(a) Policies and procedures required by the facility to ensure resident's rights are as follows:

1. (1)

   1. (A) The facility must have written policies and procedures defining the rights and responsibilities of residents.
   2. (B) The policies shall present a clear statement defining treatment of residents by all who provide care or services to residents;

2. (2)

   1. (A) Any policies of resident conduct which the facility has finalized and by which it expects residents to abide must be included in the statement of rights and responsibilities which the resident signs (refer to 20 CAR § 401-309(c)(3(C)).
   2. (B) These facility policies must be approved by the Office of Long-Term Care;
3. (3) A copy of the synopsis of the resident’s bill of rights must be prominently displayed within the facility;

4. (4)

   1. (A) Each resident admitted to the facility is to be fully informed of these rights and of all rules governing resident conduct and responsibilities.
   2. (B) The facility is to communicate these expectations/rights both orally and in writing during the period of not more than two (2) weeks before or five (5) working days after admission.
   3. (C) The facility must obtain a signed resident rights statement from the resident and this statement must be maintained in the resident's record.
   4. (D) A legal guardian or other person responsible for the resident may also sign.
   5. (E) For purposes of this provision, the resident rights statement shall be deemed appropriately signed by the resident if:

(i) Resident capable of understanding: signed by the resident before one (1) witness and the witness also signs;

1. (ii) Resident incapable because of illness:

(b) (b) The resident's responsible party and two (2) witnesses sign;

1. (iii) Resident mentally incapacitated:

(b) (b) The legal guardian then signs the resident rights statement before one (1) witness, who also signs the statement; and

1. (iv) Resident capable of understanding but acknowledges with other mark (X): mark is made by the resident in front of two (2) witnesses who know the resident and also sign.
2. (5) Effective means shall be utilized to inform non-English speaking persons or persons with hearing or visual impairments of the resident rights;

3. (6)

   1. (A) Staff members will be provided a copy of the resident rights and must fully understand all rights.
   2. (B) Staff must complete a written acknowledgement stating they have received, read, and understand the resident rights.
   3. (C) A copy of the signed acknowledgement shall be placed in the employee's personnel file; and
4. (7) The facility's procedures regarding resident's rights and responsibilities will be formally included in ongoing staff development programs for all personnel, including new employees.

(b) The resident's right to know of services available shall meet the following conditions:

1. (1) Each resident admitted to the facility will be fully informed, by the time of admission and as need arises during residency, of services available in the facility, including any charges for services; and

2. (2) Residents have the right to choose, at their own expense, a personal physician and pharmacist.

   1. (c) The resident's right concerning transfers and discharges:
3. (1) The facility must develop and implement transfer and discharge policies and procedures as specified in 20 CAR § 401-309(d); and

4. (2) The facility must give the resident reasonable written notice of changes in room or roommate when the change is not requested by the resident.

   1. (d) The resident's right to constitutional and legal rights are as follows:

5. (1)

   1. (A) Each resident admitted to the facility will be encouraged and assisted to exercise all constitutional and legal rights as a resident and a citizen including the right to vote.
   2. (B) The facility shall make reasonable accommodations to ensure free exercise of these rights;

6. (2) Residents may voice grievances or recommend changes in policies or services to facility staff or to outside representatives of their choice, free from:

   1. (A) Restraint;
   2. (B) Coercion;
   3. (C) Discrimination; or
   4. (D) Reprisal; and
7. (3) Residents shall have the right to free exercise of religion including the right to rely on spiritual means for treatment.

(e)

1. (1) Resident complaints or suggestions made to the facility's staff must be responded to within ten (10) days.
2. (2) Documentation of such response will be maintained by the facility administrator or his or her designee.

(f)

1. (1) A representative resident council shall be established in each facility.

2. (2) The resident council's duties shall include:

   1. (A) Review of policies and procedures required for implementation of resident's rights;
   2. (B) Recommendation of changes or additions in the facility's policies and procedures;
   3. (C) Representation of residents in their complaints to the office or any other person or agency; and
   4. (D) Identification of problems and orderly resolution of same.

3. (3)

   1. (A) The facility administrator must designate a staff coordinator and provide suitable accommodations within the facility for the resident council.
   2. (B) The staff coordinator shall assist the council in scheduling regular meetings and preparing written reports of meetings for dissemination to residents of the facility.
   3. (C) The staff coordinator may be excluded from any meeting of the council.

(g)

1. (1) The facility shall inform resident's families of the right to establish a family council within the facility.
2. (2) The establishment of such council shall be encouraged by the facility.

3. (3) This family council shall:

   1. (A) Have the same duties and responsibilities as the resident council; and
   2. (B) Be assisted by the staff coordinator designated to assist the resident council.

(h)

1. (1) The resident has the right to be free from abuse and neglect.

2. (2) Residents shall be free from:

   1. (A) Mental and physical abuse; and
   2. (B) Chemical and physical restraints.

3. (3)

   1. (A) Restraints must not be used on any resident by staff of a residential care facility except during an emergency and only until appropriate action can be taken by persons outside the facility.
   2. (B) The facility must seek assistance immediately.

4. (4) Additional clarifications of this provision are as follows:

   1. (A) Mental abuse includes:

      1. (i) Humiliation;
      2. (ii) Harassment; and
      3. (iii) Threats of punishment or deprivation;

   2. (B) Physical abuse refers to:

      1. (i) Corporal punishment; or
      2. (ii) The use of restraints as a punishment;
   3. (C) Drugs must not be used to limit, control, or alter resident behavior for the convenience of staff;

   4. (D)

      1. (i) Physical restraints include the use of devices designed or intended to limit the resident's total mobility.
      2. (ii) Full length bed rails are considered restraints and may not be used.
      3. (iii) The gates of facilities enclosed by a fence may not be locked to restrict the movement of residents.

5. (5) Any abuse, neglect, or exploitation must be reported as specified in 20 CAR § 401-310(g).

   1. (i)
6. (1) Each resident is ensured confidential treatment of all information contained in his or her records.
7. (2) The resident's written consent or legal appointee's written consent is required for the release of information to persons not otherwise entitled to receive it.
8. (3) The records shall be available to the Department of Human Services as needed.

(j)

1. (1) Each resident will be treated with consideration, respect, and full recognition of dignity and individuality.

2. (2) Staff shall:

   1. (A) Display respect and courtesy to residents when speaking with, caring for, or talking about residents; and
   2. (B) Seek to engage in the constant affirmation of resident individuality and dignity as a human being.
3. (3) Each resident has the right to receive a response from a facility operator to any request of the resident within a reasonable period of time.

(k) Each resident shall have the right to humane care and an environment which shall include but is not limited to:

1. (1) The right to nutritional diets that follow the recommended dietary allowance set by the Food and Nutrition Board, including the right to have a diet which is consistent with any religious or health-related restrictions; and

2. (2) The right to a safe and sanitary living environment.

   1. (l) The resident's right to have control and receipt of health-related services shall include the following:
3. (1) Each resident shall have the right to retain the services of his or her own personal physician;
4. (2) Each resident shall have the right to select the pharmacy or pharmacist of his or her choice;
5. (3) Each resident shall have the right to confidentiality and privacy concerning his or her medical conditions and treatment; and

6. (4) Each resident shall have the right to select the personal care or home health provider of his or her choice and the facility shall ensure that all such providers selected by the resident have access for the purpose of delivering necessary services.

   1. (m)

7. (1) The resident shall have freedom of religion that includes the right to:

   1. (A) Practice the religion of his or her choice; or
   2. (B) Abstain from religious practices.
8. (2) Residents shall also be free from the imposition of the religious practice of others.

(n)

1. (1) Each resident shall have the right to accept or refuse employment or to perform services for the facility.

2. (2) The resident has the right to accept employment and perform services for the facility if the following conditions are met:

   1. (A) The facility has documented its need for and the resident's desire to perform the work;
   2. (B) Compensation for services is at or above prevailing rates;
   3. (C) The resident agrees to the work arrangement;
   4. (D) The employment is in keeping with the resident's care plan; and
   5. (E) The office is notified, in advance, of the work arrangement.

(o)

1. (1) Each resident shall have the right to interact freely with others both within the facility and in the community including the following:

   1. (A) The right to:

      1. (i) Receive and send unopened correspondence; and
      2. (ii) Be provided with pen, envelopes, and stamps at the expense of the resident if the resident is unable to obtain these for himself or herself;
   2. (B) The right to privately access a telephone for outgoing and incoming calls;
   3. (C) The right to unrestricted communication including personal visitation with any person of the resident's choice; and
   4. (D) The right to make contacts and interact with the community.

2. (2)

   1. (A) Policies and procedures shall permit residents to receive visits from anyone they wish.

   2. (B) Restrictions may be imposed for the following reasons:

      1. (i) The resident refuses to see the visitor;
      2. (ii) The resident's physician specifically documents that such a visit would be harmful to the resident's health;
      3. (iii)

(b) (b) This does not include those individuals who, because they advocate administrative change to protect resident rights, are considered a disruptive influence by the facility administrator; and

1. (iv) The facility has been ordered by the court or resident's guardian not to allow specified individuals access to the resident.

(p) The resident's right to personal possessions shall include:

1. (1) The right to wear his or her own clothing;

2. (2) The right to determine his or her preference of:

   1. (A) Dress;
   2. (B) Hair style; or
   3. (C) Personal effects;
3. (3) The right to retain and use his or her own personal property in the resident's own living area so as to maintain individuality and personal dignity as agreed upon at the time of admission; and
4. (4) The right to have a separate storage area in his or her own living area.

(q) Each resident's privacy shall be respected in every aspect of daily living, including:

1. (1) During any medical examination or health-related consultations the resident may have at the facility;
2. (2) During visitations with other persons;
3. (3) In written, verbal, and telephone communications;

4. (4)

   1. (A) In the resident's room or the resident's portion of the room.
   2. (B) Staff of a facility shall not enter a resident's room without making their presence known, except in an emergency;
5. (5) In the conduct of the resident's personal affairs;
6. (6) In visual privacy in tub, shower, and toilet rooms;
7. (7) In permitting, but not requiring, spouses or other consenting adults to share a room where both are residents and space is available;
8. (8) In taking all reasonable steps to comply with a resident's expressed wish for privacy in particular activities of daily living; and
9. (9) In permitting representatives of protection and advocacy groups and community legal services programs to have full and free access to the facility during normal business hours.

(r)

1. (1)

   1. (A) Each resident admitted to the facility may manage their personal financial affairs or, if the resident requests, such affairs may be managed by the facility.
   2. (B) If the facility manages residents' funds, then an accounting shall be maintained in accordance with 20 CAR § 401-311(b).

2. (2) In addition to any other requirements, the facility's management of resident financial affairs shall meet the following conditions:

   1. (A) Should the facility manage the resident's personal financial affairs, written authorization must be made and signed as provided in 20 CAR § 401-312(a)(4);
   2. (B) The financial record must be available to the resident and his or her guardian, and responsible party;
   3. (C) If the facility makes financial transactions on behalf of a resident, the resident, guardian, or responsible party shall receive an itemized accounting of disbursements and current balances at least quarterly;
   4. (D) A copy of the resident's quarterly statements shall be maintained in the facility;
   5. (E) The facility shall establish and maintain a system that ensures full and complete accounting of resident personal funds using generally accepted accounting principles;
   6. (F) The facility shall not commingle resident funds with any other funds;
   7. (G) The facility system of accounting includes written receipts for funds received by or deposited with the facility, and disbursements made to or for the resident;
   8. (H) When appropriate, individual savings accounts shall be opened for residents in accordance with Social Security rules governing savings accounts;
   9. (I) A cash fund specifically for petty cash shall be maintained in the facility to accommodate the small cash requirements of the residents; and
   10. (J) The facility will notify the resident when the resident's account reaches two hundred dollars ($200) less than the Supplemental Security Income resources limit for one (1) person.