PRIOR PRINTER'S NO. 1988 PRINTER'S NO. 2680
No. 1631 Session of 2001
INTRODUCED BY SAMUELSON, PISTELLA, SCHULER, C. WILLIAMS, WATSON,
PALLONE, ARMSTRONG, GRUCELA, SATHER, B. SMITH, YUDICHAK,
MELIO, FREEMAN, SCRIMENTI AND HABAY, MAY 21, 2001
AS AMENDED ON THIRD CONSIDERATION, HOUSE OF REPRESENTATIVES,
OCTOBER 16, 2001
AN ACT
1 Relating to long-term care facility residents' rights; and
2 providing for requirements for admission, care, transfer,
3 discharge, funds and privacy of long-term care facility
4 residents and for remedies., FOR REMEDIES AND FOR REPORT TO <--
5 GENERAL ASSEMBLY.
6 The General Assembly finds and declares as follows:
7 (1) Long-term care facilities are a critical part of
8 this Commonwealth's long-term care services system. It is the
9 intent of the General Assembly that individuals who reside in
10 long-term care facilities receive appropriate services, be
11 treated with courtesy and continue to enjoy their basic civil
12 and legal rights.
13 (2) It is further the intent of the General Assembly
14 that long-term care facility residents have the opportunity
15 to exercise reasonable control over life decisions. The
16 General Assembly finds that choice, participation, privacy
17 and the opportunity to engage in religious, political, civic,
18 recreational and other social activities foster a sense of
1 self-worth and enhance the quality of life for long-term care
2 residents.
3 (3) The public interest would be best served by
4 providing the same basic resident rights in all long-term
5 care settings. Residents in nursing facilities are guaranteed
6 certain rights by Federal law and regulation under section
7 1919 of the Social Security Act (49 Stat. 620, 42 U.S.C. §
8 1396r) and 42 CFR Pt. 483 (relating to requirements for
9 states and long-term care facilities). It is the intent of
10 the General Assembly to extend those basic rights to
11 residents in personal care homes, boarding homes and adult
12 day-care facilities.
13 (4) It is further the intent of the General Assembly
14 that a facility should care for its residents in a manner and
15 in an environment that promotes maintenance or enhancement of
16 each resident's quality of life. A resident should have a
17 safe, clean, comfortable and homelike environment allowing
18 the resident to use his or her personal belongings to the
19 extent possible. The rights set forth in this act are the
20 minimal rights guaranteed to all residents of long-term care
21 facilities and are not intended to diminish rights set forth
22 in Federal or State law that may contain additional rights.
23 TABLE OF CONTENTS
24 Section 1. Short title.
25 Section 2. Definitions.
26 Section 3. Exercise of rights.
27 Section 4. Rights and quality of life.
28 Section 5. Rights and services upon admission.
29 Section 6. Admissions, disclosures and contracts.
30 Section 7. Notification of changes in resident's condition.
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1 Section 8. Facility service capability, transfer and discharge.
2 Section 9. Protection of residents' funds.
3 Section 10. Privacy of records.
4 Section 11. Grievances.
5 Section 12. Remedies.
6 Section 13. Examination of inspection results; contact with
7 advocates.
8 Section 14. Privacy in communications.
9 Section 15. Access and visitation.
10 Section 16. Personal property.
11 Section 17. Restraints.
12 Section 18. Abuse, punishment and seclusion.
13 Section 19. Waiver of liability and residents' rights limited.
14 Section 20. Conflict with Federal requirements.
15 SECTION 21. REPORT TO GENERAL ASSEMBLY. <--
16 Section 21 22. Effective date. <--
17 The General Assembly of the Commonwealth of Pennsylvania
18 hereby enacts as follows:
19 Section 1. Short title.
20 This act shall be known and may be cited as the Long-Term
21 Care Residents' Rights Act.
22 Section 2. Definitions.
23 The following words and phrases when used in this act shall
24 have the meanings given to them in this section unless the
25 context clearly indicates otherwise:
26 "Chemical restraint." A psychopharmacological drug that is
27 used for discipline or convenience and not required to treat a
28 resident's medical symptoms.
29 "Facility." A facility licensed by the Commonwealth to <--
30 provide long-term care. The term includes, but is not limited
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1 to, a long-term nursing facility, a personal care home, a
2 boarding home and an adult daily living center. The term does
3 not include a boarding home that merely provides room, board and
4 laundry services to residents who do not need scheduled or
5 unscheduled adult daily living services.
6 "FACILITY." THE TERM MAY INCLUDE ANY OF THE FOLLOWING: <--
7 (1) A LONG-TERM CARE NURSING FACILITY AS DEFINED IN
8 SECTION 802.1 OF THE ACT OF JULY 19, 1979 (P.L.130, NO.48),
9 KNOWN AS THE HEALTH CARE FACILITIES ACT.
10 (2) A PERSONAL CARE HOME AS DEFINED IN SECTION 1001 OF
11 THE ACT OF JUNE 13, 1967 (P.L.31, NO.21), KNOWN AS THE PUBLIC
12 WELFARE CODE.
13 "FUNDAMENTAL ALTERATION." A CHANGE OR MODIFICATION TO THE
14 PROGRAM OR BUILDING THAT THE FACILITY CAN DEMONSTRATE WOULD
15 CAUSE IT TO SUFFER AN UNDUE HARDSHIP WITH REGARD TO COST, NATURE
16 AND SCOPE.
17 "Physical restraint." A manual method, obstacle or physical
18 or mechanical device, material or equipment attached or adjacent
19 to the resident's body that restricts freedom of movement or
20 access to his or her body, is used for discipline or convenience
21 and not required to treat a resident's medical symptoms.
22 "Reasonable accommodation." In relation to a facility and
23 the needs of its prospective or current residents, the term has
24 the meaning given under the Americans with Disabilities Act of
25 1990 (Public Law 101-336, 104 Stat. 327) and other applicable
26 Federal or State antidiscrimination laws and regulations.
27 "Resident." A person receiving services in a facility. The
28 term also includes that resident's attorney-in-fact, guardian or
29 other legal representative acting within the scope of his or her
30 authority.
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1 "TRANSFER AND DISCHARGE." INCLUDES MOVEMENT OF A RESIDENT TO <--
2 A BED OUTSIDE OF THE FACILITY WHETHER THAT BED IS IN THE SAME
3 PHYSICAL PLANT OR NOT. TRANSFER AND DISCHARGE DO NOT REFER TO
4 MOVEMENT OF A RESIDENT TO A BED WITHIN THE SAME FACILITY.
5 Section 3. Exercise of rights.
6 A resident has a right to a dignified existence, self-
7 determination and communication with and access to persons and
8 services inside and outside of the facility. A facility must
9 protect and promote the rights of each resident and assist the
10 resident as follows:
11 (1) The resident has the right to exercise his or her
12 rights as a resident of the facility and as a citizen of the
13 United States and a resident of this Commonwealth.
14 (2) The resident has the right to be free of
15 interference, coercion, discrimination and reprisal from the
16 facility, ITS STAFF AND ITS RESIDENTS in exercising his or <--
17 her rights.
18 (3) In the case of a resident that is judged incompetent
19 by a court of competent jurisdiction, the rights of the
20 resident are exercised by the person appointed to act on the
21 resident's behalf.
22 (4) In the case of a resident who has not been adjudged
23 incompetent by a court of competent jurisdiction, a
24 representative may exercise the resident's rights to the
25 extent provided by law.
26 Section 4. Rights and quality of life.
27 (a) General rule.--A facility must promote care for
28 residents in a manner and in an environment that maintains or
29 enhances each resident's dignity and respect in full recognition
30 of his or her individuality.
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1 (b) Quality of life.--Within reasonable facility rules
2 designed to protect the rights and quality of life of residents,
3 a resident has the right to:
4 (1) Choose activities, schedules and health care SERVICE <--
5 AND PROVIDERS consistent with his or her interests,
6 assessments and plans of care.
7 (2) Interact with members of the community both inside
8 and outside of the facility.
9 (3) Make choices about aspects of his or her life in the
10 facility which are significant to the resident.
11 (4) Wear his or her own clothing and determine his or
12 her own dress, hair style or other personal effects according
13 to individual preference.
14 (5) Unless adjudged incompetent or otherwise found to be
15 incapacitated, participate in planning care and treatment or
16 changes in care and treatment.
17 (6) Unless adjudged incompetent or otherwise found to be
18 incapacitated, to direct his or her own service plan and
19 changes in the service plan and to refuse any particular
20 service so long as such refusal is documented in the record
21 of the resident.
22 (c) Resident groups.--A resident has the right to organize
23 and participate in resident groups in the facility. The
24 following shall apply:
25 (1) If a resident group is organized, the facility must
26 provide a meeting room if one exists.
27 (2) Staff or visitors may attend meetings at the
28 resident group's invitation.
29 (3) When a resident or family group exists, a facility
30 must listen to the views and act upon the grievances and
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1 recommendations of residents and families concerning proposed
2 policy and operational decisions affecting resident care and
3 life in the facility.
4 (d) Services performed by resident.--A resident has the
5 right to refuse to perform services for the facility except as
6 voluntarily agreed by the resident and the facility in the
7 resident's service plan.
8 (e) Participation in certain activities.--A resident has the
9 right to participate in social, religious and community
10 activities that do not interfere with the rights of other
11 residents in the facility.
12 (f) Accommodation; change of room or roommate ROOM OR <--
13 ROOMMATE AND ABILITY OF CONSUMER TO ARRANGE FOR SUPPLEMENTAL
14 SERVICES TO PERMIT AGING IN PLACE.--A resident has the right to:
15 (1) RESIDE AND RECEIVE CARE AND SERVICES IN THE FACILITY <--
16 365 DAYS A YEAR WITH NO PLANNED OR INTERMITTENT
17 INTERRUPTIONS. NOTHING IN THIS PARAGRAPH SHALL PRECLUDE
18 FACILITIES FROM ADJUSTING THEIR STAFFING LEVELS IN ACCORDANCE
19 WITH A RESIDENT BEING ABSENT FROM A FACILITY FOR HOLIDAYS OR
20 VACATIONS.
21 (1) (2) Reside and receive services in the facility with <--
22 reasonable accommodation of individual needs and preferences,
23 INCLUDING THE ABILITY OF THE RESIDENT TO ARRANGE FOR <--
24 SUPPLEMENTAL SERVICES TO PERMIT AGING IN PLACE, except when
25 the health or safety of the individual or other residents
26 would be endangered.
27 (2) (3) Receive notice before the resident's room or <--
28 roommate in the facility is changed.
29 (g) Spouses.--A resident has the right to share a double
30 room with his or her spouse when married residents live in the
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1 same facility and both spouses consent to the arrangement.
2 (H) PUBLIC FUNDING.--A RESIDENT HAS THE RIGHT TO APPLY FOR <--
3 AND RECEIVE, IF DETERMINED ELIGIBLE, AVAILABLE PUBLIC FUNDING
4 FOR CARE AND SERVICES AT ANY TIME PRIOR TO OR DURING RESIDENCY.
5 AN APPLICANT WHO IS ELIGIBLE FOR PUBLIC FUNDING MAY NOT BE
6 REQUIRED TO RESIDE AS A PRIVATE PAY RESIDENT FOR ANY DURATION OF
7 TIME AS A CONDITION OF ADMISSION OR RESIDENCY.
8 Section 5. Rights and services upon admission.
9 (a) Notification.--A facility must inform the resident both
10 orally and in writing in a language that the resident
11 understands of his or her rights and all rules and regulations
12 governing resident conduct and responsibilities during the stay
13 in the facility. The notification must be made prior to or upon
14 admission. Receipt of all the information under this section
15 must be acknowledged in writing.
16 (b) Access to records.--A resident or his or her legal
17 representative has the right:
18 (1) Upon an oral or written request, to access all
19 records pertaining to himself or herself, including clinical
20 records within 24 hours of the request.
21 (2) After receipt of his or her records for inspection,
22 to purchase, at a cost not to exceed the community standard
23 for photocopies, copies of the records or portions of them
24 upon request and 15 10 working days' advance notice to the <--
25 facility.
26 (c) Admission.--A facility may only admit or retain
27 individuals whose needs it can safely and appropriately serve in
28 the facility with appropriate available staff and through the
29 provision of reasonable accommodations required by Federal or
30 State law. Except in cases of emergency, the facility may not
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1 admit an individual before obtaining a thorough assessment BY AN <--
2 APPROPRIATE ASSESSOR AS PERMITTED BY LAW. ALL APPLICANTS SHALL
3 BE INFORMED OF THEIR RIGHT TO AN INDEPENDENT ASSESSMENT BY AN
4 APPROPRIATE ASSESSOR LOCATED AT AN AREA AGENCY ON AGING OR
5 ANOTHER SITE NOT AFFILIATED WITH THE FACILITY. The assessment <--
6 shall contain, unless unavailable despite the best efforts of
7 either the facility, the resident applicant and other interested
8 parties, the following minimum information:
9 (1) Recent medical history.
10 (2) Necessary and contraindicated medications.
11 (3) A licensed medical or other health professional's
12 diagnosis, unless the individual objects for religious
13 reasons.
14 (4) Significant known behaviors or symptoms that may
15 cause concern or require special care.
16 (5) Mental illness, except where protected by
17 confidentiality laws.
18 (6) Level of personal care needs. ASSESSMENT SHALL <--
19 CONTAIN:
20 (1) A MEDICAL EVALUATION BY THE APPLICANT'S PHYSICIAN
21 INDICATING THE RESIDENT'S HEALTH STATUS AND CERTIFYING THE
22 RESIDENT'S LEVEL OF CARE NEEDS AND APPROPRIATENESS FOR THE
23 FACILITY TYPE.
24 (2) RELEVANT MEDICAL HISTORY INCLUDING:
25 (I) NECESSARY AND CONTRAINDICATED MEDICATIONS.
26 (II) RELEVANT DIAGNOSIS AND CONDITIONS.
27 (III) ALLERGIES.
28 (IV) SIGNIFICANT KNOWN BEHAVIORS OR SYMPTOMS THAT
29 MAY CAUSE CONCERN OR REQUIRE SPECIAL CARE.
30 (V) DIETARY SPECIFICATIONS.
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1 (VI) PERSONAL CARE NEEDS AS IDENTIFIED BY THE
2 EVALUATION AND ASSESSMENT.
3 (D) RETENTION.--A FACILITY SHALL RETAIN AND NOT TRANSFER OR
4 DISCHARGE A RESIDENT UNLESS:
5 (1) THERE IS NONPAYMENT OF FEES REQUIRED UNDER THE
6 CONTRACT, AFTER REASONABLE GOOD FAITH EFFORTS TO OBTAIN
7 PAYMENT, INCLUDING, WHERE APPROPRIATE, APPLICATION FOR
8 AVAILABLE PUBLIC FUNDING.
9 (2) THE RESIDENT DEVELOPS A CONDITION OF A NATURE AND
10 SEVERITY THAT THE LICENSING DEPARTMENT PRECLUDES BY
11 REGULATION FROM BEING SERVED IN THAT FACILITY TYPE.
12 (3) THE RESIDENT'S NEEDS CANNOT BE MET BY THE FACILITY,
13 EVEN WITH THE RESIDENT BRINGING IN SUPPLEMENTAL SERVICES FROM
14 AN OUTSIDE PROVIDER, WITHOUT A FUNDAMENTAL ALTERATION TO THE
15 PROGRAM OR FACILITY.
16 (D) (E) Resident preferences.--A facility shall within five <--
17 days after admission of the resident complete a list of the
18 following preferences that shall become part of the resident's
19 medical history RECORD: <--
20 (1) Preferences as to daily social and visitation
21 activities.
22 (2) Service preferences.
23 (3) Preferences regarding other issues important to the
24 resident.
25 (F) ACCOMMODATION.--RESIDENT PREFERENCES SHALL BE REASONABLY <--
26 ACCOMMODATED BY THE FACILITY.
27 (e) (G) Additional notifications.--A facility must provide <--
28 each resident, in writing in a language the resident or his or
29 her representative easily understands, before admission and at
30 least once every 18 months thereafter OR IF ANY OF THE FOLLOWING <--
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1 ARE CHANGED:
2 (1) A copy of the facility's admission and discharge
3 policies.
4 (2) A description of the facility internal grievance
5 process, including the names, office location and telephone
6 number of the facility personnel responsible for hearing and
7 resolving complaints. EACH LICENSING ENTITY SHALL DETERMINE <--
8 UNIFORM STANDARDS FOR FACILITIES TO FOLLOW IN RESOLVING
9 INTERNAL GRIEVANCES.
10 (3) Services, items and activities customarily available
11 in the facility or arranged for by the facility as permitted
12 by the facility's license.
13 (4) Advance directive information, including information
14 on the right to have or not to have an advance directive.
15 (5) A list of charges for those services, items and
16 activities, including charges for services, items and
17 activities not covered by the facility's per diem rate or
18 applicable public benefit programs.
19 (6) Changes in the availability or the charges for
20 services, items or activities or of changes in the facility's
21 rules. Except in emergencies, 30 days' advance notice must be
22 given prior to the change.
23 (7) A description of the manner of protecting personal
24 funds as provided in section 9.
25 (8) A written description of resident's rights that
26 include:
27 (i) Telephone numbers of the local long-term care
28 ombudsman program and the local area agency on aging.
29 (ii) A list of the names, addresses and telephone
30 numbers of the appropriate State licensing departments.
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1 This same document shall include a statement that the
2 resident may file a complaint with the appropriate
3 departments or with the long-term care ombudsman
4 concerning alleged resident abuse, neglect and
5 misappropriation of resident property in the facility.
6 (f) (H) Posting of information.--A facility shall also post <--
7 all the information provided to a resident in subsection (e)(5) <--
8 (G)(5) and (6) in a conspicuous location that is readily <--
9 accessible. All posted information shall be presented to the
10 residents in a form that is readable and easily understood.
11 Section 6. Admissions, disclosures and contracts.
12 (a) Disclosures required.--Prior to admission, a facility
13 that requires an admission fee, deposit or a minimum stay fee,
14 by or on behalf of a person seeking admission to the facility,
15 shall provide a resident or his or her representative, full
16 disclosure, in writing in a language the resident or his or her
17 representative understands, a statement of the amount of any
18 admission fees, deposits, prepaid charges or minimum stay fees.
19 The facility shall also disclose to the person or his or her
20 representative the facility's advance notice or transfer
21 requirements, WHICH SHALL COMPLY WITH SECTION 5, prior to <--
22 admission. In addition, the facility shall also fully disclose
23 in writing prior to admission what portion of the deposits,
24 admission fees, prepaid charges, or minimum stay fees will be
25 refunded to the resident or his or her representative if the
26 resident leaves the facility. Receipt of the disclosures
27 required under this subsection must be acknowledged in writing.
28 If the facility does not provide these disclosures, the
29 deposits, admission fees, prepaid charges or minimum stay fees
30 may not be kept by the facility. If a resident dies or is
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1 hospitalized or is transferred to another facility for more
2 appropriate care and does not return to the original facility,
3 the facility shall refund any deposit or charges already paid
4 less the facility's per diem rate for the days the resident
5 actually resided or reserved or retained a bed in the facility,
6 notwithstanding any minimum stay policy or discharge notice
7 requirements, except that the facility may retain an additional
8 amount to cover its reasonable, actual expenses incurred as a
9 result of a private-pay resident's move, not to exceed five
10 days' per diem charges, unless the resident has given advance
11 notice in compliance with the admission agreement. A facility
12 under this section is required to refund any and all refunds due
13 the resident or his or her representative within 30 days from
14 the resident's date of discharge from the facility. Nothing in
15 this section applies to provisions in contracts negotiated
16 between a facility and a certified health plan, health or
17 disability insurer, health maintenance organization, managed
18 care organization or similar entities.
19 (b) Admission contract.--Where a facility requires the <--
20 execution of THE FACILITY IS REQUIRED TO HAVE an admission <--
21 contract by or on behalf of an individual seeking admission to
22 the facility, the terms of the contract shall be consistent with
23 the requirements of this section AND OTHER LICENSING <--
24 REQUIREMENTS, and the terms of an admission contract by a
25 facility shall be consistent with the requirements of this act.
26 Section 7. Notification of changes in resident's condition.
27 (a) Notifications.--
28 (1) A facility must immediately consult with the
29 resident's physician and, if known, make reasonable efforts
30 to notify the resident's legal representative or an
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1 interested family member when there is:
2 (i) An accident involving the resident that requires
3 or has the potential for requiring physician
4 intervention.
5 (ii) A significant change in the resident's
6 physical, mental or psychosocial status such as
7 deterioration in health, mental or psychosocial status as
8 a result of a life-threatening condition or clinical
9 complication.
10 (2) The facility must promptly notify the resident or
11 the resident's representative and shall make reasonable
12 efforts to notify an interested family member, if known, when
13 there is a change in the resident's room or roommate
14 assignment.
15 (b) Recordkeeping.--The facility must record and update the
16 address and telephone number of a resident's representative or
17 interested family member, upon receipt of notice.
18 Section 8. Facility service capability, transfer and discharge.
19 (a) Service capability.--A facility shall fully disclose to
20 potential residents or their legal representative the service
21 capabilities of the facility prior to admission to the facility.
22 If the care needs of an applicant who is Medicaid eligible are <--
23 in excess of the facility's service capabilities, the respective
24 licensing department shall identify other care settings or
25 residential care options consistent with Federal law, NOTIFY THE <--
26 APPLICANT AND LEGAL REPRESENTATIVE OF THE FACILITY'S
27 DETERMINATION AND OTHER CARE SETTINGS IDENTIFIED, REFER THE
28 APPLICANT AND LEGAL REPRESENTATIVE TO THE COUNTY AGENCY THAT CAN
29 ASSIST IN PLACEMENT IN OTHER CARE SETTINGS.
30 (b) Facility obligations.--A facility must permit each
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1 resident to remain in the facility and not transfer or discharge
2 a resident from the facility unless:
3 (1) The transfer or discharge is necessary for the
4 resident's welfare and the resident's needs cannot WITH <--
5 REASONABLE ACCOMMODATION be met in the facility. REASONABLE <--
6 ACCOMMODATION SHALL INCLUDE THE ALLOWANCE OF OBTAINING
7 SUPPLEMENTAL SERVICES FROM A PROVIDER OUTSIDE OF THE LONG-
8 TERM CARE FACILITY AND SHALL PRECLUDE FUNDAMENTAL ALTERATIONS
9 IN THE FACILITY'S BASIC PROGRAM OR BUILDING.
10 (2) The safety of other individuals in the facility is
11 endangered.
12 (3) The health of individuals in the facility would
13 otherwise be endangered.
14 (4) The FACILITY HAS MADE A GOOD FAITH EFFORT TO OBTAIN <--
15 PAYMENT OF CONTRATUAL FEES AND THE resident has failed to
16 make the required payment for his or her stay, provided that
17 the failure to make payment is not based on the resident's
18 failure to receive payment from a public benefit program.
19 (5) The facility ceases to operate.
20 (c) Transfer or discharge.--Before a long-term care facility
21 transfers or discharges a resident, a facility must:
22 (1) First attempt through reasonable accommodations to
23 avoid the transfer or discharge, unless agreed to by the
24 resident.
25 (2) Notify the resident and the legal representative of
26 the resident and make a reasonable effort to notify, if
27 known, an interested family member of the transfer or
28 discharge and the reasons for the move in writing and in a
29 language and manner they understand.
30 (3) Record the reasons in the resident's record.
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1 (4) Include in the notice the items described in
2 subsection (d)(3).
3 (d) Notice procedure.--
4 (1) Except as provided under paragraph (2), the notice
5 of transfer or discharge required under subsection (c)(2)
6 must be made by the facility at least 30 days before the
7 resident is transferred or discharged.
8 (2) Notice may be made as soon as practicable before
9 transfer or discharge when:
10 (i) The safety of individuals in the facility would
11 be endangered.
12 (ii) The health of individuals in the facility would
13 be endangered.
14 (iii) An immediate transfer or discharge is required
15 by the resident's urgent medical needs.
16 (iv) A resident has not resided in the facility for
17 30 days.
18 (3) The written notice specified in subsection (c)(2)
19 must include the following:
20 (i) The reason for transfer or discharge.
21 (ii) The effective date of transfer or discharge.
22 (iii) The location to which the resident is
23 transferred or discharged.
24 (iv) The name, address and telephone number of the
25 State AND LOCAL long-term care ombudsman. <--
26 (v) For residents with developmental disabilities,
27 the mailing address and telephone number of the agency
28 responsible for the protection and advocacy of
29 developmentally disabled individuals.
30 (vi) For residents who are mentally ill, the mailing
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1 address and telephone number of the agency responsible
2 for the protection and advocacy of mentally ill
3 individuals.
4 (e) Preparation for transfer or discharge.--A facility must
5 provide sufficient preparation and orientation to residents to
6 ensure safe and orderly transfer or discharge from the facility.
7 (f) Readmission.--A resident discharged in violation of this
8 section has the right to be readmitted immediately upon the
9 first availability of a gender-appropriate bed in the facility.
10 (g) Discharge planning.--A facility must insure that a
11 transfer or discharge is safe, orderly and appropriate to TO A <--
12 SETTING CAPABLE OF MEETING the resident's needs. The following
13 shall apply:
14 (1) A FACILITY MAY NOT DISCHARGE A RESIDENT WITHOUT <--
15 WRITTEN NOTICE PURSUANT TO THIS ACT BEING PROVIDED TO THE
16 RESIDENT AND LEGAL REPRESENTATIVE INDICATING THE REASON FOR
17 THE PROPOSED TRANSFER OR DISCHARGE.
18 (1) (2) A facility may not discharge a resident either <--
19 with or without consent unless and until a discharge plan has
20 been completed and signed by the resident or his legal
21 representative that lists:
22 (i) The name and address of the facility OR OTHER <--
23 RESIDENTIAL SETTING to which the resident is being
24 transferred.
25 (ii) A list of medical or care needs that the
26 resident will need until the transfer is complete AND HOW <--
27 THOSE NEEDS WILL BE MET BY THE FACILITY.
28 (III) A LIST OF THE MEDICAL AND CARE NEEDS THAT THE
29 RESIDENT WILL NEED AFTER THE TRANSFER IS COMPLETE AND HOW
30 THEY WILL BE MET.
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1 (IV) THE REASON THE FACILITY IS DISCHARGING OR
2 TRANSFERRING THE RESIDENT.
3 (iii) (V) Any other special needs or preferences that <--
4 the resident has provided to the discharging facility.
5 (2) (3) A copy of the discharge plan shall be forwarded <--
6 to the facility OR OTHER SERVICE PROVIDER to which the <--
7 resident is transferred. A copy of the medical or care needs
8 of the resident shall be provided to the individual or entity
9 that is transferring the individual.
10 Section 9. Protection of residents' funds.
11 (a) General rule.--A resident has the right to manage his or
12 her financial affairs. A facility may not require residents to
13 deposit their personal funds with the facility NOR MAY A <--
14 FACILITY REQUIRE A RESIDENT TO MAKE THE FACILITY THE
15 REPRESENTATIVE PAYEE AS A CONDITION OF ADMISSION OR RETENTION.
16 (b) Management of residents' funds.--Upon written
17 authorization of a resident, if a facility agrees to manage the
18 resident's personal funds, the facility must hold, safeguard,
19 manage and account for the personal funds of the resident
20 deposited with the facility as follows:
21 (1) The facility must deposit a resident's personal
22 funds in excess of $50 in an interest-bearing account that is
23 separate from any of the facility's operating accounts and
24 that credits all interest earned on a resident's funds to
25 that account. In pooled accounts, there must be a separate
26 accounting for each resident's share.
27 (2) The facility must maintain a resident's personal
28 funds that do not exceed $50 in a noninterest-bearing
29 account, interest-bearing account or petty cash fund.
30 (3) The facility must establish and maintain a system
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1 that assures a full and complete and separate accounting of
2 each resident's personal funds entrusted to the facility on
3 the resident's behalf. The system must preclude any
4 commingling of resident funds with facility funds or with the
5 funds of any person other than another resident. THE <--
6 ADMINISTRATOR MUST INSURE THAT RESIDENTS HAVE PROMPT ACCESS
7 TO THEIR FUNDS. The individual financial record must be
8 SUMMARIZED IN MONTHLY STATEMENTS PROVIDED TO AND OTHERWISE <--
9 available on request to the resident or his or her legal
10 representative.
11 (4) Upon the death of a resident with personal funds
12 deposited with the facility, the facility must convey within
13 60 days the resident's funds and a final accounting of those <--
14 funds to the individual or probate jurisdiction administering
15 the resident's estate. 30 DAYS AN ESTIMATED ACCOUNTING OF THE <--
16 RESIDENT'S FUNDS DEPOSITED AT THE FACILITY, AN ESTIMATE OF
17 THE FINAL CHARGES BASED ON PRIOR MONTHLY CHARGES AND OTHER
18 AVAILABLE INFORMATION, AND THE AMOUNT OF FUNDS ON DEPOSIT
19 THAT EXCEED THE ESTIMATED FINAL CHARGES TO THE INDIVIDUAL OR
20 PROBATE JURISDICTION ADMINISTERING THE RESIDENT'S ESTATE.
21 WITHIN 60 DAYS OF THE DEATH OF A RESIDENT WITH PERSONAL FUNDS
22 DEPOSITED WITH THE FACILITY, THE FACILITY MUST CONVEY A FINAL
23 ACCOUNTING AND DISPERSE ANY REMAINING RESIDENT'S FUNDS TO THE
24 INDIVIDUAL OR PROBATE JURISDICTION ADMINISTERING THE
25 RESIDENT'S ESTATE.
26 (5) In the case of a resident who received long-term
27 care services paid for by the Commonwealth, the funds and <--
28 accounting shall be sent to the Department of Public Welfare
29 for determination of financial recovery. The department shall
30 establish a release procedure that assures that funds not
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1 subject to recovery are released within 60 days of receipt
2 and are released for use for burial expenses. THE FACILITY <--
3 SHALL NOTIFY THE DEPARTMENT OF PUBLIC WELFARE OF THE DEATH
4 AND THE NAME OF THE PERSON KNOWN TO BE EXECUTOR OF THE
5 ESTATE.
6 Section 10. Privacy of records.
7 A resident has the right to personal privacy and
8 confidentiality of his or her personal and clinical records.
9 Personal privacy includes accommodations, medical treatment,
10 written and telephone communications, personal care, visits and
11 meetings of family and resident groups. This does not require
12 the facility to provide a private room for each resident.
13 However, a resident may not be prohibited by the facility from
14 meeting with guests in his or her bedroom if no roommates
15 object. The resident may approve or refuse the release of
16 personal and clinical records to an individual outside the
17 facility unless otherwise provided by law.
18 Section 11. Grievances.
19 A resident has the right to:
20 (1) Voice grievances. Grievances include those with
21 respect to treatment that has been furnished as well as that
22 which has not been furnished.
23 (2) Prompt efforts by the facility to resolve grievances
24 the resident may have, including those with respect to the
25 behavior of other residents.
26 (3) ASSURANCE THAT THE FOCUS IS ON HIS OR HER WELL- <--
27 BEING. IT IS ESSENTIAL THAT THE FOCUS IN GRIEVANCE RESOLUTION
28 REMAIN ON INSURING THE HEALTH, SAFETY AND WELL-BEING OF THE
29 RESIDENTS IN LONG-TERM CARE FACILITIES IN THIS COMMONWEALTH.
30 (4) PROTECTION AGAINST RETALIATING ACTION. THE FACILITY
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1 SHALL NOT TAKE ANY ACTION AGAINST A RESIDENT IN RETALIATION,
2 INCLUDING, BUT NOT LIMITED TO, THREATENING TO TRANSFER OR
3 DISCHARGE, TRANSFERRING OR DISCHARGING, THREATENING TO
4 INFRINGE OR INFRINGING ON ANY OF THE CONSUMER RIGHTS
5 ARTICULATED IN THIS ACT, FOR THE RESIDENT'S VOICING OF
6 GRIEVANCES.
7 Section 12. Remedies.
8 The General Assembly intends that facility residents, their
9 family members or guardians, long-term care ombudsman,
10 protection and advocacy personnel identified in this act and
11 others who may seek to assist facility residents use the least
12 formal means available to satisfactorily resolve disputes that
13 may arise regarding the rights conferred by this act. Wherever
14 feasible, direct discussion with facility personnel or
15 administrators should be employed. Failing that, and where
16 feasible, recourse may be sought through Federal or State long-
17 term care or nursing home licensing or other regulatory
18 authorities. However, the procedures suggested in this section
19 are cumulative and shall not restrict an agency or person from
20 seeking a remedy provided by law or from obtaining additional
21 relief based on the same facts, including any remedy available
22 to an individual at common law.
23 Section 13. Examination of inspection results; contact with
24 advocates.
25 A resident has the right to:
26 (1) Examine the results of the most recent inspection of
27 the facility conducted by Federal or State inspectors and
28 plans of correction in effect with respect to the facility. A
29 notice that the results are available must be publicly posted
30 with the facility's license, and the results must be made
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1 available for examination by the facility in a conspicuous
2 place readily accessible to residents.
3 (2) Receive information from departments, agencies or
4 programs acting as resident advocates and be afforded the
5 opportunity to contact these entities.
6 Section 14. Privacy in communications.
7 A resident has the right to privacy in communications,
8 including the right to:
9 (1) Send and promptly receive mail that is unopened.
10 (2) Have access to stationery, postage and writing
11 implements at the resident's own expense.
12 (3) Have reasonable access to the use of a telephone
13 where calls can be made without being overheard.
14 Section 15. Access and visitation.
15 (a) Access.--A resident has the right and a facility must
16 not interfere with access to any resident by the following:
17 (1) Any representative of the Commonwealth.
18 (2) The resident's individual physician.
19 (3) The long-term care ombudsman.
20 (4) A department responsible for the protection and
21 advocacy for mentally ill individuals.
22 (5) Subject to reasonable restrictions to protect the
23 rights of others and to the resident's right to deny or
24 withdraw consent at any time, immediate family or other
25 relatives of the resident and others who are visiting with
26 the consent of the resident.
27 (6) An agency responsible for the protection and
28 advocacy for individuals with disabilities.
29 (b) Access to services.--A facility must provide reasonable
30 access to a resident by his or her representative or an entity
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1 or individual that provides health, social, legal or other
2 services to the resident, subject to the resident's right to
3 deny or withdraw consent at any time.
4 (c) Access to records.--A facility must allow
5 representatives of the long-term care ombudsman to examine a
6 resident's clinical records with the permission of the resident
7 or the resident's legal representative and consistent with
8 Federal and State law.
9 Section 16. Personal property.
10 (a) Personal property generally.--A resident has the right
11 to retain and use personal possessions, including some
12 furnishings, and appropriate clothing, as space permits, unless
13 to do so would infringe upon the rights or health and safety of
14 other residents.
15 (b) Storage.--A facility shall, upon request, provide the
16 resident with a lockable container or other lockable storage
17 space for small items of personal property, unless the
18 resident's individual room is lockable with a key issued to the
19 resident.
20 Section 17. Restraints.
21 A resident has the right to be free from physical restraint
22 and chemical restraint. This section does not require or
23 prohibit facility staff from reviewing the judgment of the
24 resident's physician in prescribing psychopharmacologic
25 medications.
26 Section 18. Abuse, punishment and seclusion.
27 A resident has the right to be free from verbal, sexual,
28 physical and mental abuse, NEGLECT, FINANCIAL EXPLOITATION, <--
29 corporal punishment and involuntary seclusion.
30 Section 19. Waiver of liability and residents' rights limited.
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1 No facility shall request residents to sign waivers of
2 potential liability for losses of personal property or injury or
3 to sign waivers of residents' rights set forth in this act or in
4 applicable licensing or certification laws.
5 Section 20. Conflict with Federal requirements.
6 If any part of this act is found to be in conflict with
7 Federal requirements that are a prescribed condition to the
8 allocation of Federal funds to the Commonwealth, the conflicting
9 part of this act is inoperative solely to the extent of the
10 conflict and with respect to the agencies directly affected, and
11 this finding does not affect the operation of the remainder of
12 this act in its application to the agencies concerned. The rules
13 under this act shall meet Federal requirements that are a
14 necessary condition to the receipt of Federal funds by the
15 Commonwealth.
16 SECTION 21. REPORT TO GENERAL ASSEMBLY. <--
17 WITHIN ONE YEAR OF THE EFFECTIVE DATE OF THIS SECTION, THE
18 DEPARTMENT OF AGING SHALL PROVIDE TO THE GENERAL ASSEMBLY A
19 REPORT ON PROGRAMS WITHIN THIS COMMONWEALTH AND THROUGHOUT THE
20 UNITED STATES THAT SEEK TO MAXIMIZE THE EFFECTIVENESS OF
21 CHARITABLE PHARMACEUTICAL PROGRAMS AND TO PROVIDE
22 RECOMMENDATIONS FOR NEW LAWS AND INITIATIVES WITHIN THIS
23 COMMONWEALTH TO ENHANCE THE ABILITY OF PENNSYLVANIANS TO TAKE
24 ADVANTAGE OF SUCH PROGRAMS.
25 Section 21 22. Effective date. <--
26 This act shall take effect in 180 days. AS FOLLOWS: <--
27 (1) SECTION 21 SHALL TAKE EFFECT IMMEDIATELY.
28 (2) THIS SECTION SHALL TAKE EFFECT IMMEDIATELY.
29 (3) THE REMAINDER OF THIS ACT SHALL TAKE EFFECT IN 180
30 DAYS.
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