The following information is based on federal regulations that apply to all nursing homes receiving Medicare or Medicaid funding. This is for informational purposes only and should not be taken as legal advice. If you feel your rights or the rights of your loved one in long-term care have been violated seek professional legal advice on how to proceed.

While federal regulations are public domain, this comprehensive interpretation, organization, and family-friendly presentation is © 2025 NursingHomeFamilyCouncil.com. All rights reserved. Distribution and linking permitted with attribution intact.

Your Loved One’s Rights in Long-Term Care

 

Overview: What Every Family Should Know

Your loved one doesn’t give up their rights when they move into a nursing home or long-term care facility. Federal law guarantees specific rights that protect their dignity, choices, and quality of life. This guide breaks down those rights in plain language so you can advocate effectively for your family member.

Core Principles: The Foundation of All Rights

Dignity and Respect: Your loved one has the right to be treated with dignity and respect at all times. The facility must care for them in a way that maintains or improves their quality of life while recognizing who they are as an individual.

Equal Treatment: Everyone deserves quality care regardless of their medical condition, how severe their needs are, or how their care is paid for (Medicare, Medicaid, or private pay).

Protection from Retaliation: Your loved one can exercise their rights without fear of punishment, discrimination, or retaliation from the facility.

Want to connect with other families navigating similar challenges? Join our community to share experiences and get support from families across the country.

Federal Authority:  42 CFR §483.10(a) – Basic Resident Rights
→ Violation Remedies if these basic rights are being violated

Making Decisions: Who Can Speak for Your Loved One?

If Your Loved One Can Make Their Own Decisions

  • They have the right to make their own choices about their care and daily life
  • They can designate someone (like you) to help make decisions or speak for them
  • They can change their mind about who helps them make decisions
  • Same-sex spouses have the same rights as opposite-sex spouses

If Your Loved One Cannot Make Decisions

  • A court-appointed guardian makes decisions within the limits set by the court
  • Even with a guardian, your loved one should still be included in conversations about their care when possible
  • Their wishes and preferences must still be considered

Important Note for Families

If the facility believes someone making decisions for your loved one is not acting in their best interest, they must report this according to state law.

Want to connect with other families navigating similar challenges? Join our community to share experiences and get support from families across the country.

Federal Authority:  42 CFR §483.10(b) – Exercise of Rights and Representative Authority
→ Violation Remedies if decision-making rights are being violated

Freedom from Abuse, Neglect & Exploitation

 

Zero Tolerance Policy

Your loved one has the absolute right to be free from abuse, neglect, and exploitation of any kind. Federal law requires nursing homes to have zero tolerance for these violations.

What Constitutes Abuse & Neglect

Physical Abuse:

  • Hitting, slapping, pushing, or any unwanted physical contact
  • Rough handling during care
  • Inappropriate use of restraints
  • Force-feeding or withholding food/water as punishment

Emotional/Psychological Abuse:

  • Verbal harassment, threats, or intimidation
  • Humiliation or degrading treatment
  • Isolation as punishment
  • Threats of abandonment or harm

Neglect:

  • Failure to provide necessary care, treatment, or services
  • Ignoring calls for help or assistance
  • Not maintaining proper hygiene or medical care
  • Allowing preventable injuries or medical complications

Financial Exploitation:

  • Stealing money or possessions
  • Unauthorized use of resident’s credit cards or accounts
  • Coercing residents to change wills or financial documents
  • Charging for services not provided

Facility’s Legal Obligations

The nursing home must:

  • Immediately investigate any allegations of abuse or neglect
  • Report incidents to state authorities within 24 hours
  • Protect the resident from further potential abuse during investigation
  • Take corrective action including removing staff if necessary
  • Notify the resident’s representative of the incident and investigation
  • Document everything and make reports available to authorities

Your Rights During an Investigation

  • Right to be notified immediately of any incident
  • Right to review investigation reports
  • Right to have your loved one protected during the process
  • Right to contact law enforcement independently
  • Right to move your loved one to a safe environment if necessary

🚨 IMMEDIATE ACTION REQUIRED

If you suspect abuse or neglect:

  1. Ensure immediate safety – remove your loved one from danger if possible
  2. Document everything – photos, notes, witness information
  3. Report immediately to facility administration
  4. Contact authorities – police if criminal, state ombudsman, state health department
  5. Seek medical attention if needed
  6. Contact family and consider legal representation

Remember: You don’t need “proof” to report concerns – suspicions are enough to trigger investigations that protect your loved one.

Want to connect with other families navigating similar challenges? Join our community to share experiences and get support from families across the country.

Federal Authority: 42 CFR §483.12 – Freedom from Abuse, Neglect, and Exploitation
Violation Remedies if abuse or neglect protections are being violated

Quality of Life Standards

Beyond basic care, your loved one has the right to quality of life that maintains their dignity, promotes their well-being, and respects their individuality.

Dignity in All Interactions

Staff must:

  • Treat your loved one with respect regardless of their condition or abilities
  • Use their preferred name and appropriate titles (Mr., Mrs., etc.)
  • Speak directly to them rather than about them when they’re present
  • Respect their privacy during personal care and medical discussions
  • Honor their personal preferences whenever possible

Social and Emotional Well-being

Your loved one has the right to:

  • Meaningful relationships with family, friends, and other residents
  • Social activities that match their interests and abilities
  • Privacy for personal conversations and visits
  • Express their personality through clothing, room decoration, and daily choices
  • Participate in community life within and outside the facility

Cultural and Religious Respect

The facility must:

  • Accommodate religious practices and provide access to spiritual care
  • Respect cultural preferences in food, clothing, and customs
  • Provide interpretation services when language barriers exist
  • Honor cultural attitudes toward medical care and family involvement
  • Celebrate cultural holidays and traditions when possible

Environmental Quality

Your loved one deserves:

  • Clean, safe living spaces that feel like home
  • Comfortable temperature and lighting that promote well-being
  • Noise control that allows for rest and peaceful activities
  • Access to outdoor spaces and natural light when possible
  • Spaces for both social interaction and privacy

Activities and Engagement

The facility must provide:

  • Activities programs that match residents’ interests and abilities
  • Opportunities for choice in how to spend their time
  • Mental stimulation appropriate to their cognitive level
  • Physical activities suited to their mobility and health
  • Social interaction opportunities with other residents and community members

Warning Signs of Poor Quality of Life

Contact the facility if you notice:

  • Your loved one seems withdrawn, depressed, or hopeless
  • Staff consistently rush through care or ignore personal preferences
  • Limited or no activities offered that interest your loved one
  • Residents left alone for long periods with no interaction
  • Cultural or religious needs consistently ignored
  • Physical environment is institutional rather than homelike

Quality of life isn’t a luxury – it’s a federal requirement that ensures your loved one can thrive, not just survive, in long-term care.

Want to connect with other families navigating similar challenges? Join our community to share experiences and get support from families across the country.

Federal Authority: 42 CFR §483.24 – Quality of Life
Violation Remedies if quality of life standards are being violated

Medical Care and Treatment Rights

Understanding Their Health and Care Plan

Your loved one has the right to:

  • Know their medical condition in language they can understand
  • Participate in creating their care plan – they should be involved in setting goals and deciding what care they receive
  • Request meetings about their care plan and ask for changes
  • See their care plan and sign it when there are major changes
  • Know in advance what care they’ll receive and who will provide it

Making Treatment Decisions

Your loved one can:

  • Choose their doctor (as long as the doctor is licensed and willing to work with the facility)
  • Accept or refuse treatment, including experimental treatments
  • Be told about risks and benefits before agreeing to any treatment
  • Create advance directives (living wills, healthcare proxies)
  • Take their own medications if the care team agrees it’s safe

Important Limitation

Your loved one cannot demand medically unnecessary or inappropriate treatment.

Want to connect with other families navigating similar challenges? Join our community to share experiences and get support from families across the country.

Federal Authority:  42 CFR §483.10(c) – Planning and Implementing Care
→ Violation Remedies if medical care rights are being violated

Visiting Rights: Who Can See Your Loved One

Immediate Access (Cannot Be Restricted)

Federal law guarantees that these people must be allowed immediate access to any resident at any time:

  • Government inspectors and ombudsmen
  • Your loved one’s doctor
  • Family members, relatives, and resident representatives (unless your loved one says no)
  • Anyone your loved one wants to see (with reasonable safety limits)

🔑 IMPORTANT: Your Right to Immediate Access

As family members or resident representatives, you have the legal right to immediate access to your loved one at any time – this means:

  • No visiting hour restrictions apply to family members
  • No appointment required – you can visit anytime
  • The facility cannot delay or restrict your access unless your loved one specifically requests it
  • This is a federal right that facilities must honor

This right exists specifically so families can monitor care and ensure their loved one’s safety and well-being. If a facility tries to restrict your access with policies like “visiting hours only” or “call first,” they are violating federal regulations – unless your loved one has specifically asked to limit your visits.

Facility Rules for Visitors

  • The facility must have written visitor policies
  • They cannot restrict visitors based on race, religion, gender, sexual orientation, or disability
  • All visitors must be treated equally
  • Your loved one can withdraw permission for anyone to visit at any time

Want to connect with other families navigating similar challenges? Join our community to share experiences and get support from families across the country.

Federal Authority:  42 CFR §483.10(f)(4) – Self-determination and Visiting Rights
→ Violation Remedies if visiting rights are being violated

Daily Life and Personal Choices

Living Their Way

Your loved one has the right to:

  • Choose their daily schedule including when to sleep and wake up (within reason)
  • Choose activities they want to participate in
  • Keep personal belongings like furniture and clothes (space permitting)
  • Have visitors when they want, including the right to refuse visitors
  • Participate in religious and community activities

Room and Living Arrangements

Your loved one can:

  • Share a room with their spouse if both live in the facility and both agree
  • Choose their roommate when possible, if both residents agree
  • Get written notice before their room or roommate is changed
  • Refuse room changes that are just for staff convenience

Money Management

Your loved one:

  • Controls their own money – the facility cannot require them to let the facility manage their funds
  • Must be told in advance about any charges the facility might impose
  • If they choose to let the facility manage their money, strict rules protect their funds

Want to connect with other families navigating similar challenges? Join our community to share experiences and get support from families across the country.

Federal Authority:  42 CFR §483.10(f) – Self-determination and Personal Choice
→ Violation Remedies if daily life rights are being violated

Resident and Family Groups

Your loved one has the right to:

  • Form or join resident groups within the facility
  • Participate in family groups where families can meet together
  • Get private space for group meetings
  • Have the facility respond to group concerns and recommendations

The facility must provide a staff person to help these groups and must consider their suggestions seriously.

Family Council Formation Rights

Families and friends of residents have the specific right to form a Family Council (also called a Family Group) within the facility. Federal regulations require facilities to support this important advocacy tool.

The facility must:

  • Allow families to organize and meet independently without facility staff interference
  • Advertise the formation to other resident family members when a Family Council is being established
  • Post information visibly about the Family Council so other families know it exists and can join
  • Provide a private meeting space within the facility for council meetings
  • Assign a facility representative to interface with the Family Council and respond to their concerns
  • Take reasonable steps to address the goals and concerns raised by the Family Council
  • Respond promptly to grievances and recommendations from the council.

What this means for your family:

  • You have the legal right to organize with other families
  • The facility cannot prevent or discourage Family Council formation
  • Staff can only attend meetings if specifically invited by the council
  • The facility must demonstrate their response to council recommendations
  • Family Councils can communicate concerns collectively, which often carries more weight than individual complaints

Want to connect with other families navigating similar challenges? Join our community to share experiences and get support from families across the country.

Federal Authority: 42 CFR §483.10(f)(5)-(7) – Resident and Family Groups

Violation Remedies if group formation rights are being violated

Financial Protections

What Cannot Be Charged

If Medicare or Medicaid is paying, the facility cannot charge extra for:

  • Nursing care
  • Meals and nutrition services
  • Activities programs
  • Basic room maintenance
  • Personal hygiene items (soap, toothbrush, razor, deodorant, etc.)
  • Basic laundry service
  • Over-the-counter medications

What Can Be Charged (If Requested)

The facility may charge for extras like:

  • Private telephone or cell phone
  • Personal TV or computer
  • Special clothing or personal items
  • Private room (unless medically necessary)
  • Special meals not required for health
  • Private nurses or aides

ImportantThe facility can only charge for things your loved one specifically requests, and they must tell you the cost upfront.

Want to connect with other families navigating similar challenges? Join our community to share experiences and get support from families across the country.

Federal Authority: 42 CFR §483.10(f)(11) – Financial Management and Billing Restrictions
→ Violation Remedies if financial protection rights are being violated

Freedom from Restraints

Your loved one has the right to be free from physical or chemical restraints used for punishment or staff convenience. Restraints can only be used when medically necessary to treat symptoms and must be properly ordered by a doctor.

Want to connect with other families navigating similar challenges? Join our community to share experiences and get support from families across the country.

Federal Authority: 42 CFR §483.10(e)(1) – Freedom from Restraints
→ Violation Remedies if restraint rights are being violated

Work and Services

Your loved one:

  • Cannot be forced to work for the facility
  • Can choose to work if they want to and it’s documented in their care plan
  • Must be paid fairly if they do paid work for the facility

Federal Authority: 42 CFR §483.10(f)(9) – Work and Services
→ Violation Remedies if work-related rights are being violated

Red Flags: When to Take Action

Contact the facility administration, ombudsman, or state authorities if:

  • Your loved one is being treated disrespectfully or their dignity is not being respected
  • They’re being charged for services that should be covered by Medicare/Medicaid
  • They’re not being included in care planning decisions
  • Their visitor rights are being restricted inappropriately
  • They’re being pressured to give up any of these rights
  • Staff threatens retaliation for exercising rights

Getting Help

  • If you have concerns about your loved one’s rights:
  • Talk to the facility administrator first
  • Contact your state’s Long-Term Care Ombudsman
  • File a complaint with your state health department
  • Contact Medicare or Medicaid if payment issues are involved
  • Remember: These rights exist to protect your loved one’s dignity and quality of life. Don’t hesitate to speak up if you see problems.

Want to connect with other families navigating similar challenges? Join our community to share experiences and get support from families across the country.

Federal Authority: 42 CFR §483.12 – Reporting and Investigation Requirements
→ Violation Remedies for comprehensive guidance on reporting violations

eCFR Reference: View complete regulations