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.

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.

Department of Health Services Licensing and Certification office
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 (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 (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 (NCEA)
This site offers information and nursing home abuse statistics for Ventura County seniors.

Ventura County Sheriff
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


Senior Advocacy Groups

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.

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.

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.

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 (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.

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