Consumer Reports: Nursing Home Rights and Wrongs

*Nursing-home patients are often not given the choice of the medical care they do and don't get
Recently one of my patients transferred her 83-year-old mother from a hospital to a nursing home for physical therapy and recuperation after an illness. Upon discharge, her mother went to the nursing home by ambulance. My patient followed shortly after by car. Imagine her surprise when she learned that in the brief interval between her mother’s arrival and hers, a visiting dentist had performed an admission dental exam and—without explanation to or consent from the daughter, who held power of attorney for her mother’s health care—extracted a tooth. Her mother, who was in the early stages of Alzheimer’s disease, was confused and frightened. My patient was enraged.

*Know your rights
The rights of nursing-home residents are protected under the federal Nursing Home Reform Act. Passed in 1987, it applies to every nursing home certified to accept Medicare or Medicaid patients. Among the law’s provisions are the right to freedom of choice over medical care, the right to refuse treatment, and the right to advance notice of changes to the resident’s care or treatment plan. But some nursing homes disregard the law, and often they get away with it. One reason is that residents or their families might be reluctant to make a formal complaint because they fear the staff will retaliate. Some also worry, wrongly, that refusing an unwanted treatment will lead to eviction. (That is illegal.) As a result, a culture of acquiescence develops, and egregious behavior continues.

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Nursing Home Rights and Wrongs