Your Rights as a Resident Are Set by State Law and Federal Rules
When you move into a care home, you do not give up your legal rights. Federal law and your state's regulations protect you as a resident. You have the right to make decisions about your own care, to be treated with dignity, to have your property respected, and to report problems without fear of retaliation. These rights explore whether you pay privately, use Medicaid, or use Medicare.
The rules come from two places: the Centers for Medicare & Medicaid Services (CMS), which sets federal standards for facilities that take Medicare or Medicaid, and your state's health department or long-term care licensing board, which may add stronger protections. Some states have a separate ombudsman office that investigates complaints about care homes. Knowing which rules explore to you and who enforces them is the first step to protecting yourself.
Key Takeaways
- Federal law gives you the right to make your own medical decisions, keep your money and belongings, and receive respectful care free from abuse or neglect.
- Your state's health department or licensing board enforces care home rules and can investigate complaints, and many states have a separate ombudsman office for residents.
- Care homes must give you a written statement of your rights when you arrive, and you can request a copy at any time.
- You have the right to report problems to the facility, your state's health department, or a long-term care ombudsman without the facility punishing you.
- If you cannot make decisions for yourself, a legal representative (power of attorney, guardian, or healthcare proxy) can exercise your rights on your behalf.
What Rights You Have Over Your Own Medical Care and Decisions
You have the right to make decisions about your medical treatment, even if you live in a care home. This means you can refuse a medication, a procedure, or a treatment plan. The facility must tell you what they are recommending, why, and what the risks are if you refuse. If you cannot communicate your wishes, a healthcare proxy, power of attorney, or court-appointed guardian can make those decisions for you.
You also have the right to see your own medical records and to have a doctor of your choice, though the facility may have contracts with certain providers. If you want a second opinion or want to see a specialist outside the facility, you can request that. The facility cannot force you to take medication or undergo treatment as punishment or for convenience — medication must be medically necessary and documented in your care plan.
If you have advance directives (a living will or do-not-resuscitate order), the facility must follow them. You can change your advance directives at any time, and the facility must update your file and inform your healthcare providers. If the facility cannot or will not follow your wishes, they must help you move to another facility.
Your Right to Keep Your Money, Belongings, and Personal Privacy
Your money and belongings are yours. The facility cannot take them or use them without your permission. If the facility holds money for you (for example, to pay for personal items or outings), they must keep it in a separate account, show you statements, and return it to you on request. They cannot require you to turn over your Social Security check, pension, or other income.
Your room is your private space. Staff cannot enter without permission except in emergencies. Your mail, phone calls, and visits are private. The facility cannot open your mail, listen to your calls, or restrict visitors unless there is a safety or medical reason, and even then they must document it. You have the right to make phone calls in private and to receive visitors at reasonable hours.
If you share a room, you still have privacy rights. You can ask for a private room if one is available, though the facility may charge extra. You have the right to lock your drawers and closet to keep your belongings find.
Protection From Abuse, Neglect, and Mistreatment
Care homes must provide care that is free from abuse, neglect, exploitation, and mistreatment. Abuse includes physical harm, sexual assault, or threats. Neglect means failing to provide food, water, medication, hygiene, or medical care. Exploitation means someone using your money or property without permission. Mistreatment includes verbal abuse, intimidation, or humiliation.
The facility must have policies to prevent abuse and must train all staff on these policies. If you are abused or neglected, you have the right to report it to the facility, to your state's health department, to law enforcement, or to a long-term care ombudsman. You cannot be punished for reporting — retaliation is illegal. The facility must investigate complaints and take action to stop the harm.
If you are in when ready danger, call 911. If you believe abuse or neglect has happened, you can also contact your state's adult protective services office or the Eldercare Locator (1-800-677-1116), which can connect you to local resources and ombudsman offices.
How to Report Problems and Who to Contact
Start by reporting the problem to the facility itself. Tell a staff member, the nursing supervisor, or the facility administrator. Ask for the complaint to be documented in writing. The facility must investigate and tell you what they found and what they will do about it.
If the facility does not respond or if you do not feel safe reporting to them, contact your state's health department or long-term care licensing board. They can investigate without telling the facility who reported it (though in some cases the facility may figure it out). You can find your state health department by searching "[your state] health department long-term care complaints" or by calling the Eldercare Locator.
Many states have a long-term care ombudsman — a person or office whose job is to investigate complaints and advocate for residents. The ombudsman is independent from the facility and the state health department. They can visit the facility, talk to residents, review records, and push for changes. Ombudsman services are free. To find your state's ombudsman, call the Eldercare Locator or search "[your state] long-term care ombudsman."
You can also file a complaint with Medicare (if the facility takes Medicare) by calling 1-800-MEDICARE or visiting Medicare.gov. You can report to law enforcement if you believe a crime has been committed.
Your Rights if You Cannot Make Decisions for Yourself
If you have dementia, a serious illness, or another condition that affects your ability to make decisions, someone else can exercise your rights on your behalf. This person might be a healthcare proxy (named in a healthcare power of attorney), a financial power of attorney, or a court-appointed guardian or conservator.
The facility must know who this person is and must include them in care decisions. They must give this person access to your medical records and involve them in your care planning. If you named someone in a power of attorney document before you lost decision-making ability, that person's authority is valid. If you did not, your family may need to go to court to have a guardian appointed.
Even if someone else makes decisions for you, you still have rights. Your representative must act in your best interest, not their own. If you disagree with a decision your representative is making, you can report it to the ombudsman or to adult protective services. The facility must also protect you from exploitation by a representative who is misusing your money or property.
Understanding Your Admission Agreement and Care Plan
Before you move in, the facility must give you a written admission agreement that explains the services they provide, the cost, what happens if you cannot pay, and your rights as a resident. Read this carefully and ask questions before you sign. You can negotiate some terms — for example, the length of notice required if the facility wants to discharge you, or what happens to your deposit if you leave.
The facility must also develop a written care plan with you (or with your representative if you cannot participate). This plan describes your medical needs, your medications, your daily routine, and your goals. You have the right to see your care plan, to understand it, and to have input into it. The facility must update it regularly and must tell you if anything changes.
If you disagree with your care plan or with the services you are receiving, you can request a meeting with the care team to discuss changes. If the facility cannot meet your needs, they must help you move to another facility rather than discharge you without a plan.
What Happens if a Facility Wants to Discharge You
A facility can only discharge you for specific reasons: you no longer need the level of care they provide, your behavior is a danger to yourself or others, the facility is closing, or you cannot pay and have no way to pay. They cannot discharge you because you are difficult, because you complain, or because you have a disability or illness.
The facility must give you written notice before discharge — the amount of notice varies by state but is usually 30 days. The notice must explain the reason and must tell you how to appeal. You have the right to a hearing or review before the discharge takes effect. The facility must help you find another place to live and must not discharge you until you have somewhere to go.
If you believe the discharge is illegal or unfair, you can file a complaint with your state's health department or with the ombudsman. You can also consult a lawyer who handles elder law or long-term care issues.
Frequently Asked Questions
Can a care home force me to take medication I do not want?
No. You have the right to refuse any medication or treatment. The facility must tell you why they are recommending it and what happens if you refuse. If you lack decision-making ability, your healthcare proxy or guardian can refuse on your behalf. The facility cannot use medication as punishment or for staff convenience.
What should I do if I think I am being abused in a care home?
Tell a staff member, call 911 if you are in when ready danger, and report to your state's health department, the ombudsman, or law enforcement. You can also call the Eldercare Locator (1-800-677-1116) for help finding your local ombudsman. You cannot be punished for reporting abuse.
Can the facility take my Social Security check?
No. Your income is yours. The facility can charge you for room, board, and services, but you must authorize any payment. If the facility holds money for you, they must keep it separate and show you statements. You can ask for your money back at any time.
What is a long-term care ombudsman and how do I contact one?
An ombudsman is an independent person or office that investigates complaints about care homes and advocates for residents. Services are free. Call the Eldercare Locator (1-800-677-1116) or search "[your state] long-term care ombudsman" to find yours.
What if I do not have a power of attorney and cannot make decisions for myself?
Your family can petition the court to have a guardian or conservator appointed. This person will have legal authority to make decisions for you. The process takes time and costs money, so it is better to set up a power of attorney before you lose decision-making ability. A lawyer who handles elder law can help you understand your options.