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What Are My Rights in a Nursing Home or Assisted Living Facility?

Read this in: Español

Author: Emily Hardy

If you or a loved one lives in a nursing home or assisted living facility (ALF), you have legal rights. Those rights protect your dignity, your choices, and your safety.

Important: Nursing homes and assisted living facilities follow different rules. The rights, protections, and complaint processes are different.

Not sure if it's a nursing home or an assisted living facility? You can use the DSS Assisted Living Facility Search to check.

What rights do nursing home residents have? 

A federal law, called the 1987 Nursing Home Reform Act, sets basic requirements nursing homes have to follow. Nearly all nursing homes in Virginia must follow this federal law.

The federal law requires nursing homes to care for residents in a way that promotes and protects their quality of life. This includes:

  • Giving residents dignity, choice, and self-determination. This means residents keep their rights to: have visitors, manage their own finances, choose their own doctor, refuse treatment and access their medical records
  • Providing services to help each resident maintain their highest possible physical, mental, and emotional health
  • Creating a written plan of care for each resident, with that person’s participation when possible
  • Limiting the circumstances under which a resident can be discharged from a nursing home and providing discharge protections for the resident

For a detailed overview, see the Residents' Rights Fact Sheet from the Long-Term Care Ombudsman.

If your facility is one of the handful that does not follow federal law, they must follow Virginia state law and the Long-Term Care Ombudsman can help you.

What rights do assisted living facility (ALF) residents have? 

Virginia law includes a resident bill of rights for people living in assisted living facilities (ALFs).

Many of the rights discussed above also apply to ALF residents, including rights related to dignity, privacy, participation in care, and protection from abuse or neglect. Some details are different because assisted living facilities and nursing homes provide different types of care and follow different rules.

For example, the reasons an ALF can discharge a resident are different from the reasons allowed in a nursing home. But both settings limit when a resident can be forced to leave and provide protections during the discharge process.

The long-term care ombudsman program created a short guide for residents and families and you can also refer to the full law: Virginia ALF Resident Rights (§ 63.2-1808).

Are nursing homes allowed to use medication or physical constraints to control behavior?

No. Nursing homes and assisted living facilities cannot use medication just to control a resident’s behavior or make them easier to manage. When medication is used for that purpose instead of to treat a medical condition, it is called a “chemical restraint.” 

Medications should only be used as part of appropriate medical treatment tailored to the resident’s needs. A doctor adjusting medication doses for legitimate medical reasons or at the resident’s request is not chemical restraint.

Facilities also generally cannot use physical restraints to control behavior unless there is a genuine medical or safety need.

If you believe a resident is being chemically or physically restrained improperly, you can:

  • Talk with the resident’s doctor, especially if the doctor does not work for the facility.
  • Raise your concerns directly with the facility.
  • Contact an advocate or legal resource. See the “Where can I get legal help?” section below.
  • File a complaint with the state licensing agency.
  • You may also want to file a human rights complaint. Talk to an advocate about this option.

Can a facility evict or punish someone for complaining?

No. Both nursing homes and ALFs cannot retaliate against (punish) residents or their families for filing complaints.

Nursing home discharge protections

Federal law limits when a nursing home can discharge a resident. Filing a complaint is not one of the allowed reasons.

In general, a nursing home can only discharge a resident for one of these reasons:

  1. The resident has not paid.
  2. The resident no longer needs nursing home care.
  3. The facility cannot meet the resident’s needs.
  4. The resident poses a danger to others’ safety.
  5. The resident poses a danger to others’ health.
  6. The facility is closing.

If you think a nursing home is trying to discharge you or someone you care about because they complained:

  • Do not panic.
  • Do not move out right away.
  • Contact the long-term care ombudsman as soon as possible.
  • File an appeal before the deadline if you want to stay or if you are appealing on behalf of another person who wants to stay. Talk with a lawyer or the Ombudsman about the appeal. See the “Where can I get legal help?” section below.
  • Depending on the circumstances, you may want to file a complaint with the Virginia Department of Health (other care settings may have licensing with a different state agency).

Read more on Fighting Nursing Home Evictions from Justice in Aging.

If a nursing home accepts Medicare or Medicaid for any resident, federal discharge protections apply to all residents in the facility. A small number of Virginia facilities do not participate in Medicare or Medicaid and instead follow Virginia state discharge law. The ombudsman can help you determine which rules apply to a particular facility.

Assisted living facility discharge protections

Virginia law also limits when ALFs can discharge residents. Residents generally have the right to appeal a discharge decision.

An ALF can usually discharge a resident only for reasons such as:

  • The facility cannot meet the resident’s care needs despite reasonable efforts
  • Nonpayment after an opportunity to cure the problem
  • Serious violations of the residency agreement
  • The facility is closing
  • The resident has care needs the ALF is not legally allowed to provide

Residents can appeal most discharge decisions, except when the facility is closing.

If this happens:

  • Do not panic.
  • Do not move out right away.
  • Contact the long-term care ombudsman or a lawyer right away.
  • File an appeal before the deadline if you want to stay or if you are appealing on behalf of another person who wants to stay. Talk with a lawyer or the Ombudsman about the appeal. See the “Where can I get legal help?” section below.
  • Depending on the circumstances, you may want to file a complaint with the Department of Social Services.

What about home care, hospice, and other places? 

People receiving home care, hospice, or adult day care services also have legal rights and protections, but the rules vary depending on the type of service.

The long-term care ombudsman also helps people receiving some home- and community-based services.

When should I contact the Ombudsman? 

Contact the Ombudsman if:

  • You have a problem with the quality of care a resident is receiving
  • You believe a resident's rights are being violated
  • You need help resolving a conflict with a facility
  • A resident is being discharged and you want help appealing
  • You need information about choosing a care facility

How do I find my local Ombudsman? 

Visit the Virginia Department for Aging and Rehabilitative Services to find your local Ombudsman.

You can also contact the State Ombudsman directly through the same link.

Remember: The Ombudsman is free. You do not need a lawyer to use this service. If you are unsure whether to call APS or the Ombudsman, you can always call both.

Where can I get legal help?