Every LTC facility must protect and promote the rights of each resident. The facility must provide professional care and support services that meet the individual's medical and personal care needs.
LTC facilities must give each resident an Admissions Notice Packet (MA 401) and review the contents with the individual or with his or her representative.
The MA 401 has four parts:
A notice of patients’ rights
Information about Medical Assistance
Information about protecting the resources and income for the spouse
The Resource Assessment Form (PA 1572), which must be completed for married couples when one of the spouses is admitted to an LTC facility for at least 30 days
The LTC facility must keep a signed copy of the first page of the MA 401 to verify that the resident received the packet.
When an LTC resident is ready to be discharged or transferred, the LTC facility must give written notice to the resident and a relative (or other responsible person named by the resident) 30 days in advance. This does not apply in emergency situations, such as cases of urgent need for medical or other emergency services that the LTC facility cannot provide. See Chapter 423, Residence, for information about discharges and transfers. 42 CFR § 483.10
A resident who is on hospital or therapeutic leave has the right to return. If the LTC facility is receiving payment from the Department for "reserved bed days”, the facility must hold the bed that the resident occupied before the absence. If the facility is not receiving payment, it must give the resident the first available bed in a semiprivate room. See Long Term Care Handbook Chapter 438, Benefits and Billing for more information about reserved bed days.
If an LTC facility may be violating the rights of a resident or improperly applying those rights, it can be reported by contacting one of the following:
For quality of care issues: the Department of Health at 1-800-254-5164
For payment, admission, or discharge issues: the DHS, Office of Long Term Living, Bureau of Provider Support, 1-717-772-2570
Any individual who has a complaint about the services provided by an LTC facility must contact one of the following:
The Long Term Care Ombudsman Program in the Department of Aging through the local AAA
The Office of State Long Term Care Ombudsman, 555 Walnut Street, 5th Floor, Harrisburg, PA 17101-1919 (717) 783-7247
The local ombudsman is responsible for investigating and resolving complaints related to the health, safety, or rights of older persons who reside in LTC facilities.
Residents who receive services in an LTC facility are allowed to keep a portion of their income for personal care items. A monthly Personal Needs Allowance (PNA) may be used to purchase personal items and services not covered by Medical Assistance. An LTC facility may not require residents to deposit personal funds with the facility. If the resident does deposit personal funds with the facility, the facility must have written authorization from the resident. The facility must follow these rules:
If the amount is over $50, the facility must deposit the resident’s money in an interest-earning account. Funds of less than $50 may be placed in an interest-earning account, a non-interest-earning account, or a petty cash fund.
The facility must keep the funds separate from its own operating accounts.
Interest must be credited to the resident.
The facility must maintain a written record of all financial transactions and provide it to the resident.
The facility must notify the resident when the account balance is within $200 of the MA LTC resource limit.
The facility must purchase a surety bond or provide self-insurance on money deposited with the facility.
The facility must not use personal funds for an item covered by MA or Medicare.
If an item purchased for a patient’s care is not an allowable medical expense, the facility must notify the person before taking the cost of the item from the person’s personal funds.
Any resident’s income that is not used to pay for the person’s care in the month it is received will count as a resource in the following month. Resources may accumulate when the resident receives Veterans Aid and Attendance, is hospitalized, does not use his or her PNA, resides in an ICF/ID or ICF/ORC, or has third-party medical coverage.
An LTC facility must provide a final accounting of funds remaining in a resident’s account within 60 days after a representative responsible for handling the resident’s estate is appointed. The funds must be transferred to the resident’s estate.
55 Pa. Code § 1187.78 (g) 20 Pa. C.S.A. § 3101 (c)
Updated September 21, 2020, Replacing March 12, 2012