Free Nursing Home Resident Rights Agreement Template
Nursing Home Resident
Rights Agreement
This Nursing Home Resident Rights Agreement ("Agreement") is entered into by and between [Your Company Name] ("Facility") and the undersigned individual ("Resident"), and is effective as of [Effective Date]. The Facility and Resident collectively may be referred to as the "Parties."
WHEREAS, the Facility is dedicated to providing the highest standards of personalized care, safety, and respect for all Residents within its community, striving to maintain an environment that supports the dignity, privacy, and independence of each Resident;
WHEREAS, the Resident seeks to receive care from the Facility, understanding that mutual respect, information sharing, and cooperation are key components of the care relationship;
WHEREAS, the Facility acknowledges its obligation to ensure that all Residents are informed of and understand their rights as outlined in this Agreement, and to provide mechanisms to address concerns and uphold these rights;
NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein, and intending to be legally bound, the Parties agree to uphold and abide by the stipulations set forth in this Agreement, as detailed in the subsequent sections.
I. Basic Rights and Freedoms
A. Respect and Dignity: The Resident shall be treated with respect and dignity at all times. This treatment extends to interactions with staff, the provision of services, and all activities within the Facility. The Resident has the right to be addressed by their chosen name and pronoun, and to express their preferences and concerns without fear of reprisal.
B. Privacy: The Resident is entitled to privacy in their personal accommodations, during medical treatments, and in their communications. Staff shall knock and receive permission before entering the Resident's room, except in emergencies. The Facility ensures confidentiality of all Resident records and communications, accessible only to authorized personnel.
C. Freedom from Abuse: The Resident shall be free from verbal, sexual, physical, and mental abuse, as well as from involuntary seclusion and neglect. Any suspected abuse must be reported by staff immediately to the Facility management and investigated within 24 hours. Corrective actions, if required, shall be initiated within 72 hours of confirming an incident.
D. Personal Possessions: The Resident may retain and use personal possessions, including furniture and clothing, as space permits. The Facility will provide secure storage for valuables upon request, and will assist the Resident in managing their personal items if needed.
II. Medical Care Autonomy
A. Informed Consent: The Resident has the right to be informed about their medical condition, treatment options, and potential risks in a language they understand. They must consent to all treatments and may refuse treatment at any time without jeopardizing their right to appropriate care or facing discrimination.
B. Medical Records: The Resident has unrestricted access to their medical records within 48 hours of a request and may obtain copies at a cost of $0.25 per page. The Facility will assist in interpreting these records if needed.
C. Medication: The Resident has the right to be fully informed about their medication, including possible side effects and interactions. Medications will be administered as prescribed by a licensed physician, and the Resident may refuse medication as part of their treatment rights.
D. Choice of Physician: The Resident may choose their own physician and other health care providers, subject to availability and Facility policies. The Facility will provide a list of available providers within 5 miles of the Facility, updated annually.
III. Accommodations and Living Conditions
A. Accommodation Preferences: The Resident may request room changes based on availability or health needs. Requests will be addressed within 7 days, and the Facility will make every effort to accommodate preferences regarding room and floor location.
B. Food and Nutrition: The Resident will receive three nutritionally balanced meals daily, accommodating dietary restrictions and preferences. Snacks are also available upon request between meals. Meal times are scheduled at regular intervals (breakfast at 8:00 AM, lunch at 12:00 PM, and dinner at 6:00 PM).
C. Living Environment: The Facility commits to maintaining a clean, safe, and comfortable environment. Housekeeping services are provided daily, and maintenance issues are addressed within 24 hours of being reported. Temperature in common areas and individual rooms is maintained between 68-74°F.
IV. Social and Personal Interactions
A. Visitation: The Resident has the right to receive visitors of their choice between the hours of 9:00 AM and 8:00 PM daily, under conditions that do not impose on the rights or safety of other residents. Special accommodations for visiting hours can be arranged with Facility staff with at least 48 hours notice.
B. Social Activities: The Resident shall have access to a variety of social, recreational, and religious activities within the Facility, which are designed to maintain or improve the Resident's quality of life. A monthly schedule of activities will be provided, and transportation will be available for off-site events twice a month.
C. Personal Relationships: The Resident may freely interact and form personal relationships with other residents and staff, provided that these interactions respect the rights and privacy of all parties involved. The Facility promotes and facilitates group interactions and resident councils.
V. Financial Affairs
A. Financial Information: The Facility will provide the Resident with a detailed monthly statement of all charges and fees associated with their care, including accommodation, medical services, and optional amenities. Any changes to fees will be communicated to the Resident with a 30-day advance notice.
B. Management of Finances: Residents may choose to manage their own financial affairs or authorize the Facility to manage their finances on their behalf, under conditions agreed upon in writing. If the Facility is authorized to manage the Resident's finances, detailed accounts must be provided quarterly, and any discrepancies will be addressed within 5 business days.
VI. Complaints and Grievances
A. Grievance Process: The Resident has the right to file a complaint regarding any aspect of their care or the conditions of the Facility without fear of discrimination or reprisal. A formal complaint may be submitted in writing to the Facility's designated Complaint Officer. The Facility will acknowledge receipt of the complaint within 3 business days and a thorough investigation will be conducted within 15 business days.
B. Access to Advocates: The Facility provides the Resident with contact information for local ombudsman programs, advocacy services, and legal aid resources, which are updated annually. The Facility staff will assist the Resident in contacting these services if requested.
C. Resolution Follow-Up: Following the investigation of a complaint, the Facility will provide the Resident with a written response detailing the findings and any actions taken or proposed. If the Resident is dissatisfied with the outcome, they may request a review by an external mediator, to be arranged within 10 business days.
VII. Rights Upon Discharge
A. Discharge Planning: The Resident has the right to be actively involved in planning their own discharge. The Facility will provide a discharge planner to work with the Resident and their family or legal representative, starting no less than 30 days prior to the anticipated discharge date. This plan will address the Resident's future health care needs and ensure continuity of care.
B. Appeal Decisions: If the Resident disagrees with a discharge decision, they have the right to appeal. The Facility will provide information on the appeal process, including contact details for the appeal authority. The Resident must file the appeal within 10 business days of receiving the discharge notification. A decision on the appeal will be provided within 20 business days from the date of filing.
VIII. General Administrative Rights
A. Regulations and Standards: The Resident has the right to be informed about the Facility's compliance with federal, state, and local regulations. The Facility will provide access to documents outlining these standards upon request and will hold semi-annual meetings to discuss compliance updates and Facility improvements.
B. Changes to Agreement: The Facility reserves the right to amend this Agreement as necessary. All Residents will be notified of any changes in writing at least 30 days before they take effect. The notification will include details of the changes and the reasons for the changes.
Signature
This Agreement acknowledges that the Resident and the Facility have mutually agreed to uphold the terms and conditions stated herein. It is understood that signing this document commits both parties to adhere to these terms.
Resident
[Name]
[Date]
Facility
[Name]
[Date]
