Two sources provide rights for nursing home residents. The Illinois Nursing Home Care Act provides rights for all nursing home residents in Illinois. The Federal Nursing Home Reform Act provides additional rights for those residents receiving Medicare or Medicaid funds.

The Illinois Nursing Home Care Act ensures you the following rights:

Basic Rights

Free speech

You have the right to vote and to free speech while you live in a nursing home.

Freedom of religion

You have the right to practice your religion. You may request that the nursing home make arrangements for you to attend religious services. This is at your expense. The nursing home can't impose a religion or religious services on you.

No Discrimination

The nursing home can't subject you to unlawful or unfair treatment. This includes owners, employees, or agents of the nursing home.

Rooming with a spouse

You have the right to stay in the same room with your spouse. One exception is if there is no room available in the facility. Another exception is if your physician advises against it.

Right to mail, phone, and [no-lexicon]visitation[/no-lexicon]

When the governor has issued a proclamation under Section 7 of the Illinois Emergency Management Agency Act, there are a few limitations and expectations to visitation rights in nursing homes.  

While the Act is invoked, healthcare facilities must ensure that at least one visitor can visit a resident or patient of the health care facility. Clergy members do not count as a visitor for the purposes of this. Healthcare facilities must also shape the guidelines of their visitation policy by the recommendations of the U.S. Centers for Medicare and Medicaid Services and the Centers for Disease Control and Prevention. Your facility must inform you, and your legal representatives, of any changes in their policies.

Visitors may need to submit to health screenings if the health care facility requires them. The facility may also require that visitors wear personal protective equipment. 

The healthcare facility may deny access to a visitor who does not pass its health screening requirement. The facility may also deny visitation if they determine that visitation would endanger the physical health or safety of a patient, the visitor, or health care workers or would otherwise create a public health or safety problem.

If a visitor is denied visitation, the facility must put that information in writing and explain why the visit was denied.

• Usually, you have the right to unimpeded private contact by mail, telephone, or visitation. Physicians may order reasonable restrictions. This is to protect you or other residents from harm.
• You have the right to private visits at any reasonable hour unless they are not medically advisable.
• Your nursing home must provide space for visits.
• Letters must be conveniently received and mailed.
• Telephones must be reasonably accessible.
• Staff can't read letters from government officials or attorneys before they are delivered to you.
• In certain cases, staff must make every reasonable effort to facilitate a video call between you and a member of your family. They must do this when the Governor declares there to be a pandemic, disaster, or public health emergency. However, they do not have to do this if it would pose a danger.

You also have a right to choose an essential support person. This person can visit you outside of regular visiting hours. An essential support person:

• Assists with daily living activities, and
• Provides support, such as:
  • Physical,
  • Emotional,
  • Mental, and
  • Social support. 

Working for the facility

The nursing home cannot require you to perform work.

Abuse and [no-lexicon]Neglect[/no-lexicon]

You are entitled to be free from abuse and neglect. The facility head must report abuse or neglect to your guardian or family. They should also report to the Illinois Department of Public Health.

Privacy

Nursing home personnel must knock before entering your room. The only exception is in the event of an emergency.You have the right to privacy in your medical and personal care program. Your case discussion, consultation, exam, and treatment must be confidential. Only those directly involved in your care should be present during your treatment. Others may only be present if you consent.

Electronic Monitoring

You may place an electronic monitoring device in your room. You must have the written consent of your roommates. Also, you must provide notice to the facility. You must then pay all costs linked with the purchase, installation and upkeep of the device. Any video or audio recording created by the device is private. This means that the nursing home can't access it without your written permission.

Resident ID wristlet

You are not required to have an ID band unless ordered by a physician. They must document in your record that it is necessary.

Physical restraints

A restraint may be used only with your informed consent and only if it is the least restrictive means necessary. A restraint must be ordered by a physician. They must document in your record that it is necessary. It may be used only after less restrictive measures have failed.​

• A physical restraint is anything attached or adjacent to a resident’s body. It cannot be removed easily and restricts freedom of movement. Any drug used for discipline or convenience is considered a restraint. By law, devices used for positioning such as bed rails and gait belts are not restraints.
• If you need emergency care, restraints may be used briefly for medical treatment. An exception is if you have told the facility you are refusing the treatment in question.
• A restraint may be applied only by a person trained in the application of the particular type of restraint.
• Whenever a nursing home uses a restraint, they must advise you of your right to have a person or group notified. For example, you may notify the Illinois Guardianship and Advocacy Commission (IGAC).But, they must be notified within 24 hours. If IGAC is notified, it will contact you to determine if the restraint is necessary.
• Restraints or confinements cannot be used for the purpose of punishment. They also cannot be used for the ease of the facility personnel.

Basic Human Needs

Under the Nursing Home Care Act, you have the right to be treated with courtesy and respect by the employees of your nursing home. You are entitled to your basic human needs to be accommodated in a timely manner, including:

• Water
• Food
• Medication
• Toileting
• Personal Hygiene

Financial Rights

Spousal impoverishment

The nursing home must tell you and your spouse about spousal impoverishment rights when you are admitted. Under spousal impoverishment, Medicaid will cover the nursing home expenses of one spouse. It will also allow a spouse living in the community to keep $2,739 in monthly income and $109,560 in assets (besides certain non-eligible assets such as a home). See Nursing Home Financing for further explanation.

Managing your finances

You must be allowed to manage your own financial affairs.

Nursing home accounts

You may allow the nursing home to hold your funds for safekeeping and managing. They must keep your money in an account separate from the facility's funds. Also, the account must be interest bearing for all amounts over $100. You must be provided: 

• Access to a written record of all financial transactions involving your money; 
• A quarterly itemized statement of all financial transactions; 
• Be allowed to have the funds returned to you upon your written request.

Property Rights

Personal property

You must be permitted to use your personal property and wear your own clothing. An exception is when your doctor deems it medically improper and documents it in your clinical record. If the nursing home gives you clothing,it must fit properly.

Storage

The nursing home must provide adequate storage space for your personal property. It should also provide a means of safeguarding your valuables in your room. The facility must try to prevent loss and theft of your property.

Way to do this include: 

• Monitoring, 
• Labeling property, and 
• Conducting frequent property inventories. 

The facility must promptly investigate all theft complaints.

Medical Rights

Personal physician

You have the right to retain the services of your own personal physician.

Screening prior to admission

You must be screened before entering a facility to determine the need for nursing care services. This allows for specific advice about what care and services you need to receive to enable your highest level of independent functioning.

Information and planning

You have the right to get information from your doctor about your medical diagnosis, treatment, and prognosis. You must be allowed to take part in your care planning and medical treatment to the extent that your condition permits.

Experimental research

You may not be subjected to experimental research or treatment without written consent.

Medical treatment

All medical treatment and procedures shall be administered as ordered by a physician. All new physician orders shall be reviewed by the nursing home's nurse within 24 hours after being issued. All physician's orders and plans of treatment must be signed by the physician. A mere stamp signature with the physician’s initials is insufficient.

No unnecessary drugs

You must not be given unnecessary drugs by the facility. Unnecessary drugs include those that are:

• excessive (dose or duration), 
• duplicative 
• given without adequate indications for use, 
• given without adequate monitoring, 
• given despite adverse results that indicate they should be reduced or discontinued, or
• antidepressants, anti-anxiety medication, stimulants, antipsychotics, and mood stabilizers that have not been prescribed or would not be beneficial to the patient.

Refusing medical treatment

You may refuse medical treatment unless it's documented by a physician in your clinical record that your refusal would be harmful to the health and safety of others.

Access to medical records

You have the right to inspect and copy all your records concerning your care which are kept by the facility. But you can be charged a reasonable fee for copying.

Do-Not-Resuscitate orders

The facility must have a policy for the format, method of documentation and duration of physician orders limiting resuscitation.These are commonly known as "Do-Not-Resuscitate" orders. Nursing homes must honor the Department of Public Health Uniform Practitioner Forms for Life Sustaining Treatment.

Vaccinations

The nursing home must offer you yearly influenza and pneumococcal vaccinations. An exception is if there is a medical reason not to.You have a right to refuse either or both vaccines.

Legal Rights

Information about health care surrogates

If you do not have a power of attorney or guardian, you must be provided written information about your right to name a health care surrogate. Your health care surrogate should be consulted if you are unable to make healthcare decisions for yourself. This information must be provided to you within 30 days of your being admitted to the facility.

Discharge at your request

The facility must transfer or discharge you at your request or at the request of your guardian.

Involuntary discharge or transfer

You have a right to remain in the nursing home unless the facility can prove that a transfer or discharge is necessary for one of the specific reasons set out by statute. For more on involuntary discharge and the reasons you can be transferred or discharged against your will, see “Your right to stay in your nursing home."

Written contract

You must be provided with a written nursing home contract prior to admission which must specify:

• The terms of the contract,
• The services covered under the contract and related charges,
• Supplemental services that may be provided upon request and related charges,
• The persons or entities liable for payments,
• The deposit paid, and
• The rights, duties, and obligations of the resident.

Hospitalizations

If you are hospitalized and discharged within 10 days, the nursing home should allow you back to the next available bed.

Mental Health Rights

Screening prior to admission

If you have a serious mental illness, the screening prior to admission must be performed by:

• a psychiatrist, 
• a psychologist, 
• a registered nurse certified in psychiatric nursing, 
• a licensed clinical counselor, or 
• a licensed clinical social worker.

It shall include your current need for treatment. It must also include whether there is a community-based housing option for you.

Continued mental health screenings

If you are admitted to a facility with a diagnosis of serious mental illness, you must be re-screened after 90 days. This screening must reoccur after 6 months. After the first year, they must then screen you yearly. This is to assess your continuing need for the facility.

Psychotropic medication

Except in emergencies, psychotropic medication may not be prescribed or the dosage changed without your informed consent. In some situations informed consent is not required for a dosage change. The facility must still inform you or the person making decisions for you of the change. Psychotropic medication is used for:

• Antipsychotic, 
• Antidepressant, 
• Antimanic, or 
• Anti-anxiety behavior modification.

[no-lexicon]Complaint[/no-lexicon] and Assistance Rights

Ombudsmen

The nursing home must provide the address and phone number of the Office of the Long Term Care Ombudsman. This information must be in an easy-to-read format and accessible to both visitors and residents. The ombudsmen are advocates for nursing home residents. They provide information regarding: 

• Resident rights, 
• Options, 
• Supports, and 
• Available services. 

Ombudsmen have a duty to investigate and resolve resident complaints.

Complaints

You have the right to file complaints with: 

• The facility administrator, 
• The Long-Term Care Facility Advisory Board, 
• The facilities advisory council, and 
• State agencies. 

The facility is not allowed to retaliate against you for making any complaints. They must give you the contact information of the appropriate state government office where you may file your complaint.

Residents’ Council

Each facility must have a residents' advisory council. The council consists of at least five residents or reps. No employee of the facility may be a member of the council. Facility staff does help host the council. The council must meet and its purpose is:

• Getting and giving information to residents;
• Making suggestions to the facility about programming and improvements;
• Finding and recommending solutions to facility problems; and
• Presenting resident complaints to the Illinois Department of Public Health or to any other person it considers appropriate.

The Federal Nursing Home Reform Act gives you the following additional rights:

Determining Eligibility for Medicare Reimbursement

You can insist that the nursing home bill Medicare. This is true even when the nursing home finds you need custodial care only. The nursing home does not decide whether your condition qualifies for Medicare repayment.

Continued Stay in Medicare-Certified Bed

You can refuse a transfer out of a Medicare-certified bed after Medicare services have ended. You could owe the facility money if you receive Medicaid and the bed is not in a Medicaid-certified section.

Readmission from the Hospital

If you must leave the nursing home to be hospitalized, you have the right to be re-admitted to the next available bed. It does not matter how long you were at the hospital.

Care Planning

You and your family have the right to participate in creating your care plan. The nursing home staff is required to schedule care plan meetings when your family is able to attend.

Honoring Resident Preferences

The nursing home must make reasonable adjustments to honor your needs and preferences. You have the right to choose activities, schedules, and health care consistent with your interests and with your care plan. The nursing home cannot force you to wake up at 6AM just because it suits its schedule.

Providing Necessary Services

The nursing home must provide the necessary care that you need to reach or maintain the highest practicable level of physical, mental, and psychosocial well-being.

Use of Feeding Tubes

The nursing home cannot compel you to use a feeding tube, except as a last resort. The nursing home must help you to eat, as needed.

The nursing home may:

• Prompt you to eat,
• Provide therapy to improve swallowing skills,
• Provide assistive devices, or
• Feed you by hand.

Payment

If your care is covered, the nursing home must accept payment from Medicare and Medicaid as payment in full. The resident’s financial obligations are limited to deductibles and co-payments.

Withdrawal from Medicaid program

If a nursing home withdraws from the Medicaid program it can't discharge any current residents who are receiving Medicaid.

Reporting Crime

All reasonable suspicions of crimes against residents must be reported by:

• Nursing home owners,
• Supervisors,
• Employees, and
• Agents

The reports are made to the Illinois Department of Public Health and law enforcement.

Notice of room changes

Nursing homes are required to give you notice before they change your room or roommate.