CHAPTER 465

FORMERLY

SENATE BILL NO. 304

AS AMENDED BY SENATE AMENDMENT NO. 1 AND

HOUSE AMENDMENT NOS. 1 AND 2

AN ACT TO AMEND TITLE 16, DELAWARE CODE, RELATING TO PATIENT'S RIGHTS.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:

Section I. Amend §1121, Title 16, Delaware Code by rewording said section to read as follows:

"§1121. Patient's rights.

It is the intent of the General Assembly, and the purpose of this section, to promote the interests and well-being of the patients and residents in sanitoria, rest homes, nursing homes, boarding homes and related institutions. It is declared to be the public policy of this State that the interests of the patient shall be protected by a declaration of a patient's rights, and by requiring that all facilities treat their patients in accordance with such rights, which shall include but not be limited to the following:

(1) Every patient and resident shall have the right to receive considerate, respectful, and appropriate care, treatment and services, in compliance with relevant federal and state law and regulations, recognizing each person's basic personal and property rights which include dignity and individuality.

(0) Each patient or resident and the family of such patient or resident shall, prior to or at the time of admission, receive a written statement of the services provided by the facility including those required to be offered on an as needed' basis, and a statement of related charges for services not covered under Medicare or Medicaid, or not covered by the facility's basic per diem rate. Upon receiving such statement, the patient and the patient's representative shall sign a written receipt which must be retained by the facility in its files.

(1) After admission, each facility shall submit to the patient, resident, or legal representative, on a monthly basis, a written, itemized statement detailing in language comprehensible to the ordinary layperson the charges and expenses the patient or resident incurred during the previous month. The statement shall contain a description of specific services, equipment, and supplies received and expenses incurred for each such item. The statement shall include an explanation of any items identified by code or by initials, but shall not include nursing home based physician charges if billed separately. The facility shall make reasonable efforts to communicate the contents of the individual written statement to persons who it has reason to believe cannot read the statement.

(2) Each patient shall receive from the attending physician or the resident physician of the facility complete and current information concerning the patient's diagnosis, treatment and prognosis in terms and language the patient can reasonably be expected to understand, unless medically inadvisable. The patient or resident shall participate in the planning of the patient's or resident's medical treatment, including attendance at care plan meetings, may refuse medication or treatment, be informed of the medical consequences of all medication and treatment alternatives and shall give prior informed consent to participation in any experimental research after a complete disclosure of the goals, possible effects on the patient and whether or not the patient can expect any benefits or alleviation of the patient's condition. In any instance of any type of experiment or administration of experimental medicine, there shall be written evidence of compliance with this section, including the signature of the patient, or the signature of the patient's guardian or representative if the patient has been adjudicated incompetent. A copy of signed acknowledgment or informed consent, or, both when required, shall be forwarded to each signer and a copy shall be retained by the facility.

(5) At the bedside of each patient and resident the facility shall place and maintain in good order the name, address and telephone number of the physician responsible for the patient's care.

(6) Each patient and resident shall receive respect and privacy in the patient's or resident's own medical care program. Case discussion, consultation, examination and treatment shall be confidential, and shall be conducted discreetly. In the patient's discretion, persons not directly involved in the patient's care shall not be permitted to be present during such discussions, consultations, examinations or treatment, except with the consent of the patient or resident. Personal and medical records shall be treated confidentially, and shall not be made public without the consent of the patient or resident, except such records as are needed for a patient's transfer to another health care institution or as required by law or third-party payment contract. No personal or medical records shall be released to any person inside or outside the facility who has no demonstrable need for such records.

(7) Every patient and resident shall be free from chemical and physical restraints imposed for purposes of discipline and convenience, and not necessary to treat the patient's medical condition.

(8) Every patient and resident shall receive from the administrator or staff of the facility a courteous, timely, and reasonable response to requests, and the facility shall make prompt efforts to resolve grievances. Responses to requests and grievances shall be made in writing upon written request by the patient or resident.

(9) Every patient and resident shall be provided with information as to any relationship the facility has with other healthcare and related institutions and/or service providers, including, but not limited to, pharmacy and rehabilitation services, to the extent the patient is offered care and/or services from these related entities. Such information shall be provided in writing upon admission, and thereafter when additional services are offered.

(10) Every patient and resident shall receive reasonable continuity of care.

(11) Every patient and resident may associate and communicate privately and without restriction with persons and groups of the patient's or resident's own choice (on the patient's or resident's own or their initiative) at any reasonable hour; may send and shall receive mail promptly and unopened; shall have access at any reasonable hour to a telephone where the patient may speak privately; and shall have access to writing instruments, stationery and postage.

(12) Each patient and resident has the right to manage his/her financial affairs. If, by written request signed by the patient or resident, or by the guardian or representative of a patient or resident who has been adjudicated incompetent, the facility manages the patient's or resident's financial affairs, it shall have available for inspection a monthly accounting, and shall furnish the patient or resident and his/her family or representative with a quarterly statement of the patient's or resident's account. The patient and resident shall have unrestricted access to such account at reasonable hours.

(13) If married, every patient and resident shall enjoy privacy in visits by his/her spouse, and, if both are in-patients of the facility, they shall be afforded the opportunity where feasible to share a room, unless medically contraindicated.

(14) Every patient and resident has the right of privacy in his/her room, and personnel of the facility shall respect this right by knocking on the door before entering the patient's or resident's room.

(15) Every patient and resident has the right, personally or through other persons or in combination with others, to exercise his/her rights; to present grievances; to recommend changes in facility policies or services on behalf of himself/herself or others; to present complaints or petitions to the facility's staff or administrator, to the Division of Services for Aging and Adults With Physical Disabilities or to other persons or groups without fear of reprisal, restraint, interference, coercion or discrimination.

(16) A patient or resident shall not be required to perform services for the facility.

(17) Each patient and resident shall have the right to retain and use his/her personal clothing and possessions where reasonable, and shall have the right to security in the storage and use of such clothing and possessions.

(18) No patient or resident shall be transferred or discharged out of a facility except for medical reasons; the patient's or resident's own welfare or the welfare of the other patients; or for nonpayment of justified charges. If good cause for transferal is reasonably believed to exist, the patient or resident shall be given at least 30 days' advance notice of the proposed action, together with the reasons for the decision, and the patient or resident shall have the opportunity for an impartial hearing to challenge such action if he/she so desires. In emergency situations such notice need not be given.

(19) Every patient and resident shall have the right to inspect all records pertaining to him/her, upon oral or written request within 24 hours of notice to the facility. Every patient and resident shall have the right to purchase photocopies of such records or any portion of them, at a cost not to exceed the community standard, upon written request and two working days advance notice to the facility.

(20) Every patient and resident shall be fully informed, in language he/she can understand, of his/her rights and all rules and regulations governing patient or resident conduct and his/her responsibilities during the stay at the facility.

(21) Every patient and resident shall have the right to choose a personal attending physician.

(22) Every patient and resident shall have the right to examine the results of the most recent survey of the facility conducted by federal and/or state surveyors and any plan of correction in effect with respect to the facility. Survey results shall be posted by the facility in a place readily accessible to patients and residents.

(23) Every patient and resident shall have the right to receive information from agencies acting as client advocates and be afforded the opportunity to contact those agencies.

(24) Every patient and resident shall be free from verbal, physical or mental abuse, cruel and unusual punishment, involuntary seclusion, withholding of monetary allowance, withholding of food, and deprivation of sleep.

(0) Every patient and resident shall be free to make choices regarding activities, schedules, health care, and other aspects of his/her life that are significant to the patient or resident, as long as such choices are consistent with the patient's or resident's interests, assessments, and plan of care and do not compromise the health or safety of the individual or other patients or residents within the facility.

(0) Every patient and resident has the right to participate in an ongoing program of activities designed to meet, in accordance with his/her assessments and plan of care, the patient's or resident's interests and physical, mental and psychosocial well-being.

(1) Every patient and resident shall have the right to participate in social, religious and community activities that do not interfere with the rights of other patients or residents.

(28) Every patient and resident shall receive notice before the resident's room or roommate is changed, except in emergencies. The facility shall endeavor to honor the room or roommate requests of the resident whenever possible.

(29) Every patient and resident shall be encouraged to exercise his/her rights as a citizen of the State of Delaware and the United States of America.

(30) Every patient and resident shall have the right to request and receive information regarding minimum acceptable staffing levels as it relates to his/her care.

(31) Every patient and resident shall have the right to request and receive the names and positions of staff members providing care to the patient or resident.

(32) Every patient and resident shall have the right to request and receive an organizational chart outlining the facility's chain of command for purposes of making requests and asserting grievances.

(33) Where a patient or resident is adjudicated incompetent, is determined to be incompetent by his/her attending physician, or is unable to communicate, his/her rights shall devolve to his/her next of kin, guardian, or representative.

Approved July 17, 1998