The 1987 Nursing Home Reform Law was instrumental in transforming the mindset of long-term care providers and creating the modern senior living realm as we know it today. The law places a strong emphasis on individual dignity and independence guaranteeing them a quality of life that is similar to living in a community at large. Many states, as well as the District of Columbia, have adopted their own set of regulations regarding resident rights in the assisted living facility as seen below:
10109 RESIDENT’S RIGHTS AND QUALITY OF LIFE
10109.1 The ALR shall promote and facilitate resident self-determination through the support of resident choice and all the rights specified in the Act and this chapter.
10109.2 The ALR shall support the resident (or surrogate) in exercising the resident’s rights under this chapter without interference, coercion, discrimination, or threat of retaliation.
10109.3 An ALR shall not discriminate against a resident in treatment or access to services based on reasons prohibited by the District of Columbia Human Rights Act of 1977, effective December 13, 1977 (D.C. Law 2-38; D.C. Official Code §§ 2-1401.01 et seq. (2016 Repl.)) or any other applicable anti-discrimination law, or rule issued pursuant thereto.
10109.4 An ALR shall honor a duly-executed supported decision-making agreement provided to it by a resident with a disability or a prospective resident with a disability, in accordance with Title III of the Disability Services Reform Amendment Act of 2018 (D.C. Law 22-93; D.C. Official Code §§ 7-2131.01 et seq. (2018 Repl.)). An ALR that has received a supported decision-making agreement from a resident shall be advised that all notices required to be sent to that resident under the Act or this chapter must also be sent to the resident’s supported decision maker as designated in the resident’s supported decisionmaking agreement, pursuant to § 303(c) of Title III of the Disability Services Reform Amendment Act of 2018 (D.C. Official Code § 7-2133(c)). For the purpose of this subsection, “supported decision-making agreement” and “disability” shall have the meanings prescribed to them by Title III of the Disability Services Reform Amendment Act of 2018 (D.C. Official Code §§ 7- 2131.01 et seq.).
10109.5 An ALR shall allow notices of upcoming resident group meetings to be posted prominently and conspicuously in designated areas. The ALR shall also include the date, time, and location of upcoming resident group meetings in the calendars or schedules of activities that are published by the ALR for residents on a regular basis, provided that the resident group submits the pertinent information to the ALR prior to the date of the calendar or schedule’s publication.
10109.6 By the rights granted under § 505(a)(7) of the Act (D.C. Official Code § 44- 105.05(a)(7)):
(a) A resident shall have the right to organize and participate in resident groups in the ALR;
(b) A resident shall have the right to invite staff or visitors, including family members and other individuals interested in the resident’s wellbeing, to resident group meetings in the ALR;
(c) The ALR shall provide meeting space of appropriate size and with appropriate seating to accommodate the resident group meeting’s attendees; and
(d) The ALR shall designate an employee or employees who shall assist with resident group meetings, and through whom the resident group may submit its written requests to the ALR and shall receive the ALR’s response to those requests.
10109.7 An ALR shall consider the written requests and grievances submitted by a resident or resident group and respond within fifteen (15) days, in writing, indicating its intended action or inaction in response to the issues of resident care and life in the ALR raised by the resident or resident group. The ALR shall act promptly to complete the actions indicated in its response within a reasonable amount of time. This subsection shall not be construed to imply that the ALR must implement the requests of a resident or resident group in the exact manner recommended by that resident or resident group.
10109.8 An ALR shall maintain complete written records of the filing and disposition of all requests, grievances, and appeals.
10109.9 An ALR shall permit a resident group meeting to have in attendance family members, visitors, and other guests invited by the resident group’s members. ALR staff may attend a resident group meeting only at a resident group member’s invitation. This subsection shall not prevent a resident’s surrogate from attending a resident group meeting with, or instead of, the resident he or she represents.
10109.10 For the purpose of § 506(a)(1) of the Act (D.C. Official Code § 44-105.06(a)(1)) “the ALA and healthcare records” to which a resident shall have access on demand shall mean the aggregate of the following records maintained by the ALR with respect to a particular resident:
(a) Signed resident agreements written pursuant to § 602 of the Act (D.C. Official Code § 44-106.02), including the financial provisions required by § 603 of the Act (D.C. Official Code § 44-106.03); 11
(b) Healthcare records, including healthcare notes and progress reports written by ALR staff, the record of prescription medication stored by the ALR pursuant to § 904 of the Act (D.C. Official Code § 44-109.04) to administer to the resident, and the record of prescription and non-prescription medication and dietary supplements stored by a resident in his or her living unit pursuant to § 10123.3 of this chapter;
(c) Individualized service plans (ISPs), including all SRAs pertaining thereto;
(d) Medication administration records, including records of drug errors and adverse drug reactions; and
(e) Medication and treatment orders.
10109.11 A resident (or surrogate, to the extent that disclosure of the resident’s health information of is not prohibited by applicable laws) shall be entitled to access, on demand, the following documents from the ALR, and to obtain a copy at a fee not to exceed that which is reasonable to cover the cost of its reproduction:
(a) The resident’s ALA and healthcare records, as described in § 10109.10;
(b) The resident’s financial records pertaining to the funds and personal property deposited or managed by an ALR for the benefit of the resident described in § 603(a)(2) of the Act (D.C. Official Code § 44-106.03(a)(2)); and
(c) The results of investigations conducted by the ALR that were prompted by the resident’s submission of a complaint.
10109.12 An ALR shall provide a space with adequate privacy for a resident (or surrogate) to review the document or documents he or she requested to access pursuant to § 10109.11. The space shall have the means to view the document in the format in which the ALR presented it. This subsection is not intended to accommodate copies of documents made at a resident’s request pursuant to § 10109.11.
10109.13 An ALR shall not name a group, council, meeting, or other gathering of individuals a “resident group,” “resident council,” “family group,” “family council,” or combination thereof if the ALR conducts or otherwise controls that gathering beyond providing its resident’s the support and services specified in the Act and this chapter.
10109.14 A copy of all signed agreements between an ALR and a resident (or surrogate), and all notifications required under the Act or this chapter, shall be retained in the resident’s record. An ALR shall provide its residents (or surrogates) with a copy of signed documents within three (3) business days of signing the document.
10109.15 An ALR shall maintain each resident’s record for no less than three (3) years after transfer, discharge, or death.
Top Takeaways:
- 1 The ALR shall promote and facilitate resident self-determination through support of resident choice and all the rights specified in the Act and this chapter
As stated previously, it is the ALFs goal to promote independence and autonomy through decision making. Your facility must ensure you are promoting the residents through the decision-making process.
- 7 An ALR shall consider the written requests and grievances submitted by a resident or resident group and respond within fifteen (15) days, in writing, indicating its intended action or inaction in response to the issues of resident care and life in the ALR raised by the resident or resident group. The ALR shall act promptly to complete the actions indicated in its response within a reasonable amount of time. This subsection shall not be construed to imply that the ALR must implement the requests of a resident or resident group in the exact manner recommended by that resident or resident group.
The inspection team will certainly want to know your policy regarding how residents can file a grievance or complaint. Ensure this process is seamless and covers how the facility will respond to the reported incidents as well. It would behoove you to have a grievance log with record of all grievances filed and how they were responded to.
Pro Tip:
- Develop a committee of residents, such as a resident council, to assist with the upholding of resident’s rights. Use this council to get a pulse of the community and stay in touch with what your residents are going through.
- Work with the CRF/CRCFD/HRA and the local ombudsman closely to promote the standards of resident rights within your community.