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Your Rights in Residential Facilities

Ideally, a residential care or assisted living facility should provide a homelike environment which promotes the dignity, independence, privacy, and decision making ability of the resident. If your loved one is a resident of such a facility, it is important to understand his or her rights.

Licensed residential care or assisted living facilities are subject to a state’s local Ombudsman Program, which oversees complaints about long–term care facilities. Some states have laws aimed at protecting the rights of the facilities’ senior citizens. California and Oregon are examples of such states.

California’s Regulation of Residential Care Facilities for the Elderly

California spells out the rights of residents of a “residential care facility for the elderly” or RCFE (22 Cal Code Reg §87572). These rights include:

  • dignified treatment by staff, and freedom from intimidation, mental abuse, or other punitive actions, such as interference with eating or sleeping patterns;
  • safe, healthful, and comfortable accommodations;
  • information from the facility about how to file complaints, including the telephone number of the local licensing agency;
  • choice in attending religious or community activities;
  • right to leave the facility at any time (some limitations apply to Alzheimer’s disease patients);
  • freedom to retain family ties and receive visitors (facilities are expected to encourage family and resident councils);
  • entitlement to obtain telephone services, including equipment for the deaf and hearing–impaired (Health & Safety Code §1524.159);
  • privacy with regard to mail and telephones;
  • right to wear one’s own clothes, keep personal articles, and spend one’s own money;
  • access to individual storage space;
  • right to reject medical treatment; and
  • assistance in exercising the right to vote.

A California RCFE may not use restraining devices other than postural supports, which must be approved in advance by the Department of Social Services (22 Cal Code Reg §87578). Postural supports are limited to devices such as braces, spring release trays, or soft ties, used to achieve proper body position and balance, to improve a resident’s mobility and independent functioning, or to position rather than restrict movement. Orthopedic devices such as casts are considered postural supports.

Oregon Assisted Living Facilities

Oregon provides a “Residents’ Bill of Rights” for elders in assisted care facilities (OAR 411–056–0010). These rights include:

  • freedom from neglect, financial exploitation, verbal, mental, physical or sexual abuse;
  • access to personal records;
  • confidential treatment of medical and other records;
  • access to social activities and to others within the assisted living home and in the community;
  • freedom from physical restraints and inappropriate use of psychoactive medications;
  • management of one’s own personal financial affairs;
  • encouragement and assistance in exercising rights as a citizen such as voting;
  • freedom to voice grievances and to receive information about grievance procedures;
  • proper notification, an informal hearing and a conference if requested to move out of the facility. A resident can be asked to move out only for specific reasons: the resident’s needs or medical condition exceeds the level of services that the facility can provide, the resident’s behavior interferes with the rights of others, he or she has severe cognitive problems, or fails to pay required charges (OAR 411–056–0020).

The facility must have “qualified staff sufficient in number” to meet the 24–hour needs of each resident, and to respond in emergency situations (OAR 411–056–0018). An Oregon–licensed nurse must be part of the staff or on contract. At least one staff member per shift must be trained in the use of the Heimlich Maneuver, CPR, and First Aid. All staff members must receive orientation and training on the principles of assisted living, changes associated with aging, residents’ rights, and behavior issues.

Residents should be helped with “activities of daily living,” as needed. These are activities performed during a normal day such as eating, dressing, grooming, bathing, personal hygiene, and toileting. The facility must provide three nutritional meals a day and snacks, including seasonal fresh fruit and vegetables. Meals should be based on the USDA Food Guide Pyramid.

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