32.1-138 - Enumeration; posting of policies; staff training; responsibilities devolving on guardians, etc.; exceptions; certification of compliance.
§ 32.1-138. Enumeration; posting of policies; staff training;responsibilities devolving on guardians, etc.; exceptions; certification ofcompliance.
A. The governing body of a nursing home facility required to be licensedunder the provisions of Article 1 (§ 32.1-123 et seq.) of this chapter,through the administrator of such facility, shall cause to be promulgatedpolicies and procedures to ensure that, at the minimum, each patient admittedto such facility:
1. Is fully informed, as evidenced by the patient's written acknowledgment,prior to or at the time of admission and during his stay, of his rights andof all rules and regulations governing patient conduct and responsibilities;
2. Is fully informed, as evidenced by the patient's written acknowledgment,prior to or at the time of admission and during his stay, of servicesavailable in the facility, the terms of such services, and related charges,including any charges for services not covered under Titles XVIII or XIX ofthe United States Social Security Act or not covered by the facility's basicper diem rate;
3. Is fully informed in summary form of the findings concerning the facilityin federal Centers for Medicare & Medicaid Services surveys andinvestigations, if any;
4. Is fully informed by a physician, physician assistant, or nursepractitioner of his medical condition unless medically contraindicated asdocumented by a physician, physician assistant, or nurse practitioner in hismedical record and is afforded the opportunity to participate in the planningof his medical treatment and to refuse to participate in experimentalresearch;
5. Is transferred or discharged only for medical reasons, or for his welfareor that of other patients, or for nonpayment for his stay except asprohibited by Titles XVIII or XIX of the United States Social Security Act,and is given reasonable advance notice as provided in § 32.1-138.1 to ensureorderly transfer or discharge, and such actions are documented in his medicalrecord;
6. Is encouraged and assisted, throughout the period of his stay, to exercisehis rights as a patient and as a citizen and to this end may voice grievancesand recommend changes in policies and services to facility staff and tooutside representatives of his choice, free from restraint, interference,coercion, discrimination, or reprisal;
7. May manage his personal financial affairs, or may have access to recordsof financial transactions made on his behalf at least once a month and isgiven at least a quarterly accounting of financial transactions made on hisbehalf should the facility accept his written delegation of thisresponsibility to the facility for any period of time in conformance withstate law;
8. Is free from mental and physical abuse and free from chemical and, exceptin emergencies, physical restraints except as authorized in writing by aphysician for a specified and limited period of time or when necessary toprotect the patient from injury to himself or to others;
9. Is assured confidential treatment of his personal and medical records andmay approve or refuse their release to any individual outside the facility,except in case of his transfer to another health care institution or asrequired by law or third-party payment contract;
10. Is treated with consideration, respect, and full recognition of hisdignity and individuality, including privacy in treatment and in care for hispersonal needs;
11. Is not required to perform services for the facility that are notincluded for therapeutic purposes in his plan of care;
12. May associate and communicate privately with persons of his choice andsend and receive his personal mail unopened, unless medically contraindicatedas documented by his physician in his medical record;
13. May meet with and participate in activities of social, religious andcommunity groups at his discretion, unless medically contraindicated asdocumented by his physician, physician assistant, or nurse practitioner inhis medical record;
14. May retain and use his personal clothing and possessions as space permitsunless to do so would infringe upon rights of other patients and unlessmedically contraindicated as documented by his physician, physicianassistant, or nurse practitioner in his medical record;
15. If married, is assured privacy for visits by his or her spouse and ifboth are inpatients in the facility, is permitted to share a room with suchspouse unless medically contraindicated as documented by the attendingphysician, physician assistant, or nurse practitioner in the medical record;and
16. Is fully informed, as evidenced by the written acknowledgment of theresident or his legal representative, prior to or at the time of admissionand during his stay, that he should exercise whatever due diligence he deemsnecessary with respect to information on any sexual offenders registeredpursuant to Chapter 9 (§ 9.1-900 et seq.) of Title 9.1, including how toobtain such information. Upon request, the nursing home facility shall assistthe resident, prospective resident, or the legal representative of theresident or prospective resident in accessing this information and providethe resident, prospective resident, or the legal representative of theresident or prospective resident with printed copies of the requestedinformation.
B. All established policies and procedures regarding the rights andresponsibilities of patients shall be printed in at least 12-point type andposted conspicuously in a public place in all nursing home facilitiesrequired to be licensed under the provisions of Article 1 (§ 32.1-123 etseq.) of this chapter. These policies and procedures shall include the nameand telephone number of the complaint coordinator in the Division ofLicensure and Certification of the Virginia Department of Health, the AdultProtective Services' toll-free telephone number, as well as the toll-freetelephone number for the Virginia Long-Term Care Ombudsman Program and anysubstate ombudsman program serving the area. Copies of such policies andprocedures shall be given to patients upon admittance to the facility andmade available to patients currently in residence, to any guardians,responsible party as defined in regulation, next of kin, or sponsoring agencyor agencies, and to the public.
C. The provisions of this section shall not be construed to restrict anyright that any patient in residence has under law.
D. Each facility shall provide appropriate staff training to implement eachpatient's rights included in subsection A hereof.
E. All rights and responsibilities specified in subsection A hereof and §32.1-138.1 as they pertain to (i) a patient adjudicated incapacitated inaccordance with state law, (ii) a patient who is found, by his physician, tobe medically incapable of understanding these rights, or (iii) a patient whois unable to communicate with others shall devolve to such patient'sguardian, responsible party as defined in regulation, next of kin, sponsoringagency or agencies, or representative payee, except when the facility itselfis representative payee, selected pursuant to section 205(j) of Title II ofthe United States Social Security Act. The persons to whom such rights andresponsibilities have devolved shall be deemed to have legal authority to acton the patient's behalf with respect to the matters specified in this section.
F. Nothing in this section shall be construed to prescribe, regulate, orcontrol the remedial care and treatment or nursing service provided to anypatient in a nursing institution to which the provisions of § 32.1-128 areapplicable.
G. It shall be the responsibility of the Commissioner to insure that theprovisions of this section and the provisions of § 32.1-138.1 are observedand implemented by nursing home facilities. Each nursing home facility towhich this section and § 32.1-138.1 are applicable shall certify to theCommissioner that it is in compliance with the provisions of this section andthe provisions of § 32.1-138.1 as a condition to the issuance or renewal ofthe license required by Article 1 (§ 32.1-123 et seq.) of this chapter.
(Code 1950, § 32-296.1; 1976, c. 349; 1979, c. 711; 1987, c. 221; 1997, c.801; 1999, c. 783; 2000, c. 177; 2004, c. 855; 2006, c. 396; 2007, cc. 120,163; 2010, c. 57.)