key: cord-340701-eeqgtk34
authors: Kusmaul, Nancy
title: COVID-19 and Nursing Home Residents’ Rights
date: 2020-07-29
journal: J Am Med Dir Assoc
DOI: 10.1016/j.jamda.2020.07.035
sha: 
doc_id: 340701
cord_uid: eeqgtk34

nan

Act included a bill of rights for residents out of recognition of the steep power imbalance 28 between residents and staff 1 , and the development of learned helplessness by those who live in 29 such settings 2 . Born from a time when nursing homes residents were subject to physical 30 restraints and sedation, these rights sought to give residents greater control over daily routines 31 and social interactions 2 . Could Covid-19 be sending residents rights back to this time? 32

As soon as the story about the Kirkland, Washington nursing home and Covid-19 became 33 national news the Centers for Medicare and Medicaid Services (CMS) took swift action to 34 protect nursing home residents 3 . Their press release on March 13, 2020 characterized their 35 directives as the most aggressive and decisive, and they certainly were. They immediately 36 restricted all visitors, volunteers, and nonessential personnel from entering nursing homes and 37 cancelled group activities and communal dining. 38

While the Covid-19 pandemic seemed urgent and the risks to nursing home residents 39 were real, these directives superseded and countered residents' rights. One of the core resident's 40 rights is the right to spend time with visitors of your choosing. "You have the… right: To spend 41 private time with visitors. To have visitors at any time, as long as you wish to see them, as long 42 as the visit does not interfere with the provision of care and privacy rights of other residents." 4 43

The restriction of rights is concerning, even in the face of a global pandemic. Nursing 44 homes are required by federal regulations to provide maximal quality of life. As defined in the 45 federal register, §483.24 "Quality of life is a fundamental principle that applies to all care and 46 services provided to facility residents. Each resident must receive and the facility must provide 47 the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, consistent with the resident's comprehensive assessment and plan of 49 care." 5 50

How can residents maintain the highest practicable mental and psychosocial well-being 51 when they are not able to connect with other human beings, including loved ones? CMS made 52 exceptions for "compassionate cases" which were left to the nursing homes' discretion. • Consider physical barriers. 7

The true meaning of residents' rights

Empowering the elderly nursing home resident: The resident rights 86 campaign

CMS Announces New Measures to 88

Protect Nursing Home Residents from COVID 19

Your Rights and Protections as a 92 Nursing Home Resident

Federal Register. 42 CFR §483 Requirements for States and Long Term Care Facilities

SID=f6c854ab4333a365da3f797f56f91f53&mc=true&tpl=/ecfrbrowse/Title42/42cfr 98 483_main_02.tpl. Accessed

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Frequently Asked Questions 102 (FAQs) on Nursing Home Visitation

West Virginia Department of Health and Human Resources

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