Residents Need to Know What Services Are Provided by Medicaid
Pursuant to 42 CFR.483.10(g)(17), the facility must—
(i) Inform each Medicaid-eligible resident, in writing, at the time of admission to the nursing facility and when the resident becomes eligible for Medicaid of—
(A) The items and services that are included in nursing facility services under the State plan and for which the resident may not be charged;
Medicaid Services Must Be Explained to Residents
(B) Those other items and services that the facility offers and for which the resident may be charged, and the amount of charges for those services; and
(ii) Inform each Medicaid-eligible resident when changes are made to the items and services specified in §483.10(g)(17)(i)(A) and (B) of this section.
Some Federally Mandated Resident Rights Include
The resident has the right to be informed of his or her rights and of all rules and regulations governing resident conduct and responsibilities during his or her stay in the facility.
The resident has the right to access personal and medical records pertaining to him or herself.
With the exception of information described in paragraphs (g)(2) and (g)(11) of this section, the facility must ensure that information is provided to each resident in a form and manner the resident can access and understand, including in an alternative format or in a language that the resident can understand.
The resident has the right to receive notices orally (meaning spoken) and in writing (including Braille) in a format and a language he or she understands.
The facility must post, in a form and manner accessible and understandable to residents, and resident representatives.
The resident has the right to have reasonable access to the use of a telephone, including TTY and TDD services, and a place in the facility where calls can be made without being overheard. This includes the right to retain and use a cellular phone at the resident’s own expense.
The facility must protect and facilitate that resident’s right to communicate with individuals and entities within and external to the facility.
The resident has the right to send and receive mail, and to receive letters, packages and other materials delivered to the facility for the resident through a means other than a postal service.
The resident has the right to have reasonable access to and privacy in their use of electronic communications such as email and video communications and for Internet research.
The resident has the right to examine the results of the most recent survey of the facility conducted by Federal or State surveyors and any plan of correction in effect with respect to the facility.
The facility must post in a place readily accessible to residents, and family members and legal representatives of residents, the results of the most recent survey of the facility.
The facility must comply with the requirements specified in 42 CFR part 489, subpart I (Advance Directives).
The facility must display in the facility written information, and provide to residents and applicants for admission, oral and written information about how to apply for and use Medicare and Medicaid benefits, and how to receive refunds for previous payments covered by such benefits.
A facility must immediately inform the resident; consult with the resident’s physician; and notify, consistent with his or her authority, the resident representative(s), when there is change of condition or accident.
A facility that is a composite distinct part (as defined in §483.5 must disclose in its admission agreement its physical configuration, including the various locations that comprise the composite distinct part, and must specify the policies that apply to room changes between its different locations under §483.15(c)(9).
The facility must provide a notice of rights and services to the resident prior to or upon admission and during the resident’s stay.
The facility must inform each resident before, or at the time of admission, and periodically during the resident’s stay, of services available in the facility and of charges for those services, including any charges for services not covered under Medicare/Medicaid or by the facility’s per diem rate.
The resident has a right to personal privacy and confidentiality of his or her personal and medical records.
and many others…
Please contact Attorney Kenneth LaBore with any questions you may have at 612-743-9048.