Assisted Living Rule Review - 481-67.3 Tenant Rights

As you may recall, LeadingAge Iowa is bringing members an Assisted Living Rule Review monthly. For the month of February, we will review the tenant rights rules. 481-67.3 states that all tenants have the following rights:

• To be treated with consideration, respect, and full recognition of personal dignity and autonomy.
• To receive care, treatment and services which are adequate and appropriate.
• To receive respect and privacy in the tenant’s medical care program. Personal and medical records shall be confidential, and the written consent of the tenant shall be obtained for the records’ release to any individual, including family members, except as needed in case of the tenant’s transfer to a health care facility or as required by law or a third-party payment contract.
• To be free from mental and physical abuse.
• To receive from the manager and staff of the program a reasonable response to all requests.
• To associate and communicate privately and without restriction with persons and groups of the tenant’s choice, including the tenant advocate, on the tenant’s initiative or on the initiative of the persons or groups at any reasonable hour.
• To manage the tenant’s own financial affairs unless a tenant’s legal representative has been appointed for the purpose of managing the tenant’s financial affairs.
• To present grievances and recommend changes in program policies and services, personally or through other persons or in combination with others, to the program’s staff or person in charge without fear of reprisal, restraint, interference, coercion, or discrimination.
• To be free from restraints.

Tenant rights are common insufficiencies cited during recertification, compliant, and incident monitoring visits. The two that stand out as most frequently cited are the first two bullet points (or 1 and 2 in the rules).

Consideration, respect and dignity are common concerns identified when DIAL is investigating situations of potential abuse or when tenants report that staff are not kind to them.

Ensuring that care, treatment, and services are adequate and appropriate are also frequently cited insufficiencies in circumstances when staff should have assessed tenants more frequently or should have communicated with a tenant’s physician when a change of condition has been identified.

These two tenants’ rights can be reviewed to ensure compliance is maintained by reviewing tenant’s records and interviewing the tenants. During the review identify if there are instances when the tenant potentially had a change in condition and ensure that it was addressed appropriately. During interviews ask the tenants how they are treated by the staff and other tenants to ensure that they’re receiving the privacy, dignity, and respect that they deserve.