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Essential Caregivers and Residents Rights

Essential Caregivers and Residents Rights

October is nursing home resident rights month. Residents in long term care retain all of the same rights as individuals residing in the community.

In 1987 Congress enacted the Nursing Home Reform Act that requires nursing homes that accept Medicare or Medicaid to comply with certain minimum quality of care rules. The Nursing Home Reform Act specifically states that nursing homes “must provide services and activities to attain, or maintain, the highest practicable physical, mental, and psychosocial well-being of each resident in accordance with a written plan of care.”

COVID has made it more challenging to exercise these rights freely in the past year and a half. Families, friends and advocates were all barred from entering long term care facilities for a time in 2020.

As of October 1st all healthcare workers who work for an entity that is overseen by the Rhode Island Department of Health must be fully vaccinated against COVID. There has been a lot of media coverage on how this may impact the ability of facilities (and homecare agencies) to meet the needs of their residents. Family members often supplement the care that the long-term care facility provides. It is time that family and friends visit their loved ones frequently to ensure they receive the care that they desire. Perhaps, it’s time to be named as an essential caregiver.

Earlier this year, the Rhode Island General Assembly passed H5543 amending chapter 23-17.5 of the General Laws entitled the ”Rights of Nursing Home Patients” to include the right of long term care residents to name an essential caregiver for themselves during a declaration of disaster emergency. An essential caregiver may have regular and sustained in-person visitation and physical access to a resident of the nursing home or long-term care facility.

An essential caregiver has to meet certain qualifications in order to go into a long-term care facility to provide in-person physical or emotional support to a resident. The essential caregiver will have certain safety measures that they need to comply with such as travel restrictions, enhanced COVID testing, and to wear necessary personal protective equipment to protect the health and safety of the residents of the facility. A facility can require the essential caregiver to provide the personal protective equipment themselves, or assume the cost of the personal protective equipment provided by the facility.

Although there are many safety precautions for the residents of the long-term care facility, and the essential caregivers, which could limit the nature and extent of an essential caregivers’ visit, they can’t be totally excluded. The requirements are directly linked to a declaration of disaster emergency. In addition, the requirements cannot be so burdensome and onerous as to substantially prevent an essential caregiver from being able to physically or emotionally support a resident of the nursing home or long-term care facility in person.

A nursing home or long-term care facility may suspend access to the nursing home or
long-term care facility for an essential caregiver who violates the rules and regulations. The resident should be asked who they would like to replace the individual who was suspended.

If a facility must enter a lock-down phase for 30 days, or more, for the purpose of establishing safety measures for residents of the long-term care facility, and the essential caregivers, a plan must be developed to include how to replace an essential caregiver due to necessary circumstances, including illness or death of the essential caregiver.

A year ago, healthcare workers were our heroes. They showed up to care for the vulnerable, the sick, and the dying. It’s our time to show up to help them help our loved ones.

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