GENERAL ASSEMBLY OF NORTH CAROLINA
1989 SESSION

CHAPTER 75
HOUSE BILL 174

AN ACT TO PROVIDE FOR NURSING HOME PATIENT'S RIGHT TO NOTIFICATION WHEN THE FACILITY'S LICENSE IS REVOKED OR MADE PROVISIONAL.

The General Assembly of North Carolina enacts:

Section 1.  G.S. 131E-117 reads as rewritten:
"§ 131E-117.  Declaration of patient's rights.
All facilities shall treat their patients in accordance with the provisions of this Part. Every patient shall have the following rights:
(1)	To be treated with consideration, respect, and full recognition of personal dignity and individuality;
(2)	To receive care, treatment and services which are adequate, appropriate, and in compliance with relevant federal and State statutes and rules;
(3)	To receive at the time of admission and during the stay, a written statement of the services provided by the facility, including those required to be offered on an as-needed basis, and of related charges. Charges for services not covered under Medicare or Medicaid shall be specified. Upon receiving this statement, the patient shall sign a written receipt which must be on file in the facility and available for inspection;
(4)	To have on file in the patient's record a written or verbal order of the attending physician containing any information as the attending physician deems appropriate or necessary, together with the proposed schedule of medical treatment. The patient shall give prior informed consent to participation in experimental research. Written evidence of compliance with this subdivision, including signed acknowledgements by the patient, shall be retained by the facility in the patient's file;
(5)	To receive respect and privacy in the patient's medical care  program. Case discussion, consultation, examination, and treatment shall remain confidential and shall be conducted discreetly. Personal and medical records shall be confidential and the written consent of the patient shall be obtained for their release to any individual, other than family members, except as needed in case of the patient's transfer to another health care institution or as required by law or third party payment contract;
(6)	To be free from mental and physical abuse and, except in emergencies, to be free from chemical and physical restraints unless authorized for a specified period of time by a physician according to clear and indicated medical need;
(7)	To receive from the administrator or staff of the facility a reasonable response to all requests;
(8)	To associate and communicate privately and without restriction with persons and groups of the patient's choice on the patient's initiative or that of the persons or groups at any reasonable hour; to send and receive mail promptly and unopened, unless the patient is unable to open and read personal mail; to have access at any reasonable hour to a telephone where the patient may speak privately; and to have access to writing instruments, stationery, and postage;
(9)	To manage the patient's financial affairs unless authority has been delegated to another pursuant to a power of attorney, or written agreement, or some other person or agency has been appointed for this purpose pursuant to law. Nothing shall prevent the patient and facility from entering a written agreement for the facility to manage the patient's financial affairs. In the event that the facility manages the patient's financial affairs, it shall have an accounting available for inspection and shall furnish the patient with a quarterly statement of the patient's account. The patient shall have reasonable access to this account at reasonable hours; the patient or facility may terminate the agreement for the facility to manage the patient's financial affairs at any time upon five days' notice.
(10)	To enjoy privacy in visits by the patient's spouse, and, if both are inpatients of the facility, they shall be afforded the opportunity where feasible to share a room;
(11)	To enjoy privacy in the patient's room;
(12)	To present grievances and recommend changes in policies and  services, personally or through other persons or in combination with others, on the patient's personal behalf or that of others to the facility's staff, the community advisory committee, the administrator, the Department, or other persons or groups without fear of reprisal, restraint, interference, coercion, or discrimination;
(13)	To not be required to perform services for the facility without personal consent and the written approval of the attending physician;
(14)	To retain, to secure storage for, and to use personal clothing and possessions, where reasonable;
(15)	To not be transferred or discharged from a facility except for medical reasons, the patient's own or other patients' welfare, nonpayment for the stay, or when the transfer or discharge is mandated under Title XVIII (Medicare) or Title XIX (Medicaid) of the Social Security Act. The patient shall be given at least five days' advance notice to ensure orderly transfer or discharge, unless the attending physician orders immediate transfer, and these actions, and the reasons for them, shall be documented in the patient's medical record.
(16)	To be notified within 10 days after the facility has been issued a provisional license because of violation of licensure regulations or received notice of revocation of license by the North Carolina Department of Human Resources and the basis on which the provisional license or notice of revocation of license was issued.  The patient's responsible family member or guardian shall also be notified."
Sec. 2.  This act is effective on October 1, 1989, and shall not apply to pending litigation.
In the General Assembly read three times and ratified this the 26th day of April, 1989.