Residents’ Bill of Rights

290-5-39-.03 Notification of Rights

(1) At or before being admitted to a facility, each resident and guardian, or representative if there is no guardian, must be given a copy of the written explanation of the resident’s rights, grievance procedure and enforcement procedures. A staff member must also orally explain to such persons the resident’s rights, grievance procedures and enforcement procedures. Written acknowledgement of this written and oral explanation must be given by the resident, or in the case of a resident unable to give a written acknowledgement, by the resident’s guardian or representative if there is no guardian. Such written acknowledgement shall be kept in the resident’s file.(2) At the time of admission to a facility, each resident, guardian, or representative must be provided with the following information in writing:

(a) The basic daily or monthly rate of the facility for the level of care to be received by the resident;

(b) A list of the services of the facility. Such list must show which services are offered as a part of the daily rate and which services are offered on an as-needed basis along with the related charges for such services. Such list must also show which services are not covered under Medicare or Medicaid programs and for which there are extra charges;

(c) A statement disclosing the facility’s name and business address and the administrator’s name and business address. The statement should also disclose that upon request at any time during normal business hours, a resident or a person applying to be a resident must be given a current copy of the annual disclosure statement filed with the Department of Medical Assistance.

(d) Notice of right of access to the written policies and procedures of the facility adopted pursuant to .02(1) of these rules and regulations during normal business hours;

(e) The right to select at admission, or to change at any time, the pharmacy or pharmacist of the resident’s choice for those pharmaceutical supplies and services not provided as a part of the facility’s basic rate. If the facility uses a specific type of unit dose drug system, any pharmacy or pharmacist chosen by the resident must be able to provide pharmaceuticals under such a system. Such notice at the time of admission shall also include a list of which pharmaceutical supplies and services are not provided by the facility.

(3) Provisions of these rules and regulations shall apply to current as well as future residents.

Authority Ga. L. 1981, pp. 149-167 (Ga. Code Ann. 88-1906B, 1913B, 1915B, 1919B, 1924B). Administrative History. Original Rule entitled “Notification of Rights” was filed on February 5, 1982; effective February 25, 1982.

290-5-39-.07 Resident Care and Treatment.

Each resident must receive care, treatment and services which are adequate and appropriate for the condition of the resident, as determined by periodic review of each resident’s treatment plan. Such care, treatment, and services must be provided with reasonable care and skill and in compliance with all applicable laws and regulations and with the goal of the resident’s return home or to a less restrictive environment.

(a) The quality of a particular service or treatment must be the same to all residents without regard to the source of payment for such service or treatment. In particular, the quality of care provided to a resident whose care is being paid for from Medicaid or Medicare funds must be that same quality of care provided to those residents whose care is being paid for from other sources.

(b) Care, treatment and services must be provided with respect for the resident’s personal

dignity and privacy subject to the following:

1. All aspects of a resident’s medical, personal and bodily care program shall be conducted in private and kept confidential. Any persons not directly involved in the particular aspect of care being provided to a resident must have the resident’s permission to be present at the time that component of the resident’s care is being provided;

2. A resident’s personal and medical records must be kept confidential. Only the resident or guardian may approve the release or disclosure of such records to persons or agencies outside the facility which must be in writing, unless it is a case of the resident’s transfer to another health care facility or during Medicare, Medicaid, licensure, medical care foundation, or peer review surveys, or as otherwise provided by law or third-party payment contract;

3. Each resident or guardian shall have the right of access to all information in the medical and personal records of that resident and to have given to him by the physician a complete and current explanation of his medical diagnosis, treatment and prognosis in language the resident can understand. Each resident or guardian shall have the right to inspect and receive a copy of such records unless said right is suspended in accordance with .10 of these rules and regulations. The facility may charge a reasonable fee for duplication of the medical records, not to exceed actual cost.

(c) Each resident or guardian shall be entitled to choose or change at any time the resident’s physician(s). A physician so chosen shall inform the resident in advance whether or not the physician’s fees can be paid for by Medicaid, Medicare, or from any other public or private benefits and agree to and provide documentation to any third party payor as required by law, regulations or contract.

(d) The resident or guardian shall be entitled to participate in the development of the resident’s care plan and in the provision of treatment under the plan. The resident or guardian shall be informed of the right to participate in the planning of care and treatment each time a substantial change in the treatment is needed.

(e) A resident shall not take part in any experimental research or be the recipient of any experimental treatment unless informed written consent (consistent with Ga. Code Ann., Chapter 88-29) is given by the resident or guardian. Such written consent shall be made a part of the resident’s medical record.

(f) Subject to the resident’s choice of pharmacy or pharmacist, pursuant to .03(2)(e) of these rules and regulations, each resident shall receive pharmaceutical supplies and services at reasonable prices not exceeding applicable and normally accepted prices for comparably packaged pharmaceutical supplies and services within the community.

Authority Ga. L. 1981, pp. 149-167 (Ga. Code Ann. 88-1911B, 1914B, 1915B, 1924B).

Administrative History. Original Rule entitled “Resident Care and Treatment” was filed on February 5, 1982; effective February 25, 1982.

Administrative History. Original Rule entitled “Resident Care and Treatment” was filed on February 5, 1982; effective February 25, 1982.

Administrative History. Original Rule entitled “Resident Care and Treatment” was filed on February 5, 1982; effective February 25, 1982. 

290-5-39-.14 Grievance Procedure.

Any resident, guardian or representative who believes his rights or, in the case of a guardian or representative, the rights of the resident, have been violated, may present a grievance. The grievance procedure shall be in accordance with the following:

(a) The facility shall maintain a confidential central file of documents and materials pertaining to grievances. Any resident, guardian or representative shall be free to review any document or materials pertaining to that resident. All documents and materials pertaining to grievances shall be available to the Department.

(b) To initiate a grievance, the resident, guardian, or representative must submit an oral or written complaint to the administrator or his designee, who, in the event of an oral complaint, shall promptly reduce the substance of the complaint to writing. The administrator shall also promptly act to resolve the complaint. If the complaint is not resolved within three business days, the administrator or designee shall give a written response to the complainant. The content of such response shall include:

1. The names of the complainant and of the person making the written response;

2. The date the grievance was commenced and the date of the written response;

3. A complete description of the complaint;

4. The facility’s position in regard to the complaint; and

5. A description of the review and appeal rights including the name and telephone number of the community ombudsman or state ombudsman, if there is no community ombudsman.

(c) If the complainant is not satisfied with the resolution or written response of the administrator or designee, he shall submit an oral or written complaint to the community or state ombudsman, pursuant to Ga. Code Ann., Chapter 88-19A.

(d) If the ombudsman is unable to resolve the grievance to the complainant’s satisfaction within 10 calendar days of submission to such ombudsman, the complainant may submit the grievance to an impartial referee, jointly chosen by the administrator or his designee and the complainant. The referee may be any person who is mutually acceptable to the complainant and the administrator or designee.

(e) Within 14 calendar days after the complainant has requested a hearing before an impartial referee, such hearing shall be held at a time convenient to the administrator, complainant and referee and such hearing shall be held at the facility. The complainant and the administrator may review relevant records and documents, present evidence, call witnesses, cross-examine witnesses, make oral arguments, and be represented by any persons of their choice. The referee may ask questions of any person, review relevant records and documents, call witnesses, and receive other evidence as appropriate. The referee shall keep a record of the proceedings, which may be a sound recording. In the event that the complainant and the administrator/designee cannot agree upon an imparital referee within seven calendar days after the complainant has requested a referee’s hearing, the complainant shall have the right to an administrative hearing pursuant to .15 of these rules and regulations.(f) Within 72 hours after the hearing before the referee, the referee shall render a written decision, on forms to be provided by the Department. Copies of the decision shall be given to the complainant, to the administrator for filing in the central file for that purpose, and a copy shall be sent to the Department. The decision shall be divided as follows:

1. Contentions of the parties;

2. Findings of the relevant and significant facts;

3. Decisions of the referee as to whether a violation of resident’s rights has occurred, along with a recommendation to the Department for corrective action and the date by which the correction should be made; and

4. A complete description of the right and manner in which to appeal the referee’s decision in accordance with .15 of these rules and regulations

(g) The decision of the impartial referee shall be binding upon all the parties unless

reversed upon appeal.

(h) If a resident or complainant is unable for any reason to understand any writing or communication pertinent to this section, such information shall be communicated to him in a manner that takes into account any communication impairment he may have.

(i) A resident, guardian or representative who elects not to proceed under this section shall not be prohibited from proceeding under .15 or .16 of these rules and regulations. Nothing in these rules and regulations is meant to modify or diminish any complaint procedure set up or in operation pursuant to Ga. Code Ann., Chapter 88-19A.Authority Ga. L. 1981, pp. 149-167 (Ga. Code Ann. 88-1903B, 1921B, 1924B).

Administrative History.

Original Rule entitled “Grievance Procedure” was filed on February 5, 1982; effective February 25, 1982.