U.S. to Ask Patients’ Bill of Rights and Stricter Care at Nursing Homes

WASHINGTON — A major overhaul of federal rules for nursing homes, including a “patients’ bill of rights” and more stringent rules for round-the-clock care, will be proposed this week by the Department of Health and Human Services.

The new rules would apply to all residents of any home receiving federal funds through Medicaid or Medicare, the vast majority of nursing homes. The plan, designed to improve the quality of care for more than a million people in 16,000 facilities, also requires that nurses’ aides be given at least 80 hours of training by the home before they handle patients.

The document, which will not become final until after 90 days of public comment, also recommends requiring that trained, licensed nurses be present 24 hours a day in every nursing home.

But at the insistence of the Office of Management and Budget, it lists two less stringent alternatives to the 24-hour plan that will be considered before the HHS issues its final regulation.

The proposed regulations would also:

--Require an initial assessment of a person’s needs within 48 hours after entering a nursing home, a comprehensive one within 14 days, and a care plan developed, with rechecks every three months.

--Spell out the rights of patients in a variety of situations--in many cases for the first time--to: dignity, privacy, a clean, homelike environment, a choice of activities, substitute foods if they refuse standard fare, a personally chosen “ombudsman” who could examine their records, self-administration of drugs unless a doctor disapproves, rehabilitation and social services and protection from physical mistreatment.