Section 325.20406. Patient bill of rights provisions.

To protect the rights of patients under section 20201 of the code and other relevant provisions of the code, the following requirements shall be complied with:

(a)    A nursing home shall assure that information transmitted to a patient or designated representative shall be communicated in such a manner that there is reasonable assurance that the patient understands. Where the patient's condition is such that he or she cannot be  made  to understand,  the  information  shall  be  communicated to the patient's representative or guardian in such a manner that the representative or guardian can understand. Nothing in this rule shall be deemed to limit the obligation to provide information to the patient's representative   or  guardian.   Health  status information communicated to a patient may be explained by a physician or registered nurse or other licensed health personnel unless medically contraindicated.

(b)     When a patient refuses treatment, a determination shall be made by  the attending physician as to whether or not the patient's refusal of treatment prevents the facility from providing appropriate care according to ethical and professional standards. The physician's determination  in this matter shall be in writing and shall be made a part of the patient's clinical record. When a relationship between a nursing home and patient is terminated in conjunction with the  physician's  determination  and  the action results in an involuntary transfer or discharge, such transfer or discharge shall be handled in accordance with the provisions of sections 21773 and 21774 of the code.

(c)    A plan of care  for  a   patient  that  provides  for  the  patient performing services for the home shall be authorized by the physician's written order. The order shall include the specific benefits to be derived

by the patient from such activity, and such written order shall become part of the patient's record. The patient shall have the right to refuse to perform such services for the facility, and such refusal shall not be deemed to prevent the facility from providing appropriate care.

(d)   The nursing home shall assure, through the minimum following steps, that a patient is provided with information about health facility rules and regulations affecting patient care and conduct:

(i)   The home shall provide a written  copy   of  facility  rules   and regulations to the patient or the patient's representative upon admission and when the rules and regulations are changed.

(ii)    The home shall assure that policies, rules, and regulations are communicated effectively to  all  patients,  including patients who are unable to read.

(iii)   The home shall post such rules and regulations in a public place.

(e)   A home shall provide every reasonable opportunity, at the request of the patient, the legal guardian, the patient's representative, or the next of kin, to permit a limited number of individuals to remain in the facility 24 hours a day when the patient is considered terminally ill.

History: 1981 AACS; 1983 AACS.