                                 CODE OF VIRGINIA

ENUMERATION; POSTING OF POLICIES; STAFF TRAINING; RESPONSIBILITIES DEVOLVING ON
GUARDIANS, ETC.; EXCEPTIONS; CERTIFICATION OF COMPLIANCE (§ 32.1-138)

A. The governing body of a nursing home facility required to be licensed under
the provisions of Article 1 (§ 32.1-123 et seq.) of this chapter, through the
administrator of such facility, shall cause to be promulgated policies and
procedures to ensure that, at the minimum, each patient admitted to such
facility:

   1. Is fully informed, as evidenced by the patient&#8217;s written
   acknowledgment, prior to or at the time of admission and during his stay, of
   his rights and of all rules and regulations governing patient conduct and
   responsibilities;

   2. Is fully informed, as evidenced by the patient&#8217;s written
   acknowledgment, prior to or at the time of admission and during his stay, of
   services available in the facility, the terms of such services, and related
   charges, including any charges for services not covered under Titles XVIII or
   XIX of the United States Social Security Act or not covered by the
   facility&#8217;s basic per diem rate;

   3. Is fully informed in summary form of the findings concerning the facility
   in federal Centers for Medicare &amp; Medicaid Services surveys and
   investigations, if any;

   4. Is fully informed by a physician, a physician assistant, or an advanced
   practice registered nurse of his medical condition unless medically
   contraindicated as documented by a physician, a physician assistant, or an
   advanced practice registered nurse in his medical record and is afforded the
   opportunity to participate in the planning of his medical treatment and to
   refuse to participate in experimental research;

   5. Is transferred or discharged only for medical reasons, or for his welfare
   or that of other patients, or for nonpayment for his stay except as prohibited
   by Titles XVIII or XIX of the United States Social Security Act, and is given
   reasonable advance notice as provided in &#xA7; 32.1-138.1 to ensure orderly
   transfer or discharge, and such actions are documented in his medical record;

   6. Is encouraged and assisted, throughout the period of his stay, to exercise
   his rights as a patient and as a citizen and to this end may voice grievances
   and recommend changes in policies and services to facility staff and to
   outside representatives of his choice, free from restraint, interference,
   coercion, discrimination, or reprisal;

   7. May manage his personal financial affairs, or may have access to records of
   financial transactions made on his behalf at least once a month and is given
   at least a quarterly accounting of financial transactions made on his behalf
   should the facility accept his written delegation of this responsibility to
   the facility for any period of time in conformance with state law;

   8. Is free from mental and physical abuse and free from chemical and, except
   in emergencies, physical restraints except as authorized in writing by a
   physician for a specified and limited period of time or when necessary to
   protect the patient from injury to himself or to others;

   9. Is assured confidential treatment of his personal and medical records and
   may approve or refuse their release to any individual outside the facility,
   except in case of his transfer to another health care institution or as
   required by law or third-party payment contract;

   10. Is treated with consideration, respect, and full recognition of his
   dignity and individuality, including privacy in treatment and in care for his
   personal needs;

   11. Is not required to perform services for the facility that are not included
   for therapeutic purposes in his plan of care;

   12. May associate and communicate privately with persons of his choice and
   send and receive his personal mail unopened, unless medically contraindicated
   as documented by his physician in his medical record;

   13. May meet with and participate in activities of social, religious and
   community groups at his discretion, unless medically contraindicated as
   documented by his physician, physician assistant, or advanced practice
   registered nurse in his medical record;

   14. May retain and use his personal clothing and possessions as space permits
   unless to do so would infringe upon rights of other patients and unless
   medically contraindicated as documented by his physician, physician assistant,
   or advanced practice registered nurse in his medical record;

   15. If married, is assured privacy for visits by his or her spouse and if both
   are inpatients in the facility, is permitted to share a room with such spouse
   unless medically contraindicated as documented by the attending physician,
   physician assistant, or advanced practice registered nurse in the medical
   record; and

   16. Is fully informed, as evidenced by the written acknowledgment of the
   resident or his legal representative, prior to or at the time of admission and
   during his stay, that he should exercise whatever due diligence he deems
   necessary with respect to information on any sexual offenders registered
   pursuant to Chapter 9 (&#xA7; 9.1-900 et seq.) of Title 9.1, including how to
   obtain such information. Upon request, the nursing home facility shall assist
   the resident, prospective resident, or the legal representative of the
   resident or prospective resident in accessing this information and provide the
   resident, prospective resident, or the legal representative of the resident or
   prospective resident with printed copies of the requested information.

B. All established policies and procedures regarding the rights and
responsibilities of patients shall be printed in at least 12-point type and
posted conspicuously in a public place in all nursing home facilities required
to be licensed under the provisions of Article 1 (&#xA7; 32.1-123 et seq.) of
this chapter. These policies and procedures shall include the name and telephone
number of the complaint coordinator in the Division of Licensure and
Certification of the Virginia Department of Health, the Adult Protective
Services&#8217; toll-free telephone number, as well as the toll-free telephone
number for the Virginia Long-Term Care Ombudsman Program and any substate
ombudsman program serving the area. Copies of such policies and procedures shall
be given to patients upon admittance to the facility and made available to
patients currently in residence, to any guardians, responsible party as defined
in regulation, next of kin, or sponsoring agency or agencies, and to the public.

C. The provisions of this section shall not be construed to restrict any right
that any patient in residence has under law.

D. Each facility shall provide appropriate staff training to implement each
patient&#8217;s rights included in subsection A hereof.

E. All rights and responsibilities specified in subsection A hereof and &#xA7;
32.1-138.1 as they pertain to (i) a patient adjudicated incapacitated in
accordance with state law, (ii) a patient who is found, by his physician, to be
medically incapable of understanding these rights, or (iii) a patient who is
unable to communicate with others shall devolve to such patient&#8217;s
guardian, responsible party as defined in regulation, next of kin, sponsoring
agency or agencies, or representative payee, except when the facility itself is
representative payee, selected pursuant to section 205(j) of Title II of the
United States Social Security Act. The persons to whom such rights and
responsibilities have devolved shall be deemed to have legal authority to act on
the patient&#8217;s behalf with respect to the matters specified in this
section.

F. Nothing in this section shall be construed to prescribe, regulate, or control
the remedial care and treatment or nursing service provided to any patient in a
nursing institution to which the provisions of &#xA7; 32.1-128 are applicable.

G. It shall be the responsibility of the Commissioner to insure that the
provisions of this section and the provisions of &#xA7; 32.1-138.1 are observed
and implemented by nursing home facilities. Each nursing home facility to which
this section and &#xA7; 32.1-138.1 are applicable shall certify to the
Commissioner that it is in compliance with the provisions of this section and
the provisions of &#xA7; 32.1-138.1 as a condition to the issuance or renewal of
the license required by Article 1 (&#xA7; 32.1-123 et seq.) of this chapter.

HISTORY: Code 1950, § 32-296.1; 1976, c. 349; 1979, c. 711; 1987, c. 221; 1997,
c. 801; 1999, c. 783; 2000, c. 177; 2004, c. 855; 2006, c. 396; 2007, cc. 120,
163; 2010, c. 57; 2023, c. 183.