, postage, and writing implements at the resident's own expense;
  19. Reasonable access to the private use of a telephone; 
  20. Meet or visit privately with any individual the resident chooses, subject to reasonable restrictions by the nursing facility on visiting hours and places;
  21. Visit or meet privately with the following, to whom the nursing facility shall provide reasonable access:
    1. A representative of the Secretary of the U.S. Department of Health and Human Services;
    2. A representative of the Department;
    3. The resident's personal physician;
    4. A representative of the State Long-Term Care Ombudsman Program;
    5. The agency responsible for advocacy and protection of developmentally disabled and mentally ill individuals in Maryland; or
    6. Any other legal representative;
  22. Visit privately with the resident's spouse;
  23. Consent or deny consent to all visits, and may deny or withdraw consent at any time;
  24. Examine the results of the most recent federal and State surveys, including the annual survey and any subsequent complaint investigations, not otherwise prohibited by law, of the nursing facility and any plans of correction prompted by these surveys; 
  25. Receive notice before the resident's roommate is changed and, to the extent possible, have input into the choice of roommate; 
  26. Voice grievances, including those about treatment or care that is or fails to be furnished, and recommend changes in policies and services, to the staff or administrator of the nursing facility, the Licensing and Certification Administration, the Office on Aging, or any other person, without fear of reprisal, restraint, interference, coercion, or discrimination;
  27. Prompt efforts by the nursing facility to resolve grievances the resident may have, including those with respect to the behavior of other residents;
  28. Contact and receive information from agencies acting as client advocates;
  29. Refuse to perform services for the nursing facility;
  30. Perform services for the nursing facility if the resident chooses, only if:
    1. The nursing facility has documented the need or desire for work in the plan of are;
    2. The plan specifies the nature of the services to be performed and whether the services are voluntary or paid;
    3. Compensation for paid services is at or above prevailing rates; and
    4. The resident agrees in writing to the work arrangement described in the plan of care, and the contract is part of the resident's record;
  31. Share a room with the resident's spouse if both spouses consent and it is not medically contraindicated; and 
  32. Participate in social, religious, and community activities if the activities do not interfere with the rights of other residents in the nursing facility.
D. A resident has the right to participate or refuse to participate in experimental research. When the resident is incapable of making this decision, the resident's appropriate representative may consent for participation in therapeutic experimental research only.
E. The resident or, when applicable, the resident's health care representative, has the right to be fully informed, in a language that the resident or representative can reasonably be expected to understand, of complete and current information about the resident's diagnosis, treatment, and prognosis, unless it would be medically inadvisable as documented by the resident's attending health care provider.
If this determination has been made, the health care provider shall, upon written request:
  1. Make a summary of the undisclosed portion of the medical record available to the resident or health care representative;
  2. Insert a copy of the summary in the medical record of the resident;
  3. Permit examination and copying of the medical record by another health care provider; and
  4. Inform the resident or health care representative of the resident's or health care representative's right to select another health care provider.
F. Resident and Family Groups
  1. A resident has the right to organize and participate in resident groups in the nursing facility.
  2. A resident's family has the right to meet in the nursing facility with the families of other residents.
  3. Staff or other visitors may attend meetings only at the group's invitation.