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Families can be an invaluable resource to their loved ones who reside in long-term care centers; they can help navigate cost concerns, observe conditions within their facilities and ensure their loved ones’ state and federally mandated rights are respected.

In Arkansas, the Department of Human Services’ Office of Long-Term Care Ombudsman is the primary resource for long-term care residents and their families seeking to learn about or enforce residents’ rights in such facilities. Charlotte Sudmeyer, the state ombudsperson, says many families are unaware of their loved ones’ rights within a nursing home or assisted living facility. 

“Most families are not fully aware of their loved ones’ specific rights in long-term care, often wrongly assuming that rights are lost upon admission,” Sudmeyer says. “Many families feel overwhelmed, leading to a lack of awareness regarding rights to voice grievances, participate in care planning or maintain visitation.”

Residents have legally-protected rights to dignity, respect and self-determination, Sudmeyer says. Depending on a person’s care plan and medical or legal directives, their families can also play an important part in organizing and advocating for their preferred treatment plan. 

Residents’ Bill of Rights

The Centers for Medicare & Medicaid Services and Arkansas state law mandate certain rights for all residents of long-term care facilities, known as the Residents’ Bill of Rights. Residents can manage their own finances, choose their own doctors and actively participate in their care planning, including the right to refuse treatment or medication. They’re also legally protected from unnecessary restraints. 

“Residents should receive a written copy of the Residents’ Bill of Rights upon admission and a copy of these rights should also be prominently posted in each building,” Sudmeyer says.

She says long-term care residents may also take an active role in developing and implementing their “person-centered care plan,” an integrated approach to health care planning used in long-term care facilities that involves the patient’s individual goals and preferences. This can involve participating in the planning process, identifying individuals to be included in their care plan, and requesting meetings and revisions to the plan when needed.

“Routinely, facilities will reach out to the family involved inviting them to participate in the next scheduled care plan meeting. Or if a resident would like, a resident may invite anyone they wish to sit in with them at their next care plan meeting,” Sudmeyer says. “Some ask family, friends or the ombudsman to accompany them.”

To ensure family members can weigh in on medical decisions, particularly if a resident becomes incapacitated, it’s important to legally entitle chosen proxies access to records and medical decision-making authority. The Health Insurance Portability and Accountability Act protects patients from having their medical records shared, but nursing home residents can sign authorization release forms that allow family members to access their care records.

“It is highly recommended that residents have documents such as HIPAA authorization/release, medical power of attorney, health care proxy, etc., on file in their chart,” Sudmeyer says. “A POA or similar document is required to consent to treatment, medication or changes in care.”

There are no differences in residents’ rights at different kinds of long-term care facilities — assisted living, nursing homes, etc. — Sudmeyer notes. Medicaid or insurance policies also have no bearing on a residents’ rights. 

Family Rights

In addition to care planning, residents have the right to unlimited, private visits with their loved ones. 

“Regulations state the resident has the right to receive visitors of his or her choosing at the time of his or her choosing. The facility must provide immediate access to a resident by family at the resident’s discretion,” Sudmeyer says.

Facilities can impose some reasonable visitation restrictions. According to Arkansas code, those may include when the presence of visitors would be medically inadvisable, would interfere with the care or rights of any resident in the facility, or if the visitors’ behavior is violent, disruptive, threatening or noncompliant with the facility’s policies.

“Facilites are required to maintain written policies and procedures outlining residents’ visitation rights and any permissible limitations,” Sudmeyer says. “Restrictions cannot be imposed arbitrarily, as a form of punishment or for staff convenience.”

Voicing a Complaint

The Office of Long-Term Care Ombudsman  can  facilitate communication between families and facilities, including taking and investigating complaints lodged by nursing home residents or their family members. Sudmeyer notes that complaints can be kept confidential and that families are often their loved ones’ best advocates.

“Families should see themselves as essential advocates and support systems for their loved ones in long-term care facilities. Their involvement can enhance emotional well-being, ensure personalized care and help monitor health needs effectively,” she says. 

Sudmeyer says family members can help watch for common signs that their loved ones’ rights are being violated, including poor hygiene, sudden emotional withdrawal or fear, unexplained injuries, rapid weight loss, restricted access to their loved ones, missing personal items, neglect of privacy and staff failing to answer calls. Families should document suspected abuse or rights violations, which can help ombudspersons in evaluating complaints.

“Common conflicts between families and long-term care facilities often include disagreements about the level of care provided, communication issues and financial concerns related to the costs of care,” Sudmeyer says. “Other common concerns we encountered include improper transfer and discharge, billing issues, slow response to requests for assistance or violations of resident rights.”

Facilities must be licensed by the Office of Long-Term Care, which is the regulatory office for such centers. Ombudspersons ensure that facilities are in compliance with state and federal regulations, advocate for residents’ rights and provide education on resident rights.

“Residents have the right to voice grievances without fear of retaliation, and facilities are required to protect those rights,” Sudmeyer says. “Ombudsmen are independent advocates for residents in licensed long-term care facilities. We promote resident choice and ensure each person’s voice and wishes are respected.”

To file a concern about a long-term care facility, residents or their loved ones can call the Office of Long-Term Care complaint line at 1-800-582-4887. Learn more at arombudsman.com.

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