Privacy Private Telephone Conversations [§483.10 (k)] Private telephone conversations are included in the federal law. Residents may face a number of problems using the telephone in a facility. The law and the Guidance to Surveyors say that residents must have reasonable access to the use of a telephone where calls can be made without being overheard. That includes placing telephones at a height accessible to residents in wheelchairs and adapting telephones for use by the hearing impaired. Privacy [§483.10 (e), §483.15 (c)] Privacy also includes the rights to privacy with whomever the resident wishes to be private. Private space may be created in a number of ways; it must be accomplished in a way that does not infringe upon the rights of other residents. Privacy extends to medical treatments and bathing. It also includes visual privacy and for visits or other activities, auditory privacy to the extent desired.
Self-Determination There are several rights that underscore the self-determination and individuality principles that are so clearly stated in the Nursing Home Reform Law’s Quality of Care and Quality of Life provisions. A few of these rights are listed here because they Facilities must adapt to counter the institutional approach that often exists. These each resident’s routines rights require the facility to adapt to each resident’s routines and preferences instead of and preferences instead of expecting the resident to adjust to expecting the resident to the facility’s schedule. adjust to the facility’s Residents can choose activities, schedules, and health care schedule. consistent with their interests, assessments, and plans of care. Staff is required to make adjustments to allow residents to exercise choice. [§483.10 (b)(3) and (4), §483.15 (b)]
Residents are to reside and receive services with reasonable accommodations by the facility of individual needs and preferences. [§483.15 (e)] The Guidance to Surveyors says the facility’s physical environment and staff behaviors are to assist residents in maintaining and/or achieving independent functioning, dignity, and well-being. Facilities are directed to adapt such things as schedules, call systems, and room arrangements to accommodate the resident’s preferences, desires, and unique needs. Facilities must learn each resident’s preferences and take them into account when discussing changes of room or roommates and the timing of such change.