651 CMR 12.08
Resident Rights and Required Disclosures
Prior to scheduling a formal meeting with a prospective Resident, the Residence shall inform
him or her of the right to be accompanied by a Legal Representative, Resident Representative,
or other advisor. During its first formal meeting with a prospective Resident, the Residence shall
deliver to and verbally review with the prospective Resident a consumer guide developed by
EOAI and the Disclosure of Rights and Services required by 651 CMR 12.08(3), which
incorporates the provisions of 651 CMR 12.08(1). At the time of or prior to the execution of the
Residency Agreement or the transfer of any money to a Sponsor by or on behalf of a prospective
Resident, whichever first shall occur, the Sponsor shall deliver to and verbally review with the
prospective Resident, the person with whom the contract is entered into, and, if applicable, the
prospective Resident's Legal Representative a copy of the Residency Agreement, which shall
state all applicable costs and terms of payment, services offered and not offered, shared risks, and
all other important terms and conditions of the Agreement. All documents shall be written in
plain language and published in typeface no smaller than 14-point type. EOAI may require that
any applicable disclosure statement be in the form and format as required by EOAI.
(1) Resident Rights. Every Resident of an Assisted Living Residence shall have the right to:
(a) Live in a decent, safe, and habitable residential living environment;
(b) Be treated with consideration and respect and with due recognition of personal dignity,
individuality, and the need for privacy;
(c) Privacy within the Resident's Unit subject to rules of the Assisted Living Residence
reasonably designed to promote the health, safety and welfare of Residents;
(d) Retain and use their own personal property, space permitting, in the Resident's living
area so as to maintain individuality and personal dignity;
(e) Private communications, including receiving and sending unopened correspondence,
access to a telephone, and visiting with any person of her or his choice;
(f) Freedom to participate in and benefit from community services and activities and to
achieve the highest possible level of independence, autonomy, and interaction within the
community;
(g) Directly engage or contract with licensed or certified health care providers to obtain
necessary health care services in the Resident's Unit or in such other space in the Assisted
Living Residence as may be available to Residents to the same extent available to persons
residing in their own homes, and with other necessary care and service providers, including,
but not limited to, the pharmacy of the Resident's choice subject to reasonable requirements
of the Residence. The Resident mayselect a medication packaging system within reasonable
limits set bythe Assisted LivingResidence. AnyAssisted LivingResidence policystatement
that sets limits on medication packaging systems must first be approved by EOAI;
(h) Manage their own financial affairs, unless the Resident has a Legal Guardian or other
court-appointed representative with the authority to manage the Resident's financial affairs;
(i) Exercise civil and religious liberties;
(j) Present grievances and recommended changes in policies, procedures, and services to
the Sponsor, Executive Director or staff of the Assisted Living Residence, government
officials, or any other person without restraint, interference, coercion, discrimination, or
reprisal. This right includes access to representatives of the Statewide Long-Term Care
Ombudsman program established under M.G.L. c. 6A, § 16CC, the Elder Protective Services
program established under M.G.L. c. 19A, §§ 14 through 26, and the Disabled Persons
Protection Commission (DPPC) established under M.G.L. c. 19C;
(k)
Upon request, obtain from the Assisted Living Residence, the name and contact
information of the Executive Director, Resident Care Director, and any other persons
responsible for their care or the coordination of their care;
(l) Confidentiality of all records and communications to the extent provided by law;
(m) Have all reasonable requests responded to promptly and adequately within the capacity
of the Assisted Living Residence;
(n) Upon request, obtain an explanation of the relationship, if any, of the Residence to any
health care facility or educational institution to the extent the relationship relates to their care
or treatment;
(o) Obtain from a person designated by the Residence a copy of any rules or regulations of
the Residence which apply to their conduct as a Resident;
(p) Privacy during medical treatment or other rendering of services within the capacity of
the Assisted Living Residence;
(q) Informed consent to the extent provided by law;
(r)
Not be evicted from the Assisted Living Residence except in accordance with the
provisions of landlord/tenant law as established byM.G.L. c. 186 or M.G.L. c. 239 including,
but not limited to, an eviction notice and utilization of such court proceedings as are required
by law;
(s) Be free from Restraints;
(t)
Receive an itemized bill for fees, charges, expenses and other assessments for the
provision of Resident services, Personal Care Services, and optional services;
(u) Have a written notice of the Residents' Rights published in typeface no smaller than 14
point type posted in a prominent place or places in the Assisted Living Residence where it
can be easily seen by all Residents. This notice shall include the address, and telephone
number of the Long-Term Care Ombudsman Program, and the telephone number of the
Elder Abuse Hotline;
(v)
Be informed in writing by the Sponsor of the Assisted Living Residence of the
community resources available to assist the Resident in the event of an eviction procedure
against him or her. Such information shall include the name, address and telephone number
of the Long-Term Care Ombudsman Program.
(w)
To organize and participate in self-governed, confidential Resident groups in the
Residence;
(x) To participate in self-governed, confidential family groups; and
(y) Have family member(s) or other Resident Representatives meet in the Residence with
the families or Resident Representative(s) of other Residents in the Residence.
(z) Be able to review a copy of the Residence's disaster and emergency preparedness plan
at any time.
(2) Residency Agreement.
(a) The Residency Agreement shall include, at a minimum, the following:
1. Charges, expenses and other assessments for the provision of Resident services,
Personal Care Services, Lodging and meals, and optional services;
2. All fees associated with the provision of Basic Health Services, if applicable;
3. The agreement of the Resident to make payment of the charges specified;
4. The policy and procedures regarding a Resident's financial liability or other
expectation for payment of services during Resident absences from the Residence;
5. Arrangements for payment;
6. A Resident grievance procedure which meets the requirements of 651 CMR
12.08(1)(j);
7. The Sponsor's covenant to comply with applicable federal and state laws and
regulations concerning consumer protection and protection from abuse, neglect and
financial exploitation of the elderly and disabled;
8. The conditions under which the Residency Agreement may be terminated by either
party, including criteria the Residence may use to determine whether the conditions have
been met, and the length of the required notice period for termination of the Residency
Agreement;
9. Reasonable rules for the conduct and behavior of staff, management and the Resident;
10. The Resident's rights required by 651 CMR 12.08(1);
11. A clear explanation of the services included in any fees, a description and
itemization of all other bundled services as well as an explanation of other services
available at an additional charge;
12. An explanation of any limitations on the services the Residence will provide,
specifically including any limitations on services to address specific Activities of Daily
Living and behavioral management. Such explanation shall also include a description
of the role of the nurse(s) employed by the Residence, and the nursing and personal care
worker staffing levels;
13. An explanation of the eligibility requirements for any available subsidy programs,
including a statement of any costs associated with services beyond the scope of the
subsidy program for which the Resident or their Legal Representative would be
responsible;
14. The refund policies for all Administrative Fees, deposits, and other charges; and
15. A copy of the Residence's medication management policy: its Self-administered
Medication Management (SAMM) policy, including its policy on assistance with
as-necessary or PRN medication when part of the SAMM plan; and, if applicable,
Limited Medication Administration.
(b) If the Disclosure of Rights and Services required by 651 CMR 12.08(3) fully states all
of the items required by 651 CMR 12.08(2)(a)6., 9., 10., 12., 13. and 15., the Residency
Agreement may incorporate those requirements by reference.
(c) The Residency Agreement may include the agreement of the Sponsor to provide or
arrange for the provision of additional services, including, but not limited to, the following:
1. Barber and beauty services, sundries for personal consumption, and other amenities;
and
2. Local transportation for medical and recreational purposes.
(d)
The Residency Agreement shall be for a term not to exceed one year and may be
renewable upon the agreement of both parties.
(e) The Residency Agreement shall be for a single or double living Unit in the Residence
with lockable entry doors on each Unit which meet the bathroom, Bathing Facility and
kitchenette requirements of 651 CMR 12.04(1).
(f) A Residency Agreement for a Residence receiving funding through MassDevelopment
pursuant to M.G.L. c. 23A, which otherwise meets the requirements of 651 CMR 12.08(2),
may be executed for an initial period not to exceed 13 months.
(g)
A Resident may voluntarily agree to vacate their Unit in accordance with their
Residency Agreement. A Resident may not be evicted from the Resident's Unit following
termination of the Residency Agreement except in accordance with the provisions of
landlord/tenant law as set forth in M.G.L. c. 186 and M.G.L. c. 239.
(3) Disclosure of Rights and Services. The disclosure statement shall include, at a minimum,
the following:
(a) The number and type of Units the Residence is certified to operate;
(b) The number of staff currently employed by the Residence, by shift, an explanation of
how the Residence determines staffing, and the availability of overnight staff, and shall
provide this information separately for any Special Care Residence within the Residence;
(c) A copy of the list of Residents' Rights set forth in 651 CMR 12.08(1);
(d) An explanation of the eligibility requirements for any subsidy programs including a
statement of any additional costs associated with services beyond the scope of the subsidy
program for which the Resident or their Legal Representative would be responsible. This
explanation should also state the number of available Units, and whether those Units are
shared;
(e)
A copy of the Residence's medication management policy, its Self-administered
Medication Management policyfor dealing with medication that is prescribed to be taken "as
necessary", and an explanation of its Limited Medication Administration policy;
(f) An explanation of any limitations on the services the Residence will provide, including,
but not limited to, any limitations on specific services to address Activities of Daily Living
and any limitations on behavioral management;
(g) An explanation of the role of the nurse(s) employed by the Residence;
(h) An explanation of entry criteria and the process used for Resident assessment;
(i) A statement on the number of staff who are qualified to administer cardiopulmonary
resuscitation (CPR) and use an Automated External Defibrillator (AED), and the Residence's
policy on the circumstances in which CPR will be administered and when an AED will be
used;
(j)
An explanation of the conditions under which the Residency Agreement may be
terminated by either party, including the criteria the Residence mayuse to determine whether
conditions have been met, and the length of the required notice period for termination of the
Residency Agreement;
(k) An explanation of the physical design features of the Residence including that of any
Special Care Residence;
(l) An illustrative sample of the Residence's Service Plan, an explanation of its use, the
frequency of review and revisions, and the signatures required;
(m) An explanation of the different or special types of diets available;
(n) A list of enrichment activities, including the minimum number of hours provided each
day;
(o) An explanation of the security policy of the Residence, including the procedure for
admitting guests;
(p) A copy of the instructions to Residents in the Residence's disaster and emergency
preparedness plan;
(q) A statement of the Residence's policy and procedures, if any, on the circumstances under
which it will, with the member's permission, include family members in meetings and
planning;
(r) Each Residence that provides special care shall provide a written statement describing
its special care philosophy and mission, and explaining how it implements this philosophy
and achieves the stated mission.
(s) If a Residence allows non-Residents to use any of its facilities, such as a swimming pool,
gymnasium or other meeting or function room, it shall disclose the fact of such usage to its
Residents. Said disclosure shall:
1. inform the Residents of the existence of non-regulated programming on-site;
2. disclose the amount of interaction or shared use of the facilities; and
3. describe any resultant impact on Residence staffing.
(t) The policy for a Resident's financial liability or other expectation for payment of services
during Resident absences from the Residence;
(u) A statement regarding the procedures that will take place during an emergency and an
evacuation;
(v) The policies and procedures concerning smoking on the Residence's premises; and
(w) The policies and procedures regarding the proper use, administration, and maintenance
of oxygen, including safety protocols.
(4) Additional Disclosures. EOAI may develop specific documents that must be included with
the Residency Agreement and disclosed to both current and prospective Residents. EOAI may
require Residences to submit such documents to EOAI regularly or upon any change. EOAI may
make these documents public. EOAI may require that the Residence post these documents on
the Residence's website in the form and format as prescribed by EOAI. Each Resident or Legal
Representative executing the Residency Agreement must also sign any required documents in
the presence of a witness.
(5) Disclosures regarding Basic Health Services. A Residence providing Basic Health Services
must create a written disclosure containing information pertaining to all Basic Health Services
offered to current and prospective Residents.
(a) Such written disclosure must include, but is not necessarily limited to, the following:
1. the Residence's philosophy and mission regarding how Basic Health Services are
provided;
2. the processes employed to ensure continuity of services for when a Resident leaves
the Residence such as during a leave of absence (for medical or personal reasons), or the
termination of the residency;
3. the processes used for assessment, service planning, and implementation of Basic
Health Services for Residents;
4. the roles of family and others who provide support to the Resident receiving Basic
Health Services;
5. program costs, including options should a Resident no longer be able to afford Basic
Health Services;
6. a statement informing the Resident of any limitations regarding the provision of Basic
Health Services; and
7. any additional information EOAI may require.
(b)
The disclosure must be provided to EOAI and distributed to all Residents, Legal
Representatives, or Resident Representatives, if applicable, the Long-Term Care
Ombudsman, and the Residents' Health Care Agents, if applicable.
(c) Any changes to the Residence's disclosure statement must be provided in advance to
EOAI, and subsequently provided to all Residents, Legal Representatives, or Resident
Representatives, if applicable, the Long-Term Care Ombudsman, and the Residents' Health
Care Agents, if applicable.