RESIDENTS’ RIGHTS (Music) [NO AUDIO] Ester Houser, State Long-Term Care Ombudsman OKDHS Esther: Hello everyone, I’m Esther [NO AUDIO] Dorya Huser, Chief of Long-Term Care Oklahoma State Department of Health Doria: And I’m Doria. Thank you for watching this today. Esther: We know you’re watching because you care. D: Yes. Because you care about the rights of residents in long-term care facilities. E: That includes nursing homes, assisted living centers, and residential care facilities. D: You may be a resident yourself, and ombudsman, caregiver, or healthcare provider. E: Regardless of your role you need to know what a resident’s rights are. D: You’ll see a couple of scenarios that show common situations concerning resident’s rights and the appropriate solution. E: Sometimes a situation can be complex or not easily interpreted. Fortunately, there are guidelines to which we can always refer. There are federal laws as detailed in the Omnibus Budget Reconciliation Act of 1987. We’ll refer to that as OBRA ’87. [NO AUDIO] OBRA 87 Nursing Home Care Act, Constitutional Rights There’s also state law, the Nursing Home Care Act. It also defines the rights of residents. Constitutional rights apply as well. D: First let’s talk about some basic rights that all residents should understand and expect. Know that these rights are not negotiable. They belong to the resident. E: Every resident has the right to respectful and courteous care and treatment. A resident’s individual needs and preferences should be accommodated by the facility. D: All residents have the right to make independent personal decisions, and to be informed of available choices, that includes care choices, financial choices, religious choices, and community activity choices; as long as they do not interfere with the rights of other residents. E: The Nursing Home Care Act states, every resident shall have the right to have private communications, including telephone communications, visits, and consultations with a physician or attorney, and meetings with family and resident groups, or any other person or persons of the resident’s choice. Residents may also send and promptly receive, unopened, their personal mail. [NO AUDIO] Private Communications: telephone calls, visits, consultations with physicians and attorneys. Meetings: family, resident’s groups, any person of resident’s choice. Personal Mail: prompt receipt. D: That brings us to the first scenario. Mr. Dickenson is a resident of a nursing home. Let’s see what happens when he has a visitor. (music) Nicole: Mr. Dickenson, can you wake up for me? It’s time for your medication. Dickenson: Oh? What is it? Nicole: It’s your cholesterol pill and your diuretic. Dickenson: Okay. Nicole: Are you feeling better this afternoon? Dickenson: Not too peppy. Nicole: Yea, that’s what I thought. Your friend Frank came by but I didn’t let him in because I knew you weren’t feeling up to it. Dickenson: What did you do that for Nicole? He had some papers that I needed. Nicole: The last time he was here you guys got into a pretty heated discussion so I thought you weren’t feeling up to it. Doria: In this situation what are Mr. Dickenson’s rights? Esther: Did Nicole, the nursing aide, do the right thing? Doria: The answer is no. She did not. Even though she was concerned about the outcome of the visit she did not have the authority to turn away Mr. Dickenson’s visitor. Esther: The decision about visitors always belongs to the resident. Watch how Mr. Dickenson resolves the situation. Dickenson: Nicole, I know you were just looking out for me, but Frank is my friend, and I have a right to see him. Nicole: You’re right Mr. Dickenson. From now on I’ll leave all the decision making up to you. Dickenson: Thank you Nicole. It is the law you know. Now, when is lunch? Nicole: Um, 45 minutes. And we’re having cherry cobbler this afternoon. Dickenson: Oh! That’s my favorite! I’ll see you then. Nicole: Okay, you got it. Esther: Mr. Dickenson is absolutely correct. Both federal and state laws provide that a nursing facility must permit immediate access to a resident. The resident also has the right to deny or withdraw consent at any time to see visitors. Doria: Nicole’s assumption that Mr. Dickenson wouldn’t enjoy a visit from Frank does not permit her to refuse the visit. She would need to check with Mr. Dickenson and let him receive or deny the visitor. Esther: Next we have another scenario with Mr. Dickenson. This time it concerns medical treatment. Doria: Besides the clear right to receive adequate and appropriate medical care the resident also has the right to self-determination, and the right to refuse treatment. Esther: The resident’s rights section of the Nursing Home Care Act states, every resident shall have the right to refuse medication and treatment after being fully informed of and understanding the consequences of such actions, unless adjudged to be mentally incapacitated. Doria: Now adjudged in this situation means a formal declaration by a court. This is not a decision made by staff or family. Let’s see what happens. (Music) Kyle: Hey Charlie! Charlie: Oh hello Kyle! What do you know? Kyle: I know we have a pretty good chance of rain this afternoon. And it’s time to take your meds. Charlie: Oh? What is it? Kyle: It’s your heart pill and your antidepressant. Charlie: Not the antidepressant. I’m only going to take the heart pill. Kyle: *sighs* C’mon Charlie, you’re prescribed for it. Charlie: Well yes, Dr. Thomlin recommended that I take the antidepressant for a while, and then we discussed it, she and I, but I didn’t like it. She and I, you know, we discussed it, and I don’t have to take it. Kyle: But it’s what helped you out so much after Charlotte died. I think you need it. Charlie: Well… Esther: Is Mr. Dickenson correct? Does he have the right to refuse medication? Doria: The answer is yes, he does have the right. When Kyle, the aide, checks Mr. Dickenson’s records he will see that he has not been adjudged mentally incapacitated. And he has consulted with his physician and is aware of the consequences of refusing the medication. Let’s see how Charlie handles the situation. Charlie: C’mon Charlie, you have to take your meds. Charlie: In fact Kyle, I don’t. Now I have the right to refuse as long as I know the consequences. Check my records. Check the law. Kyle: Whatever you say Charlie. And remember to take your umbrella if you head over to the chapel? Charlie: Okie-dokie. See you later. Esther: Mr. Dickenson handled that well. More importantly, he’s aware of his rights. His awareness empowers him. Both OBRA ’87 and the Nursing Home Care Act require that residents be verbally advised of their rights, and provided with a written copy of their rights at the time of admission. Doria: Section 1-1918 D of the Oklahoma Nursing Home Care Act requires that each facility shall prepare a written plan and provide appropriate staff training to implement each resident’s rights. Esther: Even with the required notification it’s always important to refresh our understanding of resident’s rights and refer to OBRA ’87, The Nursing Home Care Act, and the Constitution if there’s any doubt. [NO AUDIO] Other Residents’ Right: medical privacy and confidentiality, use of personal possessions and clothes, room and roommate change notice, manage financial affairs. Doria: Let’s quickly run through some other rights. Residents have the right to privacy and confidentiality in their medical care program, including records. Esther: Residents have the right to use their own personal clothing and possessions that includes the provision of secure storage. Doria: A resident has the right to receive notice before his or her room or roommate is changed. Esther: Residents may manage their own financial affairs, or they can authorize someone else to manage them. Residents also have the right to receive a full statement of charges from the facility. Doria: A resident has the right to present complaints to anyone he or she chooses without fear of retaliation or discrimination. The facility is required to act promptly to resolve grievances, including those related to the behavior of other residents. [NO AUDIO] Other Residents’ Rights: have grievances reported and resolved, not be required to work, freedom from abuse or unauthorized restraint. Esther: No resident should ever be required to work or perform services for a facility. Doria: Residents are entitled to be free from mental and physical abuse, corporal punishment, and involuntary seclusion. No physical or chemical restraints can be used for discipline or convenience of staff. Esther: Restraints may be authorized in writing by a physician for a specified period of time if they’re required to treat a medical condition. A resident or his or her representative must be consulted, and the resident has the right to refuse. Doria: A resident may share a room with his or her spouse if they both reside in the same facility. Residents have the right to privacy for spousal visits. [NO AUDIO] Other Residents’ Rights: reside with spouse or visit privately Esther: Violation of these rights is punishable by fine and or imprisonment. It’s a serious issue for everyone involved. Doria: That’s why ombudsmen are such a vital link between residents who may be confused or uninformed of their rights, and staff members who do not know how to discern the complexities of policy. Esther: Ombudsmen advocate for residents and support accountability. The knowledge they share can help prevent the violation of rights. Doria: Volunteer Ombudsmen help empower people to speak out and also can be the voice for those who cannot speak for themselves. Esther: We thank you for watching and caring. Please encourage others who visit people who live in long-term care facilities to volunteer and become ombudsmen. Doria: Thank you for watching. [NO AUDIO] The state long-term care ombudsman office: 405-521-6734. Area agency on aging: 1-800-211-2116. Health department hotline: 1-800-747-8419 (Music) Male voice: To become a volunteer ombudsman contact the state long-term care ombudsman office. It’s part of the aging services division of the Oklahoma Department of Human Services. Call 405-5216734 or contact your area agency on aging at the toll-free number 1-800-211-2116. If you are aware of a right violation contact the ombudsman office at 405-521-6734, or the Heath Department Hotline at 1-800-747-8419. [NO AUDIO] Aging Services Division: Oklahoma Department of Human Services (Music) Sattrn is a production of the Oklahoma Department of Human Services, in cooperation with the University Of Oklahoma College of Continuing Education. [NO AUDIO] SATTRN logo, Oklahoma Department of Human Services log, University of Oklahoma logo (Music) [NO AUDIO] Produced by: Television & Satellite Services, College of Continuing Education, University of Oklahoma.