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<regulation prefix="Regulation" num=".08" citation="COMAR 10.07.09.08" title_num="10" subtitle_num="07" chapter_num="09" heading="Resident's Rights and Services.">
  <paragraph num="A.">
    <text>A nursing facility shall provide care for residents in a manner and in an environment that maintains or enhances each resident's dignity and respect, and in full recognition of the resident's individuality.</text>
  </paragraph>
  <paragraph num="B.">
    <text>A nursing facility may not interfere with a resident's exercise of rights guaranteed under the Constitution or laws of the United States and Maryland.</text>
  </paragraph>
  <paragraph num="C.">
    <text>A resident has the right to:</text>
    <paragraph num="(1)">
      <text>Reside and receive services in a nursing facility with reasonable accommodations of individual needs and preferences, except when accommodations would endanger the health or safety of the resident or other residents;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Receive treatment, care, and services that are in an environment that promotes maintenance or enhancement of each resident's quality of life;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>A dignified existence, self-determination, and communication with and access to individuals and services inside and outside the nursing facility;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Be free of interference, coercion, discrimination, or reprisal from the nursing facility when exercising the resident's rights;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Be free from:</text>
      <paragraph num="(a)">
        <text>Physical abuse;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Verbal abuse;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Sexual abuse;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Physical or chemical restraints imposed for purposes of discipline or convenience;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Mental abuse; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Involuntary seclusion;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>Choose an attending physician, if the physician agrees to abide by nursing facility policies and procedures, and the regulations in this chapter;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Choose a pharmacy to obtain medications as set forth in COMAR 10.07.02.15B(3) and D(3);</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Be fully informed in advance about care and treatment, and of proposed changes in that care or treatment;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Participate in planning care and treatment, or changes in care or treatment;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Seek advice from the resident care advisory committee concerning the options for medical care and treatment for an individual with a life-threatening condition in accordance with Health-General Article, §19-370 et seq., Annotated Code of Maryland;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Consent to or refuse treatment, including the right to accept or reject artificially administered sustenance in accordance with State law;</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Self-administer drugs if the interdisciplinary team determines that the practice is safe;</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Access the resident's records within 24 hours, excluding weekends and holidays, upon an oral or written request;</text>
    </paragraph>
    <paragraph num="(14)">
      <text>Purchase copies of all or part of the resident's records upon request by giving 2 working days advance notice to the nursing facility;</text>
    </paragraph>
    <paragraph num="(15)">
      <text>Approve or refuse the release of personal and clinical records to an individual outside the nursing facility unless:</text>
      <paragraph num="(a)">
        <text>Otherwise provided by Health-General Article, §4-301 et seq., Annotated Code of Maryland; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The release is required by law;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(16)">
      <text>Personal privacy, including:</text>
      <paragraph num="(a)">
        <text>Confidentiality of personal records; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Privacy in:</text>
        <paragraph num="(i)">
          <text>Medical treatment, and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Personal care;</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(17)">
      <text>Privacy in the resident's room, including the right to have nursing facility staff knock before entering the resident's room;</text>
    </paragraph>
    <paragraph num="(18)">
      <text>Privacy in written communication, including the right to:</text>
      <paragraph num="(a)">
        <text>Send and receive mail promptly without it being opened by anyone other than the resident, except when the resident requests assistance; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Have access to stationery, postage, and writing implements at the resident's own expense;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(19)">
      <text>Reasonable access to the private use of a telephone;</text>
    </paragraph>
    <paragraph num="(20)">
      <text>Meet or visit privately with any individual the resident chooses, subject to reasonable restrictions by the nursing facility on visiting hours and places;</text>
    </paragraph>
    <paragraph num="(21)">
      <text>Visit or meet privately with the following, to whom the nursing facility shall provide reasonable access:</text>
      <paragraph num="(a)">
        <text>A representative of the Secretary of the U.S. Department of Health and Human Services;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A representative of the Department;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The resident's personal physician;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>A representative of the State Long-Term Care Ombudsman Program;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>The agency responsible for advocacy and protection of developmentally disabled and mentally ill individuals in Maryland; or</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Any other legal representative;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(22)">
      <text>Visit privately with the resident’s spouse or domestic partner;</text>
    </paragraph>
    <paragraph num="(23)">
      <text>Consent or deny consent to all visits, and may deny or withdraw consent at any time;</text>
    </paragraph>
    <paragraph num="(24)">
      <text>Examine the results of the most recent federal and State surveys, including the annual survey and any subsequent complaint investigations, not otherwise prohibited by law, of the nursing facility and any plans of correction prompted by these surveys;</text>
    </paragraph>
    <paragraph num="(25)">
      <text>Receive notice before the resident's roommate is changed and, to the extent possible, have input into the choice of roommate;</text>
    </paragraph>
    <paragraph num="(26)">
      <text>Voice grievances, including those about treatment or care that is or fails to be furnished, and recommend changes in policies and services, to the staff or administrator of the nursing facility, the Licensing and Certification Administration, the Office on Aging, or any other person, without fear of reprisal, restraint, interference, coercion, or discrimination;</text>
    </paragraph>
    <paragraph num="(27)">
      <text>Prompt efforts by the nursing facility to resolve grievances the resident may have, including those with respect to the behavior of other residents;</text>
    </paragraph>
    <paragraph num="(28)">
      <text>Contact and receive information from agencies acting as client advocates;</text>
    </paragraph>
    <paragraph num="(29)">
      <text>Refuse to perform services for the nursing facility;</text>
    </paragraph>
    <paragraph num="(30)">
      <text>Perform services for the nursing facility if the resident chooses, only if:</text>
      <paragraph num="(a)">
        <text>The nursing facility has documented the need or desire for work in the plan of care;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The plan specifies the nature of the services to be performed and whether the services are voluntary or paid;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Compensation for paid services is at or above prevailing rates; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The resident agrees in writing to the work arrangement described in the plan of care, and the contract is part of the resident's record;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(31)">
      <text>Share a room with the resident's spouse if both spouses consent and it is not medically contraindicated; and</text>
    </paragraph>
    <paragraph num="(32)">
      <text>Participate in social, religious, and community activities if the activities do not interfere with the rights of other residents in the nursing facility.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>A resident has the right to participate or refuse to participate in experimental research. When the resident is incapable of making this decision, the resident's appropriate representative may consent for participation in therapeutic experimental research only.</text>
  </paragraph>
  <paragraph num="E.">
    <text>The resident or, when applicable, the resident's health care representative, has the right to be fully informed, in a language that the resident or representative can reasonably be expected to understand, of complete and current information about the resident's diagnosis, treatment, and prognosis, unless it would be medically inadvisable as documented by the resident's attending health care provider. If this determination has been made, the health care provider shall, upon written request:</text>
    <paragraph num="(1)">
      <text>Make a summary of the undisclosed portion of the medical record available to the resident or health care representative;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Insert a copy of the summary in the medical record of the resident;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Permit examination and copying of the medical record by another health care provider; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Inform the resident or health care representative of the resident's or health care representative's right to select another health care provider.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>Resident and Family Groups.</text>
    <paragraph num="(1)">
      <text>A resident has the right to organize and participate in resident groups in the nursing facility.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>A resident's family has the right to meet in the nursing facility with the families of other residents.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Staff or other visitors may attend meetings only at the group's invitation.</text>
    </paragraph>
  </paragraph>
</regulation>