PATIENTS’ RIGHTS

You may sometimes see the word resident, patient or client used. Each word refers to the same individual. For the purpose of this educational content, we will refer to our clients as patients.

In 1987 the federal government enacted a law guaranteeing all patients of certain fundamental rights. Rights are both human privileges and legal protection. Patients have the same rights as you:

• To be treated with respect and dignity
• To pursue a meaningful life
• To be free of fear
• The right to vote
• Freedom from discrimination on the basis of age, sex, race, religion, ethnic group, or disability
• To high quality care regardless of how their care is paid for

This law was passed because studies show rights were not being protected in all places for all patients. This law is called The Omnibus Budget Reconciliation Act (OBRA). It is the responsibility of all facilities to first and foremost inform all patients of their rights both orally and in writing. This is often referred to as "The Residents Bill of Rights".

The law also requires an ombudsman program to protect patients' rights. Each state must appoint an advocate; call the ombudsman to investigate complaints by patients or others about violation of rights.

Patients have many specific rights. They are grouped here under the following headings to make it easier to remember:

• Rights to exercise one's rights
• Rights to privacy and confidentiality
• Rights to information
• Rights to choose
• Rights to notification of change
• Protection of residents' personal funds
• Grievance rights
• Rights to be free from restraint and abuse

EXERCISING ONE'S RIGHTS

1. As clients of a facility or home bound and a citizen of the United States, each patient has the right to exercise his or her rights.
2. When a patient wants to exercise his or her rights, they are to be free of discrimination, interference coercion and reprisal.
3. If a patient is judged incompetent under the laws of a state, the rights of the patient are exercised by the person appointed by the state to act on their patients' behalf.

HOW TO ASSIST A CLIENT WITH THEIR RIGHTS

What does all this mean? You encourage patients' to exercise their rights by giving them choices and an opportunity to be heard. If they are not mentally competent to make their decisions, an appointed person acts for them legally.

RIGHTS TO PRIVACY AND CONFIDENTIALITY

How many times have you stood in a line, perhaps in a grocery store, and discussed with a friend about what an awful day you've had and how main a particular patient was? Maybe never, but if you have, the particular client's sister might have been standing in front of you or even in the next line and overheard everything that you said about her sister. Put yourself in that sister's place. How would you feel if they were talking about your sister?

As a team, we all must protect the client s' rights (This is the law!) We can do this by:

• Never discussing patients’ personal or medical information with anyone without a legitimate need to know.
• Never talking about patients’ personal information with other clients, with relatives and friends of a client, with visitors, with the media, or with our own friends/family.
• Discuss clients only with other team members in a private place and only about information needed to provide care for the client.
• Never gossip or make derogatory remarks about a client.
• When you assist a patient with personal care always:
  • Provide privacy, by closing the door
  • Knock before entering a room
  • Announce yourself when entering a room
  • Pull a curtain and drape a patients' body appropriately
  • Always ask visitors to leave the room before providing any care
• Other ways to assist with providing privacy for your client is to:
  • Assist a patient when needed to read and write letters but never open mail addressed to a patient unless a patient requests you to
  • If the patient does not have a phone in his or her room, provide a private place for a phone conversation by utilizing a phone booth or a cordless phone
  • Give patients time alone with visitors and help them find a private place for a visit if possible , especially with spouses and significant others
  • If needed, engage the patients' roommate elsewhere to protect a patients' privacy in the room

INFORMATION RIGHTS

Each patient has the right to see his or her personal and medical records. If requested, a patient must receive a copy of such records within 30 days. As a CENA/HHA you should report this request to the nurse in charge.

• Patients have the right to be fully informed, in a language they can understand, of their total health status.
• Patients must be informed of services for which they cannot be charged and al l other services and the specific charges for them. Patients must be informed of any changes in these services.
• Patients have the right to see their financial records and to have everything explained to them.

YOUR RESPONSIBILITY FOR PROVIDING INFORMATION

• When a patient asks a question, actively assist them with finding the answer by contacting the person or persons who may provide them with the information they are requesting. Read a copy of patient rights with them or to them when needed.
• Go with the patient to the area where information is provided (Usually posted by the facilities administrative offices).
• With questions about their medical condition or treatment plan, ask the supervising nurse to speak with them. Inform the supervising nurse of the patients' specific concerns, if known.

RIGHTS TO CHOOSE

Patients have the right to choices about their living arrangements and their medical care, as long as those choices do not interfere with the rights of other patients.

Additionally, each patient has the right to:

• Refuse a treatment and to refuse to participate in experimental research
• To choose a personal attending physician
• To participate in treatment that may affect his or her well-being
• To keep and use personal possessions, within the limits of space and safety considerations
• Self-administer his/her medication, if the treatment team deems it safe. (A physician is required for this).
• The right to activities, schedules, and health care according to his or her own interests and needs.

RIGHTS TO NOTIFICATION OF CHANGE

Each family member, physician, and supervising nurse must be notified of any changes in a patients' physical, mental, or psychological status, including any accident or injury.

• If a treatment plan must be changed due to a patients' change of status or resources, the patient must be informed prior to the change being made.
• Each patient must be informed of any changes in their patient rights.

THE RIGHT TO BE FREE FROM RESTRAIN AND ABUSE

Each patient has the right to be free from any physical or chemical restraints imposed for discipline or convenience of the staff.

• Each patient has the right to be free from verbal, sexual, physical, and mental abuse, corporal punishment, and involuntary seclusion.
• The facility must have and follow written policies to prohibit mistreatment, neglect, and abuse of patients or their property.
• Alleged violations of these rights must be reported to the administration and other officials as required by state law. The facility must investigate the alleged violation thoroughly and report its findings.

UNDERSTANDING THE DIFFERENT TYPES OF PATIENT ABUSE

1. Physical Restraints
   • Any mechanical device that restricts a patients' movement, such as:
     • Bed rails
     • A vest restrain to keep a patient in bed or in a chair
     • A limb restraint to limit use of arms or legs
     • A Geri-chair or lap pillow to prevent standing or walking
2. Chemical Restraints
   • Any medication used to sedate a client or slow muscle activity
3. Verbal Abuse
   • Includes but not limited to profanity, calling a patient names, yelling at a patient
4. Physical Abuse
5. Any action that causes actual physical harm, such as:
   • Handling a patient too roughly
   • Performing the wrong treatment on a patient
   • Hitting, pushing, pinching, or kicking of a patient

YOUR ROLE IN REPORTING SUSPECTED PATIENT ABUSE OR NEGLECT

• All licensed personal are required by law to report suspected abuse or neglect of any patient in their care.
• Health Partners, Inc. requires all non- licensed staff to report any suspected abuse or neglect to their immediate supervising nurse