| 2. To be fully informed prior to or at the time of admission and during the stay of services available in the Center and of related charges including any charges for services not covered by Medicare and/or Medicaid or not covered by the Center’s basic per diem rate; | 10. To choose to manage my personal financial affairs or to have the Center hold safeguard manage and account for my personal funds deposited with the Center. If I authorize the Center to manage my personal funds and the Center accepts my delegation for any period in conformance with state law I have the right to have access to upon request records of | 18. To organize and participate in Resident and family groups in the Center. | 24. To be informed of Center services charges and any changes to benefits or charges. | 26. To record and periodically update the name address and telephone numbers of your legally authorized representative and/or other approved family member. |
| 4. To be informed in summary form of the most recent findings and outcomes of any surveys for compliance with Federal requirements and to access survey results as well as the Center’s plans for correction for the previous 3 years. A summary is also available at www.nursinghomecompare.gov. | 12. To be assured confidential treatment and the individual accessibility of my personal and medical records and to approve or refuse their release to any individual outside the Center except in case of my transfer to another healthcare institution or as required by law or third- party payment contract. | 16. To have immediate access to visitors and visitation rights as defined by law and Center policy and to communicate privately with persons of my choice and send and receive my personal mail unopened unless medically contraindicated as documented by my physician in my medical record. | 25. To be notified of changes in my rights. | be residing in the Center or in a surrounding zip code and to be provided with assistance in |
| 6. To be fully informed by the physician or physician-extender of my total health condition unless medically contraindicated as documented by the physician in my medical record to be fully informed in advance of care and treatment to be afforded the opportunity to participate in the planning of my medical treatment to refuse treatment to refuse to participate in experimental research to practice self-administration of drugs (if this practice is determined to be safe for me by the interdisciplinary team) and to be provided appropriate assessment and management of pain; | 13. To be treated with consideration respect and full recognition of my dignity and individuality including privacy in treatment and in care for my personal needs. | FREE | 20. To be assured privacy for visits by my spouse and if we are both Residents in the Center to be permitted upon consent of both spouses to share a room with such spouse unless medically contraindicated as documented by the attending physician or physician-extender in the medical record. | 29. To be fully informed of my right to access information on any registered sex offenders that may |
| 3. To be provided current information as to the application and utilization of benefits under Medicare and Medicaid. | financial transactions made on my behalf at least once a month and to be given at least a quarterly accounting of those financial transactions. | 15. To have regular access to the private use of a telephone as well as stationary postage and writing implements at my own expense. | 22. To inspect upon request and within twenty-four (24) hours (excluding weekends and holidays) my medical record and to receive photocopies within two (2) working days for a fee as defined by state law (Va. Code §8.01-413; see also 32.1-127.103). | 27. To be informed of the names addresses and telephone numbers of all pertinent state client advocacy groups. If you deem necessary you may file a complaint with the state survey and certification agency concerning resident abuse neglect misappropriation of resident property and non-adherence to advance directive requirements. |
| 1. To be fully informed in a language that he/she understands as evidenced by the Resident’s written acknowledgment prior to or at the time of admission and during the stay of rights and of all rules and regulations governing Resident conduct and responsibilities. | 8. To be transferred or discharged for medical reasons only or for my welfare or that of other Residents or for non-payment for my stay except as prohibited by Titles XVII or XIX of the United States Social Security Act and to be given proper notice as outlined in Federal and State law so as to ensure orderly transfer or discharge and that all such actions are documented in my medical record. | 19. To retain and use my personal clothing and possessions as space permits unless to do so would infringe upon the rights of other Residents and unless medically contraindicated as documented by my physician or physician-extender in my medical record. | 21. To be properly notified before a change in Resident room or roommate. | accessing the Virginia Sex Offender Registry if I so choose. |
This bingo card was created randomly from a total of
32 events.
Host Instructions:- Decide when to start and select your goal(s)
- Designate a judge to announce events randomly or as they happen
- Cross off events from the list when announced
Goals:- First to get any line (up, down, left, right, diagonally)
- First to get the four corners
- First to get two diagonal lines through the middle (an "X")
- First to get all squares
Guest Instructions:- Check off events on your card as they occur
- If you complete a goal, shout "Bingo!". You've won!
- The judge decides in the case of disputes
| 1. To be fully informed in a language that he/she understands as evidenced by the Resident’s written acknowledgment prior to or at the time of admission and during the stay of rights and of all rules and regulations governing Resident conduct and responsibilities. | 10. To choose to manage my personal financial affairs or to have the Center hold safeguard manage and account for my personal funds deposited with the Center. If I authorize the Center to manage my personal funds and the Center accepts my delegation for any period in conformance with state law I have the right to have access to upon request records of | 17. To meet with and participate in activities of social religious and community groups that do not interfere with the rights of other Residents at my discretion unless medically contraindicated as documented by my physician or physician-extender in my medical record. | 25. To be notified of changes in my rights. | 26. To record and periodically update the name address and telephone numbers of your legally authorized representative and/or other approved family member. |
| 3. To be provided current information as to the application and utilization of benefits under Medicare and Medicaid. | 12. To be assured confidential treatment and the individual accessibility of my personal and medical records and to approve or refuse their release to any individual outside the Center except in case of my transfer to another healthcare institution or as required by law or third- party payment contract. | 18. To organize and participate in Resident and family groups in the Center. | 21. To be properly notified before a change in Resident room or roommate. | 27. To be informed of the names addresses and telephone numbers of all pertinent state client advocacy groups. If you deem necessary you may file a complaint with the state survey and certification agency concerning resident abuse neglect misappropriation of resident property and non-adherence to advance directive requirements. |
| 6. To be fully informed by the physician or physician-extender of my total health condition unless medically contraindicated as documented by the physician in my medical record to be fully informed in advance of care and treatment to be afforded the opportunity to participate in the planning of my medical treatment to refuse treatment to refuse to participate in experimental research to practice self-administration of drugs (if this practice is determined to be safe for me by the interdisciplinary team) and to be provided appropriate assessment and management of pain; | financial transactions made on my behalf at least once a month and to be given at least a quarterly accounting of those financial transactions. | FREE | 20. To be assured privacy for visits by my spouse and if we are both Residents in the Center to be permitted upon consent of both spouses to share a room with such spouse unless medically contraindicated as documented by the attending physician or physician-extender in the medical record. | 28. To not be charged for any items or services that you do not request or which are included in your Medicare or Medicaid payment. The Center must tell you what the charge will be for any of these requested items or services |
| 5. To choose my attending physician including his or her specialty and to be fully advised as to the way of contacting the physician responsible for my care. | 13. To be treated with consideration respect and full recognition of my dignity and individuality including privacy in treatment and in care for my personal needs. | 15. To have regular access to the private use of a telephone as well as stationary postage and writing implements at my own expense. | 23. To formulate an advance directive in accordance with Center policy a | be residing in the Center or in a surrounding zip code and to be provided with assistance in |
| 4. To be informed in summary form of the most recent findings and outcomes of any surveys for compliance with Federal requirements and to access survey results as well as the Center’s plans for correction for the previous 3 years. A summary is also available at www.nursinghomecompare.gov. | 8. To be transferred or discharged for medical reasons only or for my welfare or that of other Residents or for non-payment for my stay except as prohibited by Titles XVII or XIX of the United States Social Security Act and to be given proper notice as outlined in Federal and State law so as to ensure orderly transfer or discharge and that all such actions are documented in my medical record. | 16. To have immediate access to visitors and visitation rights as defined by law and Center policy and to communicate privately with persons of my choice and send and receive my personal mail unopened unless medically contraindicated as documented by my physician in my medical record. | 24. To be informed of Center services charges and any changes to benefits or charges. | accessing the Virginia Sex Offender Registry if I so choose. |
This bingo card was created randomly from a total of
32 events.
Host Instructions:- Decide when to start and select your goal(s)
- Designate a judge to announce events randomly or as they happen
- Cross off events from the list when announced
Goals:- First to get any line (up, down, left, right, diagonally)
- First to get the four corners
- First to get two diagonal lines through the middle (an "X")
- First to get all squares
Guest Instructions:- Check off events on your card as they occur
- If you complete a goal, shout "Bingo!". You've won!
- The judge decides in the case of disputes
| 6. To be fully informed by the physician or physician-extender of my total health condition unless medically contraindicated as documented by the physician in my medical record to be fully informed in advance of care and treatment to be afforded the opportunity to participate in the planning of my medical treatment to refuse treatment to refuse to participate in experimental research to practice self-administration of drugs (if this practice is determined to be safe for me by the interdisciplinary team) and to be provided appropriate assessment and management of pain; | 12. To be assured confidential treatment and the individual accessibility of my personal and medical records and to approve or refuse their release to any individual outside the Center except in case of my transfer to another healthcare institution or as required by law or third- party payment contract. | 19. To retain and use my personal clothing and possessions as space permits unless to do so would infringe upon the rights of other Residents and unless medically contraindicated as documented by my physician or physician-extender in my medical record. | 23. To formulate an advance directive in accordance with Center policy a | 29. To be fully informed of my right to access information on any registered sex offenders that may |
| 2. To be fully informed prior to or at the time of admission and during the stay of services available in the Center and of related charges including any charges for services not covered by Medicare and/or Medicaid or not covered by the Center’s basic per diem rate; | 11. To be free from verbal sexual mental and physical abuse corporal punishment involuntary seclusion and free from chemical and except in emergencies physical restraints except as authorized in writing by a physician and with the consent of the Resident and/or legal representative for a specified and limited period of time or when necessary to protect the Resident from injury to self or to others | 15. To have regular access to the private use of a telephone as well as stationary postage and writing implements at my own expense. | 25. To be notified of changes in my rights. | 28. To not be charged for any items or services that you do not request or which are included in your Medicare or Medicaid payment. The Center must tell you what the charge will be for any of these requested items or services |
| 7. To be consulted with and to notify my physician and my authorized representative of any significant change in my condition or treatment or of any decision to transfer or discharge. | 9. To be encouraged and assisted throughout the period of my stay to exercise my rights as a Resident and as a citizen and to this end I may voice grievances and recommend changes in policies and services to Center staff and to State and outside representatives of my choice and remain free from restraint interference coercion discrimination or reprisal. | FREE | 21. To be properly notified before a change in Resident room or roommate. | 27. To be informed of the names addresses and telephone numbers of all pertinent state client advocacy groups. If you deem necessary you may file a complaint with the state survey and certification agency concerning resident abuse neglect misappropriation of resident property and non-adherence to advance directive requirements. |
| 3. To be provided current information as to the application and utilization of benefits under Medicare and Medicaid. | 8. To be transferred or discharged for medical reasons only or for my welfare or that of other Residents or for non-payment for my stay except as prohibited by Titles XVII or XIX of the United States Social Security Act and to be given proper notice as outlined in Federal and State law so as to ensure orderly transfer or discharge and that all such actions are documented in my medical record. | 14. To not be required to perform services for the Center that are not included for therapeutic purposes in my plan of care and agreed upon by me or my Agent. | 22. To inspect upon request and within twenty-four (24) hours (excluding weekends and holidays) my medical record and to receive photocopies within two (2) working days for a fee as defined by state law (Va. Code §8.01-413; see also 32.1-127.103). | accessing the Virginia Sex Offender Registry if I so choose. |
| 1. To be fully informed in a language that he/she understands as evidenced by the Resident’s written acknowledgment prior to or at the time of admission and during the stay of rights and of all rules and regulations governing Resident conduct and responsibilities. | financial transactions made on my behalf at least once a month and to be given at least a quarterly accounting of those financial transactions. | 18. To organize and participate in Resident and family groups in the Center. | 24. To be informed of Center services charges and any changes to benefits or charges. | be residing in the Center or in a surrounding zip code and to be provided with assistance in |
This bingo card was created randomly from a total of
32 events.
Host Instructions:- Decide when to start and select your goal(s)
- Designate a judge to announce events randomly or as they happen
- Cross off events from the list when announced
Goals:- First to get any line (up, down, left, right, diagonally)
- First to get the four corners
- First to get two diagonal lines through the middle (an "X")
- First to get all squares
Guest Instructions:- Check off events on your card as they occur
- If you complete a goal, shout "Bingo!". You've won!
- The judge decides in the case of disputes
