Understanding the Residents’ Bill of Rights in Long-Term Care Facilities
When a loved one moves into a nursing home or assisted living community, families trust that they will receive safe, respectful, and compassionate care. The Residents' Bill of Rights exists to protect that trust.
Mandated by the federal Nursing Home Reform Act of 1987, the Bill of Rights for nursing home residents establishes clear legal protections for individuals living in long-term care facilities. These rights are designed to ensure dignity, safety, autonomy, and accountability in nursing homes and similar settings.
Understanding these protections is essential for residents, families, and caregivers alike—especially when concerns about neglect or abuse arise.
What Is the Residents' Bill of Rights?
The Residents’ Bill of Rights is a set of federally protected standards that nursing homes must follow if they participate in Medicare or Medicaid. Many states, including California, have additional laws that expand and reinforce these protections. In addition, federal residents rights requirements establish and enforce legal protections and standards that facilities must meet to ensure residents' dignity, autonomy, and quality of care.
At its core, the Bill of Rights for nursing home residents ensures that individuals living in long-term care facilities are treated as people first—not patients second. It affirms their right to dignity, independence, and meaningful participation in decisions that affect their lives.
Nursing home facilities are required to adopt and make public a statement of the rights and responsibilities of the residents.
Core Protections Under the Residents’ Bill of Rights
The Residents’ Bill of Rights covers several essential areas that directly impact daily life and medical care in long-term care facilities. The 1987 Nursing Home Reform Law requires each nursing home to care for its residents in a manner that promotes and enhances the quality of life of each resident.
Nursing homes must provide a written statement of the services provided and the charges for these services upon admission.
1. Right to Dignity and Quality of Life
Residents have the right to:
Be treated with consideration, respect, and personal dignity
Live in a clean, safe, and comfortable environment
Participate in meaningful activities
Maintain their individuality and personal identity
Long-term care facilities must promote a high quality of life—not merely provide basic medical supervision. Nursing homes are required to provide services and activities to maintain the highest practicable physical, mental, and psychosocial well-being of each resident, ensuring that care plans address not only physical health but also psychosocial well being and quality of life.
2. Privacy and Confidentiality
Under the Residents’ Bill of Rights, residents are entitled to privacy in:
Personal and medical care
Visits with family and friends
Telephone and electronic communications
Personal and medical records, and financial records
Residents also have the right to send and receive mail promptly and unopened, unless they request that someone open and read their mail.
In California, privacy protections also extend to Residential Care Facilities for the Elderly (RCFEs), ensuring access to personal communications and confidentiality of records.
3. Informed Consent and Participation in Care Planning
Residents have the right to:
Be fully informed about their medical condition
Receive information in a language they understand
Participate in developing and modifying their care plan
Be notified of changes in their health status
Consult with their attending physician regarding medical treatment and care decisions
Residents are encouraged to participate in developing their own care plans to ensure care is tailored to their preferences.
This aspect of the Bill of Rights for nursing home residents ensures that medical decisions, including those related to medical treatment, are not made without the resident’s knowledge or input. Care plans should be based on evidence-based practices, and experimental research may inform effective treatment methods within facility policies.
4. Self-Determination and Personal Choice
The Residents’ Bill of Rights protects a resident’s independence by allowing them to:
Choose their physician
Decide what to wear
Determine daily schedules
Make personal lifestyle choices
Wear their own personal clothing and manage their personal property
Manage their own finances and financial affairs, including personal needs funds, unless they have delegated that authority to the facility
Participate in community activities and religious services of their choosing
Residents also have the right to manage their own personal needs funds unless such authority has been delegated to another.
Even within a structured care environment, residents retain the right to make decisions about their own lives.
5. Freedom from Abuse, Neglect, and Unnecessary Restraints
One of the most critical protections under the Residents’ Bill of Rights is the right to be free from:
Physical abuse
Emotional or psychological abuse
Sexual abuse
Financial exploitation
Neglect
Physical or chemical restraints used for staff convenience
Mental and physical abuse
Chemical and physical restraints
Physical restraints
Corporal punishment
Involuntary seclusion
Residents have the right to be free from mental and physical abuse, neglect, and exploitation.
Restraints may only be used when medically necessary and properly authorized. Corporal punishment and involuntary seclusion are strictly prohibited. Any use of force, intimidation, or improper medication for control purposes violates federal law.
6. Right to Voice Grievances Without Retaliation
Residents may:
File complaints
Recommend changes in policies or services
Report concerns about staff
Contact outside agencies
Present grievances to facility staff or outside agencies without fear of retaliation
Residents also have the right to receive a reasonable response to their requests from the facility administrator and staff.
Facilities are legally prohibited from retaliating against residents who speak up. The right to voice grievances is fundamental to accountability within long-term care settings.
7. Medical Care and the Right to Refuse Treatment
The Bill of Rights for nursing home residents guarantees:
Access to adequate and appropriate medical care
Access to a comprehensive medical care program
The ability to refuse medication or treatment
The right to review medical records
This protection reinforces the principle that residents maintain control over their bodies and healthcare decisions. Federal law requires nursing homes to uphold residents' rights, including informing each resident of his or her rights. Residents also have the right to manage their own personal funds unless they have delegated that authority to the facility.
Transfer and Discharge Protections
Residents cannot be arbitrarily transferred or discharged from a facility. Federal law prevents nursing homes from discharging or transferring a resident except for specific reasons. Residents have the right to not be transferred or discharged from a facility except for medical reasons or nonpayment for the stay.
In most cases, nursing homes must provide a 30-day written notice before transfer or discharge, except in emergencies. Residents and their legal representative or resident's family must be notified of the reasons for transfer or discharge, including any related charges. Residents also have the right to appeal a facility's attempt to transfer or discharge them.
This safeguard prevents facilities from discharging residents simply because they complain or require more care.
Advocacy and Oversight
Long-Term Care Ombudsman
The ombudsman program serves as an independent advocate for residents. It:
Investigates complaints
Mediates disputes
Educates families about resident rights
Helps resolve facility-related issues
Residents and families can contact their local ombudsman for assistance when rights under the Residents’ Bill of Rights may be violated.
Resident Councils
Residents also have the right to organize and participate in a resident council. A resident council provides a structured forum for raising concerns, facilitating communication between residents and management, advocating for residents' rights, and ensuring residents' concerns are addressed. It allows residents to organize, voice issues, and participate in decision-making affecting their living environment.
Residents' Rights in Assisted Living and Beyond
While the federal Residents’ Bill of Rights primarily applies to nursing homes receiving Medicare or Medicaid funding, California law extends similar protections to assisted living communities and Residential Care Facilities for the Elderly (RCFEs).
Residents also have the right to request to stay in the same facility as their spouse or loved one, when possible, to promote comfort and emotional well-being. Additionally, residents have the right to manage their own financial affairs unless other legal arrangements have been implemented.
It is important to distinguish these rights from general tenant rights in rental housing. Although tenants have protections such as 24-hour notice before entry and fair treatment under housing laws, the Bill of Rights for nursing home residents goes significantly further by safeguarding medical autonomy, protection from abuse, and healthcare participation.
When the Residents' Bill of Rights Is Violated
Unfortunately, violations of the Residents’ Bill of Rights still occur. Warning signs may include:
Unexplained injuries
Sudden behavioral changes
Poor hygiene or malnutrition
Medication errors
Isolation from family
Improper use of restraints
Family members should be vigilant for these warning signs and advocate for their loved ones.
When these rights are ignored, the consequences can be devastating for vulnerable seniors and their families.
How Peck Law Corporation Protects Nursing Home Residents in Southern California
At Peck Law Corporation, we understand how deeply families rely on long-term care facilities to honor the Residents’ Bill of Rights. When facilities fail to uphold these legal protections, we step in.
Based in Simi Valley, our firm is experienced in representing victims of nursing home abuse and neglect throughout Southern California. As elder abuse lawyers who focus specifically on nursing home abuse cases, we know how to investigate violations involving neglect, improper restraints, medication errors, physical abuse, and other breaches of these laws. Facilities are legally required to perform services that meet care and safety standards, and we hold them accountable when they do not.
We work to hold facilities accountable and pursue justice for residents whose dignity, safety, and legal protections have been compromised. Protecting the rights guaranteed under the Bill of Rights for nursing home residents is central to the work we do every day.
Contact a Southern California Nursing Home Abuse Lawyer Today
If you believe a nursing home or long-term care facility has violated your loved one’s Residents' Bill of Rights, you do not have to face the situation alone.
Peck Law Corporation is here to help families across Southern California understand their legal options and take decisive action when abuse or neglect occurs.
Contact us today to schedule a legal consultation. Let us help you protect your loved one’s rights, dignity, and safety—and ensure that long-term care facilities are held accountable under the law.
Frequently Asked Questions
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The Bill of Rights for nursing home residents protects a resident’s right to dignity, privacy, informed consent, self-determination, and freedom from abuse or neglect. It also guarantees the right to participate in care planning and to voice grievances without retaliation. These protections are legally enforceable under federal and state law.
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While the federal Residents’ Bill of Rights primarily applies to nursing homes receiving Medicare or Medicaid funding, many states, including California, extend similar protections to assisted living facilities and Residential Care Facilities for the Elderly (RCFEs). State laws often provide additional safeguards regarding privacy, communication, and personal autonomy. It is important to review state-specific regulations for full details.
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The Residents' Bill of Rights is enforced through federal and state regulatory agencies, including state health departments. Long-Term Care Ombudsman programs also advocate for residents and investigate complaints. In cases involving serious harm, legal action may be pursued to hold facilities accountable.
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You should contact a nursing home abuse lawyer if you notice signs of neglect, unexplained injuries, improper restraints, or violations of the Bill of Rights for nursing home residents. An experienced attorney can evaluate the situation, investigate potential abuse, and explain your legal options. Early legal guidance can help protect your loved one’s safety and rights.