(1) The department shall
require all skilled nursing facilities and intermediate care facilities to adopt and
make public a statement of the rights and responsibilities of the patients who are
receiving treatment in such facilities and to treat their patients in accordance with
the provisions of said statement. The statement shall ensure each patient the
following:
(a) The right to civil and religious liberties, including knowledge of available
choices and the right to independent personal decisions, which will not be infringed
upon, and the right to encouragement and assistance from the staff of the facility in
the fullest possible exercise of these rights;
(b) The right to have private and unrestricted communications with any
person of the patient's choice, except as specified in section 25-3-125 (2) and (3);
(c) The right to present grievances on behalf of himself or others to the
facility's staff or administrator, to governmental officials, or to any other person,
without fear of reprisal, and to join with other patients or individuals within or
outside of the facility to work for improvements in patient care;
(d) The right to manage his own financial affairs or to have a quarterly
accounting of any financial transactions made in his behalf, should he delegate
such responsibility to the facility for any period of time;
(e) The right to be fully informed, in writing, prior to or at the time of
admission and during his stay, of services available in the facility and of related
charges, including charges for services not covered under medicare or medicaid or
not covered by the basic per diem rate;
(f) The right to be adequately informed of his medical condition and
proposed treatment, unless otherwise indicated by his physician, and to participate
in the planning of all medical treatment, including the right to refuse medication
and treatment, unless otherwise indicated by his physician, and to know the
consequences of such actions;
(g) The right to receive adequate and appropriate health care consistent with
established and recognized practice standards within the community and with
skilled and intermediate nursing care facility rules and regulations as promulgated
by the department;
(h) The right to have privacy in treatment and in caring for personal needs,
confidentiality in the treatment of personal and medical records, and security in
storing and using personal possessions;
(i) The right to be treated courteously, fairly, and with the fullest measure of
dignity and to receive a written statement of the services provided by the facility,
including those required to be offered on an as-needed basis;
(j) The right to be free from mental and physical abuse and from physical and
chemical restraints, except those restraints initiated through the judgment of the
professional staff for a specified and limited period of time or on the written
authorization of a physician;
(k) The right to be transferred or discharged only for medical reasons or his
welfare, or that of other patients, or for nonpayment for his stay and the right to be
given reasonable advance notice of any transfer or discharge, except in the case of
an emergency as determined by the professional staff;
(l) The right to devolution of his or her rights and responsibilities upon a
sponsor, guardian, or person exercising rights contained in a designated beneficiary
agreement executed pursuant to article 22 of title 15, C.R.S., who shall see that he
or she is provided with adequate, appropriate, and respectful medical treatment
and care and all rights which he or she is capable of exercising should he or she be
determined to be incompetent pursuant to law and not be restored to legal
capacity;
(m) The right to freedom of choice in selecting a health-care facility;
(n) The right to copies of the facility's rules and regulations and an
explanation of his responsibility to obey all reasonable rules and regulations of the
facility and to respect the personal rights and private property of the other patients.
(1.5) If a facility requires a lease agreement with a provision requiring in
excess of a month-to-month tenancy and the lease agreement results in or requires
forfeiture of more than thirty days of rent if a patient moves due to a medical
condition or dies during the term of the lease agreement, then the lease agreement
shall be deemed to be against public policy and shall be void; except that inclusion
of such a provision shall not render the remainder of the contract or lease
agreement void. A contract provision or lease agreement that requires forfeiture of
rent for thirty days after the patient moves due to a medical condition or dies does
not violate this section. The provisions regarding forfeiture of rent shall appear on
the front page of the contract or lease agreement and shall be printed in no less
than twelve-point bold-faced type. The provisions shall read as follows:
This lease agreement is for a month-to-month tenancy. The lessor shall not
require the forfeiture of rent beyond a thirty-day period if the lessee moves due to
a medical condition or dies during the term of the lease.
In circumstances in which the patient moves due to a medical condition or dies
during the term of a contract or lease agreement, the facility shall return that part
of the rent paid in excess of thirty days' rent after a patient moves or dies to the
patient or the patient's estate. The facility may assess daily rental charges for any
days in which the former or deceased patient's personal possessions remain in the
patient's room after the period for which the patient has paid rent and for the usual
time to clean the room after the patient's personal possessions have been removed.
The facility shall have forty-five days after the date the patient's personal
possessions have been removed from the patient's room to reconcile the patient's
accounts and to return any moneys owed. This subsection (1.5) applies to any
facility, or a distinct part of a facility, that meets the state nursing home licensing
standards set forth in section 25-1.5-103 (1)(a)(I) and the licensing requirements
specified in section 25-3-101. For purposes of this section, daily rental charges
means an amount not to exceed one-thirtieth of thirty days' rental amount plus
reasonable expenses.
(2) Each skilled nursing facility or intermediate care facility shall provide a
copy of the statement required by subsection (1) of this section to each patient or
his guardian at or before the patient's admission to a facility and to each staff
member of a facility. Each such facility shall prepare a written plan and provide
appropriate staff training to implement the provisions of this section.
(3) Each skilled nursing facility or intermediate care facility shall prepare a
written plan and provide appropriate facilities to ensure that the rights guaranteed
by subsection (1) of this section are enforced by a grievance procedure which
contains the following procedures and rights:
(a) A resident of any facility, the residents' advisory council, or the sibling,
child, spouse, parent, or person exercising rights contained in a designated
beneficiary agreement executed pursuant to article 22 of title 15, C.R.S., of any
resident may formally complain in the manner described in this subsection (3) about
any conditions, treatment, or violations of his or her rights by the facility or its staff
or about any treatment, conditions, or violations of the rights of any other resident,
regardless of the consent of the victim of the alleged improper treatment,
condition, or violation of rights by the facility or its staff.
(b) Each facility shall designate one full-time staff member, referred to in
this subsection (3) as the designee, to receive all grievances when they are first
made.
(c) Each facility shall establish a grievance committee consisting of the chief
administrator of the facility or his designee, a resident selected by the resident
population of the facility, and a third person to be agreed upon by the administrator
and the resident representative.
(d) If anyone designated in paragraph (a) of this subsection (3) wishes to
complain about treatment, conditions, or violations of rights, he shall write or cause
to be written his grievance or shall state it orally to the designee no later than
fourteen days after the occurrence giving rise to the grievance. The designee shall
confer with persons involved in the occurrence and with any other witnesses and,
no later than three days after the grievance, give a written explanation of findings
and proposed remedies, if any, to the complainant and to the aggrieved party, if
someone other than the complainant. Where appropriate because of the mental or
physical condition of the complainant or the aggrieved party, the written
explanation shall be accompanied by an oral explanation.
(e) If the complainant or aggrieved party is dissatisfied with the findings and
remedies or the implementation thereof, he may then make the same grievance
orally or in writing, with any additional comments or information, to the grievance
committee no later than ten days after the receipt of the explanation from the
designee. Said committee shall confer with persons involved in the occurrence and
with any other witnesses and, no later than ten days after the appeal from the
designee, give a written explanation of its findings and proposed remedies, if any,
to the complainant and to the aggrieved party, if someone other than the
complainant. Where appropriate because of the mental or physical condition of the
complainant or the aggrieved party, the written explanation shall be accompanied
by an oral explanation.
(4) Each skilled nursing facility or intermediate care facility shall also
establish a residents' advisory council which shall consist of not less than five
members selected by and from the resident population of the facility. The council
shall meet at least once a month with the administrator of the facility and a
representative of the staff to make recommendations concerning policies of the
facility. The council may also present grievances to the grievance committee on
behalf of a resident.
(5) If a complainant or aggrieved party is dissatisfied with the findings and
remedies of the grievance committee or implementation thereof, except for
grievances against a physician or his prescribed treatment, he may file the same
grievance in writing with the executive director of the department. The department
shall investigate the facts and circumstances of the grievance and make findings of
fact, conclusions, and recommendations, copies of which shall be transmitted to the
complainant and the nursing home administrator. If the complainant or the nursing
home administrator is aggrieved by the findings and the recommendations of the
department, the aggrieved party may request a hearing to be conducted by the
department pursuant to section 24-4-105, C.R.S. The board shall adopt rules and
regulations to carry out the intent of this section.
(6) Implementation of this section shall be pursuant to section 25.5-6-204,
C.R.S.
(7) Nothing in this section shall apply to any nursing institution conducted by
or for the adherents of any well-recognized church or religious denomination for
the purpose of providing facilities for the care and treatment of the sick who
depend exclusively upon spiritual means through prayer for healing in the practice
of the religion of such church or denomination.
(8) (a) A patient who is eligible to receive medicaid benefits pursuant to
articles 4, 5, and 6 of title 25.5, C.R.S., and who qualifies for nursing facility care
shall have the right to select any nursing care facility recommended for
certification by the department of public health and environment under Title XIX of
the federal Social Security Act, as amended, as a provider of medicaid services
and licensed by the department pursuant to article 3 of this title where space is
available, and the department of health care policy and financing shall reimburse
the selected facility for services pursuant to section 25.5-6-204, C.R.S., unless such
nursing care facility shall have been notified by the department of health care
policy and financing that it may not qualify as a provider of medicaid services.
(b) A patient who is residing in such nursing care facility shall be assured the
resident rights which are provided by section 4211 of Title IV of the federal
Omnibus Budget Reconciliation Act of 1987, as amended, Pub.L. 100-203. Failure
to protect and promote those rights shall subject the violating facility to sanctions
imposed by the department.
(9) A patient who is eligible to receive benefits from a skilled or intermediate
nursing care facility certified by the department under Title XVIII of the federal
Social Security Act, as amended, as a provider of medicare services shall be
assured the same rights as provided in paragraph (a) of subsection (8) of this
section.