Residents Rights in an RCFE
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.
Transfer Discharge Protections
Reasons for Eviction
Eviction Notice
Appealing Proposed Transfer or Eviction
Bed Holds
Exercising Rights
Right to Be Free From Abuse
Room and Roommates
Health Care Decisions
Right to Autonomy
Privacy and Confidentiality
Safeguarding Property
Right to Complain
Additional Residents Rights
Where to Find Regulations
Transfer Discharge Protections
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.
Reasons for Eviction
There are five legal reasons for eviction:
- Nonpayment within 10 days of the due date
- Resident fails to comply with state/local law after written notice of violation
- Failure to comply with general policies of the facility that further resident harmony (must be in the admission agreement)
- The resident has an unidentified need, a reappraisal has been conducted, and facility believes it is no longer appropriate to meet the care needs of the resident
- Change of use of the facility
Eviction Notice
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 effective date of the eviction
- Must state the reason for eviction and supporting details
- Resources available to assist in identifying housing and care options, including referral services
- How a resident can file a complaint regarding the eviction, with the name, address, and telephone number of community care licensing and the ombudsman
- The notice must include a specific statement about the unlawful detainer process and that the resident has the right to contest the eviction in writing and at a hearing
Appealing Proposed Transfer or Eviction
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.
Bed Holds
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.
Exercising Rights
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.
Right to be Free from Abuse
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.
Room and Roommates
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.
Health Care Decisions
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.
Right to Autonomy
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.
Privacy and Confidentiality
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 right to visit privately, without prior notice, with whoever they want (relatives, ombudsman, and other advocacy representatives)
- The right to reasonable access to telephones with free local calls
- The right to receive mail promptly and unopened
- The right to confidential treatment of their records and personal information
- The right to prompt access to review all of their records and purchase copies, provided in two business days, using a community standard for cost
The RCFE must promptly respond to communications by family members and legal representatives.
Safeguarding Property
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.
Right to Complain
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.
Additional Residents Rights
As a rule, residents have the right to care, supervision, and services that meet their individual needs including:
- RCFE Staff sufficient in numbers, qualifications, and competency to meet their needs.
- Reasonable accommodation of individual needs and preferences in the facility
- The right to make choices concerning their daily life in the facility.
- Dignity in all relationships
- Safe, healthful, and comfortable accommodations, furnishings, equipment, and environment
- Food quality and quantity necessary to meet nutritional needs.
- Use their own personal items-including money, clothes, toiletries, and furniture.
- Maintain & develop their fullest potential for independent living through participation in activities.