Ohio Nursing Home Bill of Rights

Placing a loved one in a nursing home is a difficult decision. When this decision is made the family may worry about the care their loved one is receiving. Thankfully, federal and Ohio law provide residents in nursing homes many rights and provide obligations for nursing homes to deliver adequate care for their residents and to respect their rights.

The Ohio Nursing Home Bill of Rights (R.C. 3721.13) provides rights to patients and residents in nursing homes, residential care facilities, homes for the aging, and veterans’ homes. The Nursing Home Bill of Rights does not provide these specific rights to people in hospitals, community addiction services, opioid treatment programs, hospice care programs, or intermediate care facilities for individuals with intellectual disabilities.

Federal law and Ohio law overlap in the rights residents in certified nursing homes are entitled to, ensuring maximum protection for your loved one. The relevant federal law (42 CFR 483) only applies to certified nursing homes; these are homes that accept Medicare and Medicaid. Ohio law applies to both certified and non-certified nursing homes within the state. Since many of these rights overlap, residents in non-certified nursing homes in Ohio still have many rights and protections. If you need assistance determining which rights apply to the nursing home your loved one is in, it may be helpful to contact an attorney if you have concerns about their treatment. In Ohio, all residents are entitled to these rights, and they cannot be waived; meaning all nursing homes must accommodate and respect these rights when your loved one is in their care. Placing your loved one in a nursing home is entrusting a facility to care for their needs and rights, provide comfort, allow autonomy, and provide a homelike environment.

Unfortunately, some nursing homes do not respect the rights provided in the Nursing Home Bill of Rights. If you believe a nursing home does not follow these standards and residents’ rights are being violated, it is important to take action so the possible mistreatment is resolved. If you suspect nursing home abuse or neglect, there are resources for you to spot warning signs and determine what steps to take. (Toledo Nursing Home Abuse Lawyer | Elderly Abuse Attorney). Charles Boyk Law has over 40 years of the experience needed to successfully take action to ensure your loved one is not being harmed and that their rights are not being violated by the nursing home trusted to provide care for them.

Resident Rights

Overall, nursing homes have a duty to protect and promote the rights of their residents and treat them with dignity and respect. (42 CFR 483.10; R.C. 3721.13). Also, your loved one is entitled to advocate for themselves and make decisions in all aspects of their life that are significant to them. Their reasonable requests and inquiries must swiftly be responded to. They also have the right to exercise their rights and the facility must support them in doing so. In some instances, a representative may be appointed or designated to exercise these rights on the resident’s behalf. A resident’s rights within a nursing home include the following:

Right to file grievances

Individuals residing in nursing homes are entitled to advocate for themselves, to have someone advocate on their behalf, and to be a member of or associate with organizations engaged in assisting residents. Grievances, complaints, or recommendations for changes may be made to staff, employees of the Department of Health, or to anyone else the resident feels comfortable confiding in. If a resident has a grievance or recommendation, they do not have to suffer in silence and cannot be silenced by their nursing home nor the staff. The home cannot interfere with these efforts or discriminate or retaliate against any resident for making them.

Right to respect and dignity

Once in the care of a facility your loved one is entitled to be free from physical, verbal, mental, and emotional abuse from those trusted to care for them. They also must always be treated with courtesy and respect. All care must be provided without considering traits such as race, color, religion, national origin, age, or payment source. Overall, all residents are entitled to the best standard of care and treatment. If you believe your loved one is being discriminated against by the nursing home or employees within, Charles Boyk Law is committed to rectifying these situations and getting your loved one the professional treatment and respect they are entitled to.

Right to safety and cleanliness

Residents have the right to a safe and clean living environment while in the facility’s care. This includes having their clothes and bedding changed promptly if it is dirty. Residents should be comfortable and clean throughout their stay. If there are concerns about a resident’s safety and cleanliness, they should be brought to the attention of the nursing home to be promptly corrected. If these concerns go unresolved it may be necessary to contact an attorney to discuss whether the resident’s rights are being violated and if they are being subjected to abuse and neglect.

Right of self-determination

• In medical care/treatment

Residents are entitled to select their attending physician, even if that physician is not on staff of the home, their pharmacist, and their hospice program. Medical care is highly personalized and intrusive. Allowing the residents to select these providers ensures they are comfortable and retain their autonomy. This also allows prior medical relationships to continue during and after the residents’ stay in the home.

It is common practice in the medical field to use patient information to aid medical research and advancements. All individuals have the right to refuse to release their medical information and be a subject; residents in nursing homes continue to have this right to refuse once they enter the home. If a resident does not consent to having their medical information released, they are entitled to equal treatment and the same level of care as they would have gotten if they consented. Remember, residents in nursing homes do not lose their autonomy or right to make their own decisions once they are in the care of the home.

• In civil rights

Residents are entitled to participate in the exercise of protected liberties, civil rights, and private enjoyments. Importantly, if an individual is able to vote, the home must cooperate in arrangements for the resident to exercise this right. If the nursing home is not cooperating with arrangements for the resident to vote, it may be necessary to contact an attorney to ensure the resident is able to exercise this right prior to the voting deadline.

• In daily life

Residents are entitled to make decisions regarding their daily life within the nursing home. These decisions are subject to reasonable application within the home and medical advisability by their attending physician to ensure their safety and to not violate other resident’s rights within the home. Residents are entitled to:

• a home-like environment;
• determine when they will sleep and wake up;
• wear their personal clothing and keep personal belongings;
• a way to secure their personal belongings so they feel comfortable personalizing their rooms without fear of theft or damage;
• access to their secured personal belongings and money. The home may only deny access for good reason, such as if the resident is making continuous, persistent, and unreasonable requests or requests at unreasonable hours.

These are important considerations, because residents may feel like they have lost autonomy and control once they enter a nursing home. It must be reinforced that the goal of nursing homes is to feel home-like and ensure residents have input into decisions about their lives.

• In identity and association

Once in the care of a nursing home, residents have the right to participate in the following at their own or a third party’s expense:

• Opportunities, groups, and services that allow them to achieve their fullest potential. These activities include educational, vocational, social, recreational, and rehabilitation programs;
• Consuming alcoholic beverages and tobacco products, unless this is not medically advisable or against the facility’s written policies. This use not being medically advisable is determined based on the individual’s medical condition. Although denial of the use of these substances may be against a resident’s wishes, the home has a duty to promote and protect the resident’s quality of life and meet professional standards of care;
• Being or remaining active in their community and participating in social activities and groups. Residents are also entitled to observe religious obligations and participate in religious activities and to maintain their individual and cultural identity. These rights promote the resident’s individuality and allow them to maintain their prior lifestyle when entering the home; this reinforces the nursing home’s obligation to provide a homelike environment.

If you believe your loved one is being denied these rights and opportunities or is facing discrimination by those trusted to care for them, it may be necessary to speak with a lawyer at Charles Boyk Law.

Right to medical care and treatment

Once contracted with a nursing home, your loved one is entitled to receive adequate and appropriate treatment and care as well as any other service necessary and consistent with their treatment program. The resident’s sponsor is also entitled to be notified of any significant change in the resident’s health within 12 hours of it being known to staff. If the nursing home is not providing the care contracted for, contact Charles Boyk Law for an experienced attorney to assist you in ensuring your loved one gets the care and treatment they deserve and to be compensated for any and all harm they have suffered.

• Information regarding residents’ care

Importantly, residents are entitled to know who is involved in their medical treatment and care; have access to their current and complete medical record; know what their condition, prognosis, and treatment plan is; and have the ability to deny or provide informed consent for treatment. All of this information must be made available in terms that the resident can understand. In some instances, this information will be available to the resident’s sponsor instead of or in addition to the resident. If any of this information is withheld without a valid cause, a lawyer may be able to assist in the release of the information to the appropriate parties.

• Physical and chemical restraints and isolation

Many families are concerned with the safety and treatment of their loved ones while in a nursing home. These concerns may be eased with the knowledge that nursing homes are prohibited from using physical or chemical restraints and isolation for punishment, incentive, or for the convenience of the home. The resident’s physician may authorize the use of restraints or isolation based on an individualized determination and they may be used in an emergency situation. These restraints and isolation may only be used at the minimum level necessary to prevent self-harm, harm to others, and harm to property.

Right to privacy

• Medical

Residents retain their rights to privacy and confidentiality once they begin living within a nursing home. Personal and medical records contain highly sensitive information, and in most instances, residents can decide who has access to these records. Residents also have the right to privacy during medical exams, treatment, and in the care of personal and bodily needs to provide them comfort in the foreign environment and allow them to maintain their dignity. Families should feel confident that their loved ones are comfortable and respected while in the care of a nursing home. Residents also should feel comfortable enforcing these rights to privacy. If they need assistance or the home is ignoring their advocacy, contact an attorney at Charles Boyk Law. These experienced lawyers are dedicated to making sure the resident is being treated lawfully and respectfully and will fight for compensation for the harm your loved one has suffered.

• Living space

Within the home, residents are entitled to privacy within their rooms and with their spouses. If their spouse is also a resident of the home, they have the right to share a room with them. If their spouse is not a resident, they have the right to private visits with them. Residents are also entitled to an explanation if their room or roommate changes. All residents have the right to request to have the door to their room closed and require knocking prior to opening. Again, the nursing home should feel as home-like as possible, yet their physician may determine that these rights are not medically advisable or safe and deny them.

• Communication

It is important to many people to maintain a relationship while they or a loved one is receiving care in a nursing home. Residents have the right to private and unrestricted communication by mail, phone, or in-person visitation with anyone they choose. They may be denied this right by their physician only if it is not medically advisable to have this unrestricted communication with certain individuals. A resident cannot be restricted from communicating with public officials, their attorney, or their physician. If your loved one is being denied this right without a valid reason or is subjected to isolation from the outside world, contact an attorney at Charles Boyk Law to facilitate communication and compensation for any harm suffered as a result.

Right to financial transparency

Once a nursing home that is the best fit is determined, it is important for the resident or their sponsor to read the contract and have all terms of their stay and treatment encompassed within that contract in writing. This allows the resident and their loved ones to be confident and fully informed of what treatment they are receiving, and if the unfortunate event arises, allows you to have a document to provide to your lawyer to understand and correct mistreatment, abuse, or neglect.

The Ohio Nursing Home Bill of Rights contains rights for the residents and obligations of the nursing home provide transparency in treatment and billing and prevent financial exploitation. The nursing home shall include the basic rate charged, services available, any additional charges for services, and any charges not covered by Medicare or Medicaid. If the basic rate changes, the resident, or in some instances their sponsor, needs thirty (30) days notice of the change. The resident and the person paying for their care are entitled to receive an itemized bill for charges not included in the basic rate at least monthly. It is important to review the bill to ensure there is no financial exploitation afoot and that the home is only billing for services or visits from physicians that the resident actually received.

Residents have the right to remain in control of their finances unless this is delegated in writing to the nursing home. If delegated, a quarterly accounting of transactions should be provided to the resident. The nursing home must provide and allow the resident or their sponsor to review and copy all receipts of deposits and withdrawals regarding the resident’s finances. The home must maintain a complete record of all funds, personal property, and possessions of a resident that have been deposited for safekeeping or use within the home. If you have reason to believe that your loved one is being financially exploited or there are inconsistencies within the provided reports, it may be necessary to reach out to a lawyer and discuss your claims and beliefs. Attorneys at Charles Boyk Law are experienced in this field and dedicated to fighting for justice and compensation when a resident’s rights are violated.

Rights regarding transfer and discharge

A resident shall only be transferred or discharged from their current nursing home because of necessity. It is only necessary to make this transition from the current home if:

• their welfare and needs cannot be met;
• their safety or health is endangered;
• they are contributing to the endangerment of a fellow resident’s safety or health;
• treatment is no longer required;
• treatment is no longer being paid for;
• the nursing home ceases to operate; or
• participation in the Medicaid program is involuntarily terminated.

If this transition is necessary, there must be adequate preparation to ensure it is safe and orderly, and that there are proper arrangements for medical care and treatment services. Residents are also entitled to all related federal rights for a safe transition or discharge. If you have reason to believe that your loved one was wrongfully discharged or transferred, or had an unsafe experience doing so, contact Charles Boyk Law for a free consultation.

Obligations of Nursing Homes

As it is typically a difficult choice to determine which nursing home is best suited for a loved one, it is important that they are transparent in their policies, procedures, services, and care guidelines. Before or at the time of admission, nursing homes are required to distribute written copies of:

• residents’ rights;
• policies regarding the applicability and implementation of those rights;
• residents’ responsibilities regarding those rights;
• the nursing home’s grievance procedure;
• the nursing home’s rules; and
• addresses and telephone numbers of:
  • the district’s Board of Health;
  • the county’s Department of Job and Family Services;
  • the Ohio Departments of Health and Medicaid;
  • the Ohio and the local offices of the Department of Aging; and
  • any and all Ohio Nursing Home Ombudsman Programs.

In addition, the nursing home has an obligation to prominently display a copy of:

• the residents’ rights;
• the home’s rules and policies regarding the rights and responsibilities of residents;
• a list of residents’ rights advocates; and
• a notice that applicable Ohio, federal, and relevant rules of the Department of Health are available to be reviewed within the home at reasonable hours.

These obligations are to ensure that residents are aware of their rights, can exercise them, and have a way to notify someone if their rights are being violated or if they have any concerns regarding their home. If a copy of any of the required documents has not been provided or is not posted within the home, you should request these from the home. If the home denies your request, it may be necessary to contact an appropriate authority or lawyer to ensure the nursing home complies with Ohio law.

Contacting an advocate

Ombudsman are advocates for residents in nursing homes that work with the residents, their families, their representatives or sponsors, and the home to protect the long-term residents and investigate and resolve complaints. (Complaints – Healthcare Facilities and Nursing Homes | Ohio Department of Health, Ombudsman and Nursing Homes | What Do They Do?). The Ohio Department of Aging Long-Term Care Ombudsman program has 12 regional programs that provide confidential assistance to residents. (Contact an Ombudsman | Department of Aging). In Northwest Ohio, the Advocates for Basic Legal Equality (ABLE) have an Ombudsman program that serves 17 counties including Wood, Lucas, Fulton, Henry, Defiance, Hancock, and Allen. (Service Area | ABLE Long-Term Care Ombudsman Program).

When should I contact an Ombudsman vs. an attorney?

Before contacting the Ombudsman program or a nursing home lawyer the first step a resident or their representative should take is addressing their concerns directly with the nursing home. If an individual does not feel comfortable expressing their concerns with the nursing home, believes the nursing home will not take action, or is concerned that their right to file grievances and recommend changes will be violated, it may be helpful to contact an advocate.

Ombudsmen are knowledgeable advocates who can assist you before, during, and after an individual enters a nursing home. They are a free, confidential resource that works at your, or the family or representative’s, direction; they will not take any steps you do not want them to and will not reveal your identity if you wish to remain anonymous. They can provide information about nursing homes to help in selecting which one is best for the individual’s needs and treatment program. They can also provide important resources regarding payment, which facilities accept Medicare or Medicaid, and information regarding residents’ rights. (How Does it Work? | ABLE Long-Term Care Ombudsman Program). During residency, if there are any complaints about discomfort or distaste with the nursing home’s services, conditions, or facilities, the Ombudsman program can bring these concerns to the attention of the home without revealing the resident’s identity.  If there are larger issues regarding sanitary conditions, health and hygiene, violations of residents’ rights or severe issues such as abuse or neglect, an Ombudsman can also be a valuable resource. When a conflict or concern is resolved, the Ombudsman ensures that the nursing home follows through and continues to implement the resolution reached; their advocacy does not end the moment your issue is settled, and they are always able to assist further. The Ombudsman program monitors laws affecting nursing homes and is a valuable resource for anyone considering going into or already in a nursing home.

In some instances, such as the larger, severe issues discussed above, an attorney may be necessary to fully address the concerns and hold the nursing home responsible by compensating residents for any and all resulting harm. Attorneys can work with an Ombudsman already involved in the conflict to provide well-rounded support in all necessary areas. Charles Boyk Law Offices is a full-service firm and can assist with the personal injury matter in addition to any probate matters. If the resident cannot advocate for themselves, an Ombudsman may act on their behalf with the nursing home abuse or neglect lawyer to reach a just result. If you have reason to believe you or your loved one in a nursing home is facing a severe concern that requires legal involvement, you can contact Charles Boyk Law for a free consultation. If you are unsure whether the concern requires legal action and involvement, a consultation can clarify whether this is a matter best resolved with a lawyer and whether it would be beneficial to also work with an Ombudsman.