Residents Rights to Vote-Elections 2024

September 28, 2024

Resident Rights and Compliance in Nursing Homes: Residents Rights around Voting

Resident rights are a fundamental aspect of long-term care, ensuring that nursing home residents can live with dignity, self-determination, and freedom from discrimination or coercion. The Centers for Medicare & Medicaid Services (CMS) recently reinforced these rights, especially with respect to residents' ability to vote, in the QSO Memo 24-21. This article will outline the key F-tags relevant to resident rights and compliance, with a specific focus on voting rights, as detailed in the CMS memo.

Key Resident Rights Facilities Must Uphold

To maintain compliance with CMS regulations, nursing homes must ensure that the following residents' rights are respected and supported:

• Freedom to Exercise Rights (§483.10(b)): Residents have the right to exercise their rights as both residents of the facility and citizens of the United States. The facility must ensure that this is done without interference, coercion, discrimination, or reprisal.
• Right to Vote (§483.10(b)(1) & (2)): Residents must have unimpeded access to vote in elections, whether through in-person voting, absentee, or mail-in ballots. Facilities must collaborate with local election bodies and provide necessary support, including assistance in registration, voting, and mailing ballots.
• Communication (§483.10(g)(7)): Residents must have the right to communicate freely with people inside and outside the facility. This includes access to mail, internet, and telephones for correspondence related to voting and other personal matters.
• Privacy in Communications (§483.10(h)(2)): Residents’ right to privacy must be respected. This includes ensuring their mail (such as ballots) is delivered unopened and in a timely manner (within 24 hours).

Steps facilities must take to be in compliance

1. Voting Rights Support: Ensure residents can register to vote, request absentee ballots, or arrange for transport to polling locations. Collaborate with local voting officials to facilitate mobile polling services in the facility. Provide assistance in completing ballots as per state laws, whether by staff or a designated agent.
2. Provide Privacy and Accessibility: Respect residents' privacy in their voting decisions and ensure no interference from facility staff. Provide residents with access to mail services, ensuring timely delivery and mailing of ballots.
3. Coordination with Local Programs: Partner with state or local programs designed to assist nursing home residents in the voting process. Engage with bipartisan teams or community volunteers to facilitate mobile polling or ballot assistance.
4. Staff Training: Educate staff on the importance of resident rights, particularly the right to vote, and how to assist residents without exerting influence or bias.
5. Policy Development and Implementation: Develop facility policies that ensure residents’ voting rights are supported and establish procedures for assisting residents with absentee or mail-in voting.

Example of Non-Compliance

In a recent survey, a facility was cited for failing to support its residents' voting rights, which is a violation of F-tag 550 (Resident Rights). The facility did not have a plan in place to assist residents with absentee voting or transporting them to polling locations. Despite requests, the staff failed to provide assistance with ballot completion, citing understaffing issues. As a result, many residents missed the opportunity to vote in a state election. This failure to uphold the residents’ rights, as outlined in the QSO-24-21 memo, led to a citation, and required immediate corrective action.

Relevant F-Tags

• F550 (Resident Rights): Broadly covers the rights of residents to exercise their autonomy and receive care that promotes their dignity.
• F561 (Self-Determination): Requires facilities to honor residents' preferences and choices, which includes supporting their right to vote.
• F578 (Right to Send/Receive Mail): Facilities must ensure that residents can send and receive mail promptly, which applies directly to absentee ballots or voting materials.
• F580 (Notification of Changes): Residents and their families must be informed of any changes that could affect their rights, including changes to assistance with voting.

Conclusion

Ensuring resident rights, particularly the right to vote, is a critical responsibility of nursing homes. By adhering to these regulations and providing proper support, facilities can foster an environment of respect and dignity for their residents. Failure to comply not only leads to regulatory citations but also diminishes the autonomy and well-being of the residents under their care.

For more detailed information, nursing homes are encouraged to review the full guidance provided by CMS in the QSO-24-21 memo.(See below)

https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/policy-memos-states/compliance-residents-rights-requirement-related-nursing-home-residents-right-vote

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