Bill Of Rights

Resident's Rights

(Note: The information below is taken in part from the web site of the National Citizens' Coalition for Nursing Home Reform at www.nccnhr.com)

Residents' rights were part of the Nursing Home Reform Law enacted in 1987 by the U.S. Congress. The law requires nursing homes to promote and protect the rights of each resident and places a strong emphasis on individual dignity and self-determination. Nursing homes must meet residents' rights requirements to participate in Medicare or Medicaid.

Quality of Life

The Nursing Home Reform Act requires each nursing home to care for its residents in such a manner and in such an environment as will promote maintenance or enhancement of the quality of life of each resident. This statement highlights an emphasis on dignity, choice, and self-determination for nursing home residents.

Providing Services and Activities

Each nursing home is required to provide services and activities to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident in accordance with a written plan of care which is initially prepared, with participation to the extent practicable of the resident, the resident's family, or legal representative. This means that a resident should not decline as a direct result of the nursing facility's care.

Specific Rights

The Nursing Home Reform Act also grants nursing home residents these specific rights:

•	The Right to Be Fully Informed, including
•	The right to be informed of all services available as well as the charge for each service;
•	The right to have a copy of the nursing home's rules and regulations, including a written copy of their rights;
•	The right to be informed of the address and telephone number of the State Ombudsman, State licensure office, and other advocacy groups;
•	The right to see the State survey reports of the nursing home and the home's plan of correction;
•	The right to be notified in advance of any plans to change their room or roommate
•	The right to daily communication in their language;	Top
•	The right to assistance if they have a sensory impairment.
•	The Right to Participate in Their Own Care, including:
•	The right to receive adequate or appropriate care; The right to be informed of any changes in their medical condition;
•	The right to participate in planning their treatment, care, and discharge;
•	The right to refuse medication and treatment;
•	The right to refuse chemical and physical restraints;
•	The right to review their medical record.
•	The Right to Make Independent Choices, including:
•	The right to make independent personal decisions, such as what to wear and how to spend free time;
•	The right to reasonable accommodation of their needs and preferences by the nursing home;
•	The right to choose their own physician;	Top
•	The right to participate in community activities, both inside and outside the nursing home;
•	The right to organize and participate in a Resident Council.
•	The Right to Privacy and Confidentiality, including;
•	The right to private and unrestricted communication with any person of their choice;
•	The right to privacy in treatment and in the care of their personal needs;
•	The right to confidentiality regarding their medical, personal, or financial affairs;
•	The Right to Dignity, Respect, and Freedom, including;
•	The right to be treated with the fullest measure of consideration, respect, and dignity;
•	The right to be free from mental and physical abuse, corporal punishment, involuntary seclusion, and physical and chemical restraints;
•	The right to self-determination.	Top
•	The Right to Security of Possessions, including:
•	The right to manage their own financial affairs;
•	The right to file a complaint with the State survey and certification agency for abuse, neglect, or misappropriation of their property if the nursing home is handling their financial affairs;
•	The right to be treated with the fullest measure of consideration, respect, and dignity;
•	The right to remain in the nursing facility unless a transfer or discharge: is necessary to meet the resident's welfare; is appropriate because the resident's health has improved and the resident no longer requires nursing home care; is needed to protect the health and safety of other residents or staff; is required because the resident has failed, after reasonable notice, to pay the facility charge for an item or service provided at the resident's request;
•	The right to receive notice of transfer or discharge. A thirty-day notice is required. The notice must include the reason for transfer or discharge, the effective date, the location to which the resident is transferred or discharged, a statement of the right to appeal, and the name, address, and telephone number of the state long-term care ombudsman;
•	The right to be free from charge for services covered by Medicaid or Medicare.
•	The right to a safe transfer or discharge through sufficient preparation by the nursing home.
•	The Right to Complain, including:
•	The right to present grievances to the staff of the nursing home, or to any other person, without fear of reprisal;
•	The right to prompt efforts by the nursing home to resolve grievances.
•	The Right to Visits, including:
•	The right to immediate access by a resident's personal physician and representatives from the health department and ombudsman programs;
•	The right to immediate access by their relatives and for others subject to reasonable restriction with the resident's permission;
•	The right to reasonable visits by organizations or individuals providing health, social, legal, or other services.

Elder abuse

Types, Examples, Indicators, Risks, Prevention

Every year tens of thousands of elderly Americans are abused by those who are responsible for their care. Elder abuse tends to take place wherever the elderly person lives. Many times this is an institutional setting such as a nursing home or other long term care facility. The abusers may be caregivers and those directly responsible for their care, or they may be family members such as adult children, grandchildren, spouses or partners. Elderly persons are vulnerable to abuse as they are usually frail and less able to stand up for themselves or fight back, if attacked. They may not think clearly, and have varying degrees of dementia, nor do they see or hear as well. They may be lonely and vulnerable, thus making them prey for the unscrupulous con artist or scammer.

The Different Types of Abuse: Elder Abuse may take many forms such as intimidation, threats, neglect, and financial fraud. The most common are:

Physical Abuse: Non-accidental, (intentional) use of force resulting in physical pain, injury, or impairment. Such abuse also includes inappropriate use of drugs, restraints, or confinement.

Examples: Striking, slapping, shoving, shaking, beating, pinching, burning, and inappropriate use of restraints, rough handling.

Indicators: Bruises, welts especially those that appear symmetrically on both sides of body; broken bones, sprains, or dislocations, broken eyeglasses or frames; signs of being restrained, such as rope marks on wrists.

Mental/Emotional Verbal Abuse: Speaking or treating elderly persons in ways that cause emotional pain or distress.

Examples: Yelling, insulting, threatening, harassing, humiliation, ridicule, blaming, intimidation or isolation. Non-verbal abuse includes ignoring the elderly person; isolating an elder from friends or activities, terrorizing or menacing the elderly person.

Indicators: Confusion, anger, fear, depression, agitation on part of elder; behavior of elder that mimics dementia, such as rocking, sucking or mumbling to oneself.

Financial Abuse: Unauthorized use of an elderly person’s funds or property.

Examples: Misuse of elder’s credit cards, personal checks, bank accounts; stealing cash, income checks; forging the elder’s signature, identity theft, illegally or unethically using money or property.

Indicators: Significant withdrawals from bank accounts; sudden change in financial condition, cash/items missing; unusual changes in wills, deeds, powers of attorney; names added to bank cards; unpaid bills, lack of medical care, financial activity that elderly person could not have engaged in due to physical and mental constraints such as ATM withdrawals, online purchases.

Sexual Abuse: Contact with an elderly person without their consent.

Examples: Any kind of physical contact for sexual purposes or sex acts, also includes showing them pornographic material; forcing the elderly person to watch sex acts, or undress; inappropriate touching while providing care.

Indicators: Unexplained genital infections; bruises around breasts/genitals; unexplained vaginal/anal bleeding; torn, stained, bloody undergarments; fear, depression, anger.

Neglect/Abandonment By Caregivers: Intentional or unintentional failure to fulfill care giving duties, responsibilities, and obligations.

Examples: Dirty, unsanitary living environments; lack of running water, heat, food, water; soiled bedding, clothing; faulty and hazardous electrical systems; desertion of elder in public place; call bells tied off out of reach of elder.

Indicators: Unusual weight loss; malnutrition; untreated physical problems – infections, bed sores; elder dirty and unbathed; clothing unsuitable for climate and weather conditions.

Healthcare Fraud and Abuse: Unethical practices of doctors, nurses, staff, care providers.

Examples: Charging for healthcare services that are not provided; overcharging or double-billing for medical care; kickbacks for referrals to other providers or for prescribing certain drugs; over medication; MediCal fraud

Indicators: Elder or responsible party receives duplicate bills for same medical service; evidence of too much or too little medication; bills paid in full for inadequate care; problems with facility staff to get questions answered adequately

Risk Factors

It is difficult to provide care for an elderly person who may have many different needs, at the same time it is difficult to be elderly with all the infirmities age brings. The demands on the caregivers and the needs of the elderly person can be at cross purposes at times and create situations in which abuse may occur.

Significant risk factors among caregivers that can lead to abuse is the inability to cope with stress, depression, lack of peer support; caregiver does not find the role rewarding but rather burdensome; caregiver has issues with drugs or alcohol abuse.

Nursing home care staff may be susceptible to elder abuse if they lack training, have too many responsibilities, are unsuited to the caregiving role, or have to work under poor conditions. In many cases elder abuse is unintentional, but nevertheless real. When caregivers are physically and mentally depleted from working long hours, and are pushed beyond their capabilities, they may yell at an elder, handle them roughly, or just ignore their needs

Prevention

Preventing elder abuse requires observation/listening; taking appropriate action when you suspect elder abuse; educating others how to recognize and report elder abuse

If you suspect elder abuse in a nursing home or other long term care facility for the elderly in Ventura County contact the Long Term Care Ombudsman program at:

Tel:  805.656.1986

Fax:  805.658.8540

Email: kterry@ombudsmanventura.org

Or after hours at the 24 Hour Crisis Line: 1.800.231.4024

resources

Help For Ventura County Elder Abuse Victims

Below, are links that can help you with information on elder abuse and elder care.

LOCAL: Reporting Ventura County Elder Abuse

LOCAL: Alzheimer’s, Eldercare, Caregiving and Independent Living

STATE/U.S.: Senior Advocacy Groups

NATIONAL: Alzheimer’s, Caregiving and Independent Living

Christian Residential Centers

Mental Health and Bioethics Resources

LOCAL: Reporting Ventura County Elder Abuse

Ventura County Ombudsman Office (805) 656-1986

The Ventura County Ombudsman provides Ventura County seniors a variety of services that pertain to such issues as residents' rights, "quality of care," and finances. In addition, the Ventura County Ombudsman conducts investigations into nursing home abuse complaints filed.

The Department of Health Services Licensing and Certification (916) 558-1784 For relay services for the hearing impaired or speech impaired, please call: MCI from TDD 1-800-735-2929 or MCI from voice telephone 1-800-735-2922 Sprint from TDD 1-888-877-5378 or Sprint from voice telephone 1-888-877-5379 http://www.cdph.ca.gov/

The Department of Health Services Licensing and Certification office reviews Ventura County nursing home inspection reports. In addition, the Department of Health Services Licensing and Certification office conducts investigations into nursing home abuse complaints.

California Advocates for Nursing Home Reform 650 Harrison Street, 2nd Floor San Francisco, CA 94107 (415) 974-5171 (800) 474-1116 (toll-free; consumers only) Fax: (415) 777-2904 California Advocates for Nursing Home Reform (CANHR)

The CANHR site offers instruction for Ventura County nursing home abuse victims on how to file abuse and neglect complaints. In addition, the CANHR site provides information on nursing home abuse and nursing home neglect.

California Department of Aging 1300 National Drive, Suite 200 Sacramento, CA 95834-1992 Phone: (916) 419-7500 Fax: (916) 928-2267 TDD: (800) 735-2929 http://www.aging.ca.gov/ California Department of Aging (CDA)

The CDA provides services to Ventura County seniors and their families, including counseling victims of abuse and neglect. This site provides information on nursing home abuse and neglect.

National Center on Elder Abuse c/o Center for Community Research and Services University of Delaware 297 Graham Hall Newark, DE 19716 Send an inquiry through our online form Email us: ncea-info@aoa.hhs.gov Call during normal business hours: 302-831-3525 Send a fax: 302-831-4225 National Center on Elder Abuse (NCEA)

This site offers information and nursing home abuse statistics for Ventura County seniors.

Office of the Sheriff 800 South Victoria Avenue Ventura, CA 93009 (805) 654-2380 Sheriff Office http://www.vcsd.org/

If you or your loved is a victim of nursing home abuse, you should contact the Ventura County Sheriff's office as soon as possible.

Ventura County District Attorney's Office

Ventura County Area Agency on Aging

LOCAL: Alzheimer’s, Eldercare, Caregiving and Independent Living

Ombudsman Program administered by Long Term Care Services of Ventura County, Inc. 2021 Sperry Ave., Suite 35 Ventura, CA 93003 Phone: 805-656-1986 Fax: 805-658-8540 www.OmbudsmanVentura.org

Ombudsman is derived from a Swedish term, meaning advocate. The Ventura County Ombudsman Program’s mission is to assure the highest quality of life and care possible for elderly persons in long term care – most of whom are vulnerable and unable to represent themselves. They offer caregiver support & living options for people living in nursing homes or assisted living residences throughout California. All services are free and confidential 24 hrs a day, 7 days a week.

California Advocates for Nursing Home Reform 650 Harrison Street -- 2nd Floor San Francisco, CA 94107 Tel: (415) 974-5171 Fax: (415) 777-2904 Consumer Information Hotline: (800) 474-1116 California Advocates for Nursing Home Reform (CANHR)

The CANHR site provides information on Ventura County nursing homes and other California long-term care facilities that include citation, complaint, and financial data.

STATE/U.S.: Senior Advocacy Groups

CANHR California Advocates for Nursing Home Reform – Long Term Care Justice and Advocacy 650 Harrison Street, 2nd Floor San Francisco, CA 94107 Consumer Hotline: 800-474-1116 Website: www.canhr.org

CANHR is a statewide, nonprofit advocacy organization dedicated to improving the choices, care and quality of life for California’s long term care consumers, their families and loved ones. It is a nationally recognized model of consumer advocacy and a resource for the local, state and national long term care advocacy communities.

The United States Administration on Aging Mailing Address: Administration on Aging Washington, DC 20201 Physical Address: One Massachusetts Avenue NW Washington, DC 20001 Phone Numbers: Office of the Assistant Secretary for Aging: (202) 401-4634 Public Inquiries: (202) 619-0724 Eldercare Locator (to find local resources): (800) 677-1116 AoA Fax: (202) 357-3555 The Administration on Aging

The United States Administration on Aging provides services to Ventura County seniors and offers information on the Older Americans Act, the federal legislation, and more.

Coalition to Protect America's Elders (CPAE)

The CPAE is a national coalition group that works closely with the country's most prominent senior advocacy groups who are against elder abuse.

The Consumer Voice 1001 Connecticut Avenue, NW, Suite 425 Washington, DC 20036 202.332.2275 (phone) 202.332.2949 (fax) Email info@theconsumervoice.org National Citizens' Coalition for Nursing Home Reform (NCCNHR)

This site provides data on nursing home abuse and offers a variety of resource links pertaining to elder abuse and elder care.

ElderAngels, Inc. PO Box 981258 West Sacramento, CA 95798 Phone: (415) 284-1160 or (916) 372-8556 FAX (916) 372-8554 Elder Angels, Inc.

Elder Angels is an advocacy group in California that is dedicated to stopping financial elder abuse. Elder Angels provides support services to financial abused senior victims and their families and offers information on senior financial abuse, fraud, and scams.

Senior Citizen Bureau Tel: 832-230-1238 Toll Free:1-800-281-1088 E-mail: info@seniorcitizensbureau.com Senior Citizen Bureau (SCB)

The SCB is a national coalition for elder care reform. This site offers an informational database for Ventura County seniors and other interested parties with regard to elder abuse fraud alerts, nursing home facility complaint histories and provides other background information on long-term care facilities.

NATIONAL: Alzheimer’s, Caregiving and Independent Living

Ombudsman Long Term Care The National Long Term Care Ombudsman Resource Center (NORC): www.ltcombudsman.org 1828 L Street, NW, Suite 801 Washington, DC 20036 202.332.2275 (phone) 202.332.2949 (fax) Email National Association of Long Term Care Ombudsmen (NALLTCO): www.nalltco.org National Association of State Long-Term Care Ombudsman Programs (NASOP) 2007 Trail Wood Circle Midland, MI 48642 Phone: (989) 631-3817 www.nasop.org

Ombudsmen are dedicated to enhancing the lives of long term care residents. Use one of the listed National sites to find an organization in your state or use an Internet search for “Ombudsman Long Term Care” for your area.

Mental Health and Bioethics Resources

Toxic Medicine: What You Should Know to Fight the Misuse of Psychoactive Drugs in Nursing Homes

California Advocates for Nursing Home Reform (CANHR)

This booklet guide covers of the basics regarding psychoactive drugs in nursing homes, from uses and side effects to applicable laws. It includes tips to prevent misuse of psychoactive drugs that hasten death, dull memories, crush spirits, sap personalities and health. Often, residents with dementia receive powerful antipsychotic drugs not intended or approved for their medical conditions, but used to sedate and control them. The FDA Black Box Warning states that antipsychotic drugs cause elders with dementia to die. Despite legal requirements, there is an epidemic disregard for the rights of residents to give or withhold their informed consent.

Free Download

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

Robert Whitaker

An investigative probe into clinical studies of scientific journals dating back more than 50 years revealed a shocking anomaly. Whitaker found that drugs hailed as a cure for mental disorders were repeatedly shown to worsen mental illness over the long term. Cutting through flawed science, greed and lies, he shreds myths woven around psychiatric drugs to expose the grave risks to body and cognitive function. Scrupulous evidence and interviews testify to newfound “aliveness” of those freed from the prison of mind-numbing drugs.

Book Kindle

TOXIC MEDICINE

What You Should Know to Fight the Misuse of

Psychoactive Drugs in California Nursing Homes

There is rampant misuse of psychoactive drugs in California nursing homes. Nearly 60% of all California nursing home residents are given psychoactive drugs, a 30% increase since 2000. Many psychoactive medications
have dangerous side effects, especially antipsychotic drugs.

Below is a link to the CANHR (Long Term Care Justice and Advocacy) guide in a pdf format so that you may print from your computer.

Toxic Medicine - PDF printable guide

Table of Contents

What are Psychoactive Drugs?
Risks Galore, Including Death
Psychoactive Drugs Cannot Be Used Without Informed Consent
Advocacy Tips When Psychoactive Drugs Are Proposed
Who Can Exercise a Resident's Rights?
Right to Refuse
Chemical Restraints and Unnecessary Drugs Are Illegal
Gradual Dose Reduction
Alternatives to Drugs - Always the First Option
Remedies to Illegal Drugging
Resources
Laws and Regulations