Two sources provide rights for nursing home residents. The Illinois Nursing Home Care Act provides rights for all nursing home residents in Illinois. The Federal Nursing Home Reform Act provides additional rights for residents in Illinois nursing homes which receive Medicare or Medicaid funds.
The Illinois Nursing Home Care Act ensures you the following rights:
You have the right to vote and free speech while you live in a nursing home.
Freedom of religion
You have the right to practice your religion. You may request that the nursing home make arrangements (at your expense) for you to attend religious services. The nursing home may not impose a religion or religious services on you.
You shall not be subject to unlawful discrimination by any owner, employee or agent of the nursing home.
Rooming with a spouse
You have the right to reside in the same room with your spouse unless there is no room available in the facility or your physician advises against it.
Right to mail, phone, and visitation
- You have the right to unimpeded private communication by mail, telephone, or visitation. Physicians may order reasonable restrictions only to protect you or other residents from harm.
- You have the right to private visits at any reasonable hour unless they are not medically advisable.
- Your nursing home must provide space for visits.
- Correspondence, like writing a letter, must be conveniently received and mailed.
- Telephones must be reasonably accessible.
- Letters from government officials or attorneys may not be read by staff before being delivered to you.
Working for the facility
The nursing home cannot require you to perform work.
Abuse and Neglect
You are entitled to be free from abuse and neglect. The facility administrator must immediately report abuse or neglect to your guardian or family, and to the Illinois Department of Public Health.
Nursing home personnel must knock, except in an emergency, before entering your room. You have the right to privacy in your medical and personal care program. Your case discussion, consultation, examination, and treatment must be confidential and conducted discreetly. Anyone not directly involved in your care should not be present when you are being treated unless you consent.
You may place an electronic monitoring device in your room if you have the written consent of your roommates and have provided notice to the facility. You must pay all costs associated with the purchase, installation and upkeep of the device. The facility may not access any video or audio recording created by the device without your written permission.
Resident identification wristlet
You are not required to have an identification wristlet unless it is ordered by a physician who documents that it is necessary in your clinical record.
A restraint may be used only with your informed consent and only if it is the least restrictive means necessary. A restraint must be ordered by a physician who documents that you need it in your clinical file and may be used only after less restrictive measures have been tried and not worked.
- A physical restraint is anything attached or adjacent to a resident’s body which cannot be removed easily and restricts freedom of movement. Any drug used for discipline or convenience is considered a restraint. Devices used for positioning such as bed rails and gait belts are not considered restraints.
- If you need emergency care, restraints may be used for brief periods for medical treatment unless you have previously told the facility you are refusing the treatment in question.
- A restraint may be applied only by a person trained in the application of the particular type of restraint.
- Whenever a restraint is used, you must be advised of your right to have a person or organization, such as the Illinois Guardianship and Advocacy Commission (GAC), notified of the use of the restraint which must be notified within 24 hours. If GAC is notified, it will contact you to determine if the restraint is necessary.
- Restraints or confinements cannot be used for the purpose of punishment or for the convenience of the facility personnel.
The nursing home must tell you and your spouse about spousal impoverishment rights when you are admitted. Under spousal impoverishment, Medicaid will cover the nursing home expenses of one spouse while allowing a spouse living in the community to keep $2,739 in monthly income and $109,560 in assets (besides certain non-eligible assets such as a home). See Nursing Home Financing for further explanation.
Managing your finances
You must be allowed to manage your own financial affairs.
Nursing home accounts
You may allow the nursing home to hold your funds for safekeeping and managing. They must keep your money in an account separate from the facility's funds and the account must be interest bearing for all amounts over $100. You must be provided access to a written record of all financial transactions involving your money; be provided a quarterly itemized statement of all financial transactions; and be allowed to have the funds returned to you upon your written request.
You must be permitted to use your personal property and wear your own clothing, unless it is deemed medically inappropriate by a physician and documented in your clinical record. If clothing is provided to you by the facility, it must fit properly.
The nursing home must provide adequate storage space for your personal property and a means of safeguarding your valuables in your room. The facility must try to prevent loss and theft of your property which can include monitoring, labeling property, and conducting frequent property inventories. The facility must promptly investigate all theft complaints.
You have the right to retain the services of your own personal physician.
Screening prior to admission
You must be screened before entering a facility to determine the need for nursing care services and for specific recommendations about what care and services you need to receive to get or keep your highest level of independent functioning.
Information and planning
You have the right to obtain information from your physician concerning your medical diagnosis, treatment, and prognosis. You must be permitted to participate in the planning of your care and medical treatment to the extent that your condition permits.
You may not be subjected to experimental research or treatment without written consent.
All medical treatment and procedures shall be administered as ordered by a physician. All new physician orders shall be reviewed by the nursing home's nurse within 24 hours after being issued. All physician's orders and plans of treatment must be signed by the physician (a stamp signature with the physician’s initials is insufficient).
No unnecessary drugs
You must not be given unnecessary drugs by the facility. Unnecessary drugs include those that are excessive (dose or duration), are duplicative or given without adequate indications for use, given without adequate monitoring, or given despite adverse consequences that indicate they should be reduced or discontinued.
Refusing medical treatment
You may refuse medical treatment unless it is documented by a physician in your clinical record that your refusal would be harmful to the health and safety of others.
Access to medical records
You have the right to inspect and copy all your records concerning your care which are kept by the facility but you can be charged a reasonable fee for copying.
The facility must have a policy for the format, method of documentation and duration of physician orders limiting resuscitation which are commonly known as "Do-Not-Resuscitate" orders. The Department of Public Health Uniform Practitioner Forms for Life Sustaining Treatment) forms shall be honored by nursing homes.
You are to be provided a yearly influenza and pneumococcal vaccinations unless one or both are medically inadvisable because of a medical condition. You have a right to refuse either or both vaccines.
Information about health care surrogates
If you do not have a power of attorney or guardian, you must be provided written information about your right to name a health care surrogate who should be consulted if you are unable to make healthcare decisions for yourself. This information must be provided to you within 30 days of your being admitted to the facility.
Discharge at your request
The facility must transfer or discharge you at your request or at the request of your guardian.
Involuntary discharge or transfer
You have a right to remain in the nursing home unless the facility can prove that a transfer or discharge is necessary for one of the specific reasons set out by statute. For more on involuntary discharge and the reasons you can be transferred or discharged against your will, see “Your right to stay in your nursing home."
You must be provided with a written nursing home contract prior to admission which must specify:
- The term of the contract
- The services covered under the contract and the charges for the services
- Supplemental services that may be provided upon request and the charges for the supplemental services
- The persons or entities liable for payments
- The amount of deposit paid
- The rights, duties and obligations of the resident.
If you are hospitalized and are discharged within ten days, the nursing home should allow you back to the next available bed.
Mental Health Rights
Screening prior to admission
If you have a serious mental illness, the screening prior to admission must be performed by a psychiatrist, a psychologist, a registered nurse certified in psychiatric nursing, a licensed clinical professional counselor, or a licensed clinical social worker and shall include your current need for treatment and an evaluation of whether there is a community based housing option which would allow you to live in the community.
Continued mental health screenings
If you are admitted to a facility with a diagnosis of serious mental illness, you must be re-screened after 90 days and again after 6 months. After the first year, you must be annually screened to assess your continuing need for the facility.
Psychotropic medication may not be prescribed without your informed consent. Psychotropic medication means medication that is used for antipsychotic, antidepressant, antimanic, or anti-anxiety behavior modification.
Complaint and Assistance Rights
The nursing home must provide the address and phone number of the Office of the Long Term Care Ombudsman in an easily readable format in multiple places that are accessible to both visitors and residents. The ombudsmen are advocates for nursing home residents. They provide information regarding resident rights, options, supports and available services. Ombudsmen also have a duty to investigate and resolve resident complaints.
You have the right to file complaints with the facility administrator, the Long-Term Care Facility Advisory Board, the facilities advisory council, and state agencies. The facility is not allowed to retaliate against you for making any complaints and must provide you with the contact information of the appropriate state governmental office where complaints may be filed.
Each facility must have a residents' advisory council. The council consists of at least five residents or resident representatives. No employee of the facility may be a member of the council but facility staff does help host the council. The council must meet and its purpose is:
- Getting and giving information to residents;
- Making suggestions to the facility about programing and improvements;
- Finding and recommending solutions to facility problems; and
- Presenting resident complaints to IDPH.
The Federal Nursing Home Reform Act which applies to residents in facilities that accept Medicare and Medicaid gives you the following additional rights:
Determining Eligibility for Medicare Reimbursement
You have the right to insist that the nursing home bill Medicare even when the nursing home determines that you need custodial care only. The nursing home does not decide whether your condition qualifies for Medicare reimbursement.
Continued Stay in Medicare-Certified Bed
You have the right to veto a transfer within the nursing home if the purpose of the transfer is to move you out of Medicare-certified bed to another bed after Medicare services have ended. Although you could potentially owe the facility money if you receive Medicaid and the bed is not in a Medicaid certified section of the facility.
Readmission from the Hospital
If you have to leave the nursing home to be hospitalized, you have the right to be re-admitted to the next available bed at the nursing home when you are discharged no matter how long you were in the hospital.
You and your family have the right to participate in creating your care plan. The nursing home staff is required to schedule care plan meetings at a time that allows your family to attend.
Honoring Resident Preferences
The nursing home must make reasonable adjustments to honor your needs and preferences. You have the right to choose activities, schedules and health care consistent with your interests and with your care plan. For example, you do not have to be woken up at 6AM just because that suits the nursing home's schedule.
Providing Necessary Services
The nursing home must provide the necessary care that you need to reach or maintain the highest practicable level physical, mental, and psychosocial well-being.
Use of Feeding Tubes
The nursing home cannot compel you to use a feeding tube, except as a last resort. The nursing home must help you to eat, as needed, such as by prompting you to eat, providing therapy to improve swallowing skills, providing assistive devices such as easy-to-grip utensils or simply feeding you by hand.
If your care is covered by Medicare or Medicaid the nursing home must accept payment from Medicare and Medicaid as payment in full. The resident’s financial obligations are limited to deductibles and co-payments as authorized by law.
Withdrawal from Medicaid program
If a nursing home withdraws from the Medicaid program it may not discharge any current residents who are receiving Medicaid.
Nursing home owners, administrators, employees, and agents must report all reasonable suspicions of any crimes against residents to the Illinois Department of Public health and law enforcement.
Notice of room changes
Nursing homes are required to give advance notice before they change your room or make roommate changes.