In California, the rights of residents living in Residential Care Facilities for the Elderly (RCFE) are not as detailed as federal rights of nursing facility residents. For example, RCFE’s, also known as assisted living or board and care facilities, are not eligible to participate in federal payment programs like Medicare and only a very few may participate in Medi-Cal programs. RCFE’s are governed by state law Title 22 and are allowed to have “House Rules” included in an admissions agreement that often bypass residents’ rights. That’s why the admission agreement is so critical for residents, as it lays out the mutual agreements for those living at a facility.
Below are the most common residents’ rights.
Facilities must not involuntarily transfer or evict residents for any reason other than those set forth in state laws and regulations and must comply fully with eviction and relocation protections for residents. All eviction policies and procedures must be stated in the admission agreement.
There are five legal reasons for eviction:
The facility is required to give a 30-day written notice to evict a resident. It is only when a resident is exhibiting behavior threatening to him/herself or others, that the licensing agency may approve a 3-day notice of eviction. An eviction notice must be sent to the resident and their agent or legal representative and must contain the following:
The resident and resident’s representative have the right to file a complaint with the ombudsman and/or licensing about the eviction process or reasons for eviction. In order for a resident to remain in the facility after the effective date of the eviction, the RCFE must file an unlawful detainer action in superior court and receive a written judgement signed by a judge before the resident can be forcibly removed.
Residents pay for rent each month, so the bed is held. Sometimes residents will be in in the hospital at the first of a new month and must be encouraged to pay rent. However, it is important to note that the RCFE staff may try not to accept payment of rent in order not to permit the resident’s return to the facility after hospitalization. The RCFE staff may also try to circumvent the eviction process when a resident who has been at an acute psychiatric facility is ready to return by indicating that they can’t meet their needs. This is an unacceptable/illegal practice.
Residents in an RCFE have the right to be encouraged and assisted in exercising their rights. They also have the right to be free from interference, coercion, discrimination, and retaliation. It is also required that the facility must provide initial and ongoing training to staff to ensure residents’ rights are respected. Additionally, the admission agreement must include a copy of residents’ rights and must prominently post a copy of the residents’ rights.
Residents have a right to be free from abuse: corporal or unusual punishment, neglect, financial exploitation, involuntary seclusion, humiliation, intimidation, physical abuse, sexual abuse, verbal abuse and mental abuse. The facility must take steps to ensure that abuse does not occur.
Residents have the right to reasonable accommodation preferences regarding room and roommate choices, which means they can share a room with their spouse, domestic partner, or any person of their choice. Should any room changes be required, the RCFE must provide written notice of those room changes at least 30 days in advance, unless the request is agreed to by the resident, or is required to fill a vacant bed, or in an emergency.
Residents have the right to fully participate in planning their care, including attending meetings regarding care. They also have the right to receive necessary information to make informed decisions and choices. They can also choose their physicians, pharmacies, privately paid personal assistants, hospice, and health care providers and the RCFE cannot require the purchase of medications or medical equipment from a particular source. Residents also have the right to complete advance health care directives, the right to receive or reject medical care or other services. Importantly, the family or legal representatives of a resident must be regularly informed of their care and service activities including ongoing evaluations.
Residents have the right to organize and participate in a resident council and their family members, friends, and representatives have the right to organize a family council. Residents can also attend religious services or activities of choice; can leave facility freely and not be locked into a room; have the right to get help in exercising their right to vote and have the right to move from the facility should they so choose.
Residents in RCFE’s have the right to a reasonable level of privacy in accommodations, medical treatment, visits, communications, telephone conversations, internet use, and meetings of resident and family groups to include:
The RCFE must promptly respond to communications by family members and legal representatives.
Residents have the right to protection of their property from theft or loss. They also must be informed by the RCFE of their obligation to safeguard property. The facility shall provide individual storage space for private use.
Facilities must NOT require residents to deposit personal funds with the facility; act as conservator of the person or estate of a resident; act as a representative payee of a resident; serve as an agent for a resident under a power of attorney; or act as a joint tenant on any account with a resident. Residents have a right to manage their finances.
Residents have the right to make complaints and recommend changes in policies, procedures, and services, without discrimination, reprisal, or other retaliatory action and the RCFE must inform residents of these rights and the procedures to file complaints with licensing. Any person can file a complaint with licensing and the resident has the right to contact licensing, the Ombudsman, or both, regarding grievances against the facility. The facility must conspicuously post those telephone numbers and addresses in a location easily accessible to residents.
The licensee must notify residents that licensing reports are available for review.
As a rule, residents have the right to care, supervision, and services that meet their individual needs including: