Expertly Reviewed By: Serah Waweru, Esq., on April 11, 2023
What are the things nursing homes are not allowed to do? If you’re asking yourself this question, you probably have your loved one in a nursing home or considering the thought.
Understandably, you may be concerned about their safety and well-being, given that you won’t be around to watch them every day. For this reason, we’ve listed 13 things nursing homes are not allowed to do.
1. Abusing or Neglecting Residents
Abusing or neglecting residents is the first thing nursing homes are not allowed to do. But sadly, cases of nursing home abuse and neglect are quite common throughout the country.
Every resident in a nursing home deserves fair and dignified treatment regardless of their physical or mental state. Unfortunately, some of them experience physical, verbal, and emotional abuse from the staff or fellow residents in the nursing home. In addition, the abuse sometimes leads to trauma, injuries, or wrongful death.
Nursing home abuse and negligence come in many forms. Examples include:
- Ignoring the resident’s basic needs, such as their meals, water, and medication
- Failing to assist residents with proper personal hygiene, toileting aid, or physical support
- Manhandling a resident
- Sexually abusing a resident
- Belittling or verbally abusing a resident
- Restraining or controlling a resident using door rails, locks, and more
- Overmedicating a resident to keep asleep for too long
If you suspect that your loved one is a victim of nursing home abuse, contact an abuse attorney to investigate the matter and help you seek justice.
2. Forcing Treatment on A Resident
Generally, a nursing home resident has the right to refuse medication for different reasons. However, such a decision may interfere with their care and treatment plan and cause conflict between the resident, their caregiver, and the medical team. It may also risk the resident’s health or even cause death.
Despite these risks, a nursing home care staff can’t force the resident to take their medication or impose treatment on them. Instead, they need to advise the resident of the consequences of their decision and employ reasonable means, such as discussing the issue with the resident’s primary doctor, to solve the problem.
⚖️ PRO TIP: It is illegal for nursing home care providers to force, coerce, or secretly mix a resident’s medication in the resident’s food or drinks.
3. Discriminating Against Applicants
Although a nursing home can’t enroll everyone who knocks on their door, they aren’t allowed to reject an applicant based on race, religion, age, disability, national origin, and more. This is because such discrimination violates federal laws on civil rights.
There are several potential consequences a nursing home can face if they discriminate against an applicant. These include but are not limited to:
A Lawsuit: You may file a lawsuit against the nursing home, depending on the severity of the incident
Lost accreditations: In some cases, if a nursing home is guilty of discrimination, they may lose their accreditations, including the ability to participate in federal programs such as Medicare and Medicaid.
Disciplinary Action: The person directly responsible for discrimination in a nursing home may face disciplinary actions such as having their license revoked or losing their job.
Fines: The nursing home may end up paying fines and penalties for breaking federal laws.
4. Imposing Extra Fees and Services on A Resident
Applicants have the right to information about the services they expect to receive after enrolling in a nursing home. This must be in writing, done orally, and stipulate all chargeable and nonchargeable services. If there are changes in charges and services the resident receives, the nursing home must duly inform them in writing before adjusting the fees and services.
Additionally, other things nursing homes are not allowed to do under this category include:
- Requesting an applicant to pay a minimum fee for enrolment if Medicare or Medicaid pays for their care.
- Failing to direct an applicant on how to use Medicare or Medicaid benefits or how to request a refund in case they paid for services covered by their Medicare or Medicaid.
5. Withholding Medical Treatment or Information From a Resident
A nursing home must provide the appropriate medical care to a resident and keep all the records of their treatment information. However, they can’t withhold these details from the resident if they request to have them.
Ideally, nursing homes follow the same laws and regulations that apply to other healthcare providers. This includes providing residents with necessary medical treatment, medications, and therapies and ensuring that residents have access to their medical information and records.
Additionally, nursing homes must protect the privacy and confidentiality of the resident’s medical information. However, the resident or their designated representatives have the right to access these records whenever they need.
PRO TIP: If a nursing home withholds your medical treatment information, you can report the matter to its administration or the appropriate regulatory agency. You also have the right to take further legal action if need be.
6. Denying Residents Visitors
Can a nursing home deny visitors?
No, that’s one of the things nursing homes are not allowed to do.
As a resident, you have the right to spend time with visitors whenever you wish to have them. However, these visits shouldn’t interfere with your care program or the privacy of other residents.
Besides family members or friends, you have the right to receive other types of visitors, such as:
- Personal doctors
- Therapists
- Essential caregivers
- Attorneys
However, visiting policies vary from one nursing home to another. For example, your nursing home may restrict the number of visitors you receive per visit during an outbreak of a contagious disease to protect you and other residents in the facility.
7. Managing A Resident’s Money Without Consent
Whether a resident is mentally incapacitated or stable, a nursing home cannot manage their money without consent. However, if the resident gives written consent to the nursing home to hold or account for their money, they still reserve rights to full access to their accounts, money, and financial statements.
Additionally, nursing homes must fully account for the resident’s money in case they have their consent. They must not combine the resident’s funds with the nursing home’s funds. In addition, they must protect their residents’ money from losses. In case of death, the nursing home must submit the resident’s funds to the court handling their estate within 30 days in most cases.
8. Withholding Care
A nursing home’s primary role is to provide care to its residents to improve their quality of life. For this reason, they can’t intentionally withhold care or prevent the residents from participating in their care program.
Speaking of withholding care, some of the things nursing homes are not allowed to do include:
- Hiring inadequately trained staff to care for the residents
- Assigning too many residents to one caregiver
- Discriminating and ignoring a resident’s care needs
- Poorly planning a resident’s care and treatment programs
Withholding care can result in a case of negligence and may worsen the resident’s health condition.
9. Understaffing the Nursing Home
Nursing homes must meet the minimum staffing requirements of the federal government. These include:
- Having at least one Registered Nurse on duty at least eight consecutive hours a day, seven days a week
- Having a Licensed Practical Nurse or a Licensed Vocational Nurse on duty 24 hours a day, seven days a week
- Having an adequate number of Certified Nursing Assistants working a minimum of 2.5 hours per resident per day to qualify for Medicare and Medicaid reimbursement
Unfortunately, some nursing homes don’t meet these requirements. As a result, they risk the health and well-being of the residents. Without enough staff members, residents may not receive the care and attention they need, resulting in neglect, poor health outcomes, and decreased quality of life.
10. Failing to Prevent Infections and Communicable Diseases
One of the things nursing homes are not allowed to do is fail to protect their residents from infections and communicable diseases.
This is because they can quickly spread among residents in a nursing home if managed poorly. These diseases may result from the following:
- Poor sanitation in the facility
- Ill-prepared food and contaminated water
- Lack of proper infection control practices, such as washing hands
- Untreated bed sores and other infections
- Sharing personal items among residents
- Poor ventilation and congested living quarters
Given that most residents in a nursing home have weakened immunity, healthcare workers and other staff in the facility must maintain proper sanitation and hygiene practices. Otherwise, the residents have a right to complain about the poor hygiene in the facility to the responsible authorities for investigation.
11. Denying Residents Their Privacy
A nursing home resident is entitled to privacy per federal and state laws. First, the nursing home must keep the resident’s health information private and only disclose it to another party if the resident consents to it in writing. However, the nursing home may disclose this information under specific circumstances, such as during the resident’s medical review or treatment.
Secondly, a resident has the right to privacy and personal dignity while living in the nursing home. This includes:
- Controlling their personal belongings, such as clothes,
- Accessing private rooms or living quarters
- Requesting confidentiality of personal information
- Having privacy during personal care routines such as bathing and dressing
Suppose a nursing home denies or violates a resident’s privacy. In that case, the resident can file a complaint with the nursing home administration or the state agency responsible for regulating nursing homes.
12. Ignoring Complaints
A nursing home resident or their advocates have a right to report or register a complaint about any inhumane treatment they encounter in the facility. They can file their complaint at the facility or escalate the matter to a responsible government survey agency that enforces nursing homes’ rules and regulations.
A nursing home shouldn’t ignore complaints or retaliate against them, regardless of how insignificant the issue may seem. Additionally, they can’t punish the resident for complaining about their inhumane encounters in the facility. Instead, they should address them to ensure the resident is comfortable and satisfied with the services they receive.
Ignoring complaints from residents and their advocates may develop into bigger issues with dire consequences. For instance, some complaints may result in cases of negligence, abuse, or wrongful death.
13. Failing to Notify Your Representative of Important Incidents
A nursing home should promptly notify your family, doctor, or any other legal representative of critical incidents you’re involved in. Such incidents include when:
- you get injured in an accident at the nursing home;
- your physical and mental health deteriorates;
- you develop a life-threatening condition;
- there’s an urgent need to change your treatment;
- your medical condition becomes complicated; or
- the nursing home wants to transfer or discharge you.
There may be severe consequences if a nursing home fails to inform your family or any other responsible person of such incidents. Generally, such incidents may amount to nursing home negligence, abuse, or even personal injury. They may also infringe on your legal rights as a nursing home resident and risk your health and well-being.
FAQs About Things Nursing Homes Are Not Allowed To Do
We’ve answered some questions our readers ask us about things nursing homes are not allowed to do.
Can Assisted Living Residents Leave on Their Own?
Assisted living residents typically have the freedom to come and go as they please, provided they are mentally and physically able to do so safely. However, some restrictions or guidelines may be in place to ensure residents’ safety and well-being.
For example, some assisted living communities may have designated times for residents to come and go or require them to sign in and out when leaving and returning to the facility. In some cases, residents may be required to notify staff if they plan to be away for an extended period or when going on an overnight trip.
Residents and their families need to understand the policies and guidelines regarding leaving the facility. This also includes any existing restrictions. For example, if a resident cannot leave independently due to physical or cognitive limitations, the facility may assist or arrange transportation as needed.
What Items Not Allowed in Nursing Homes?
Certain items may not be allowed in nursing homes or restricted for the residents’ safety and well-being. Examples include:
- Weapons such as firearms.
- Illegal drugs and alcohol
- Flammable items, such as candles, incense, and matches.
- Personal space heaters: Space heaters are generally not allowed in nursing homes due to the risk of fire and the potential for burns.
- Valuable items, such as jewelry or large amounts of cash.
⚖️ PRO TIP: each nursing home may have its own policies and restrictions regarding items that are allowed. Therefore, you should check with the facility for specific guidelines.
What Are Some Common Legal Issues in Nursing Homes?
As discussed, some common legal issues in nursing homes include:
- Abuse and neglect:
- Malpractice by nursing home staff
- Inadequate staffing
- Poor infection control
- False advertising and marketing
- Improper documentation of residents’ care
- End-of-life issues, such as those related to hospice care and the use of life-sustaining treatments.
Can a Person Sign Themselves Out of a Nursing Home?
Yes, they can in most cases, but only if they can make decisions for themselves. However, the nursing home may have certain policies or requirements that must be met before a resident can leave. For example, the resident may need to provide a certain amount of notice before leaving, or they may need to be medically stable and have a safe place to go.
Suppose a resident wishes to leave but cannot decide due to cognitive or physical limitations. In that case, the nursing home may require the consent of a legal guardian or representative. In some cases, the nursing home may also involve the resident’s physician to assess their ability to leave and ensure doing so is safe.
Is There a Rule for a Nursing Home Refund After Death?
Nursing home refund policies after the death of a resident depend on the policies of the specific nursing home and the circumstances surrounding the resident’s stay. For example, in California, such facilities may offer partial or prorated refunds for unused days or services within 15 days after the residents’ personal belongings have been removed from the nursing home. The management must also inform the resident’s guardian or family about any fees involved after the resident’s death.
Can a Nursing Home Kick Out a Dementia Patient?
A nursing home cannot simply “kick out” a resident, whether or not they have dementia, without following proper legal procedures. These facilities must provide proper notice and follow specific protocols before discharging a resident.
Federal law requires nursing homes to provide written notice of a proposed discharge or transfer at least 30 days in advance unless the discharge is due to an emergency or the resident’s health needs require an immediate transfer. The nursing home must also provide a written explanation of the reason for the discharge or transfer and any applicable appeal rights.
Suppose a resident with dementia is being discharged. In that case, the nursing home must ensure that the discharge plan considers the resident’s special needs and abilities. In some cases, they may need to involve the resident’s family members or legal representatives in the discharge planning process.
Are Nursing Homes Required To Report Falls?
Yes, federal law requires nursing homes to report falls in their facilities. In fact, nursing homes participating in Medicare or Medicaid programs must maintain a system of reporting and investigating incidents that occur in the facility, including falls.
The reporting requirements for falls may vary depending on the state or local regulations. That said, these facilities should report falls to the resident’s physician, family members, and appropriate state or local agencies.
Besides reporting, nursing homes must assess residents’ risk for falls and implement fall prevention measures as part of their care plan. This may include but is not limited to adjusting medication regimens, providing mobility aids, and modifying the environment to reduce tripping hazards.
Can Nursing Homes Take Your Savings Account?
Nursing homes cannot take your savings account without your permission or a legal order from a court.
Are Nursing Homes Responsible for Lost Items?
The correct answer to this question depends on the unique circumstances of a particular case. That said, as a nursing home resident, you have a right to have your personal property respected and protected.
However, it’s important to note that nursing homes are not insurers of personal property and are not responsible for all lost items.
Generally, nursing homes are responsible for providing a safe and secure environment for their residents and taking reasonable measures to prevent the loss or theft of personal property.
Nursing Home Won’t Accept Patient, Is That Legal?
Nursing homes can refuse admission to a patient under certain circumstances. Here are a few examples of when a nursing home may legally refuse to admit a patient:
- The nursing home lacks the capacity to provide the necessary level of care the patient requires.
- The patient has a medical condition that the nursing home is not equipped to handle.
- The patient’s history of violent or disruptive behavior would create an unsafe environment for other residents and staff.
Note that nursing homes cannot refuse admission based on a person’s race, ethnicity, religion, or other protected characteristics. In addition, they must comply with federal and state anti-discrimination laws.
When they refuse admission to a patient, they should provide the patient and their family with a clear explanation for the denial and refer them to other facilities that may provide the necessary care.
Final Thoughts on Things Nursing Homes Are Not Allowed To Do
Nursing homes should be safe havens for people needing healthcare services, whether it’s assistance with medication, personal care, or dementia care. But sadly, some residents encounter inhumane treatment in some nursing homes, resulting in various cases of abuse and negligence.
Before enrolling your loved one in a nursing home, you must understand their rights to avoid overlooking some practices that may potentially cause harm to your loved one. For instance, you may look for signs of negligence, abuse, and infringement of fundamental rights, such as rights to privacy, proper care, and access to your loved medical records. The nursing home must also ensure your loved one’s safety in the facility and be responsible for promptly informing you of any life-threatening incidents that occur to them.
However, if the nursing home acts irresponsibly and endangers your loved one’s life, you can file a complaint with the facility’s administration. Alternatively, you may report the matter to an agency responsible for regulating nursing homes in your state.
Your loved one deserves to be treated with love and dignity. For this reason, you must not hesitate to seek the help of an injury lawyer if your loved one becomes a victim of nursing home negligence or abuse.
