17 Comfortable Temperature Levels 74 Name of and How to Contact Physician 72 Confidentiality About Your Condition 46 Life Safety 60 Freedom of Reprisal 5 Notice Before Discharge 28 Food Substitutes 37 Good Social Services 3 Private Closet Space 14 Participate in Community Activities 41 Information abouy Ombudsman 13 Appropriate Health Care 18 Special Diets 25 Raise Concerns 62 Religious Freedom 15 Freedom from Physical Restraints 29 Participate in Care Planning 69 Prompt Efforts by Facility to Resolve Grievances 51 Choice of Physician 56 Privacy in Treatment 42 Telephone Privacy 16 Private Communication 33 Security for personal Belongings 44 Licensed Facility 59 Receive Proper Assistive Devices 52 Appropriate Exercise 67 Communications with Persons of Your Choice 38 Have Personal Possessions 61 Comfortable Sound Levels 24 Examine Records 35 Refuse Medication or treatment 49 Nutritional Meals 27 Sufficient Staff 54 Participate in Activities of Choice 48 Married Couple Sharing a Room 21 Dental Services 2 Safe Environment 12 Choice of Routine 31 Withdraw Consent for Visitors 70 Vote 20 Consideration 45 Dignity 9 Manage Own Finances 1 Adequate Lighting 22 Trained Nurses Aids 64 Sexuality 6 Information About Rights 32 Freedom from Physical Abuse 8 Discharge Planning 50 Only Certain reason for Transfer 26 Examine Survey Results 73 Written Notice of Right to Appeal 53 Unopened Mail 40 Clean Bed Linens 75 Protection of Funds 66 Privacy 4 Have Visitors 55 Freedom from Verbal Abuse 71 Freedom of Discrimination 17 Comfortable Temperature Levels 74 Name of and How to Contact Physician 72 Confidentiality About Your Condition 46 Life Safety 60 Freedom of Reprisal 5 Notice Before Discharge 28 Food Substitutes 37 Good Social Services 3 Private Closet Space 14 Participate in Community Activities 41 Information abouy Ombudsman 13 Appropriate Health Care 18 Special Diets 25 Raise Concerns 62 Religious Freedom 15 Freedom from Physical Restraints 29 Participate in Care Planning 69 Prompt Efforts by Facility to Resolve Grievances 51 Choice of Physician 56 Privacy in Treatment 42 Telephone Privacy 16 Private Communication 33 Security for personal Belongings 44 Licensed Facility 59 Receive Proper Assistive Devices 52 Appropriate Exercise 67 Communications with Persons of Your Choice 38 Have Personal Possessions 61 Comfortable Sound Levels 24 Examine Records 35 Refuse Medication or treatment 49 Nutritional Meals 27 Sufficient Staff 54 Participate in Activities of Choice 48 Married Couple Sharing a Room 21 Dental Services 2 Safe Environment 12 Choice of Routine 31 Withdraw Consent for Visitors 70 Vote 20 Consideration 45 Dignity 9 Manage Own Finances 1 Adequate Lighting 22 Trained Nurses Aids 64 Sexuality 6 Information About Rights 32 Freedom from Physical Abuse 8 Discharge Planning 50 Only Certain reason for Transfer 26 Examine Survey Results 73 Written Notice of Right to Appeal 53 Unopened Mail 40 Clean Bed Linens 75 Protection of Funds 66 Privacy 4 Have Visitors 55 Freedom from Verbal Abuse 71 Freedom of Discrimination
(Print)
17 Comfortable Temperature Levels
74
Name of and How to Contact Physician
72
Confidentiality About Your Condition
46
Life Safety
60
Freedom of Reprisal
5
Notice Before Discharge
28
Food Substitutes
37
Good Social Services
3
Private Closet Space
14
Participate in Community Activities
41
Information abouy Ombudsman
13
Appropriate Health Care
18
Special Diets
25
Raise Concerns
62
Religious Freedom
15
Freedom from Physical Restraints
29
Participate in Care Planning
69
Prompt Efforts by Facility to Resolve Grievances
51
Choice of Physician
56
Privacy in Treatment
42
Telephone
Privacy
16
Private Communication
33
Security for personal Belongings
44
Licensed Facility
59
Receive Proper Assistive Devices
52
Appropriate Exercise
67
Communications with Persons of Your Choice
38
Have Personal Possessions
61
Comfortable Sound Levels
24
Examine Records
35
Refuse Medication or treatment
49
Nutritional Meals
27
Sufficient Staff
54
Participate in Activities of Choice
48
Married Couple Sharing a Room
21
Dental Services
2
Safe Environment
12
Choice of Routine
31
Withdraw Consent for Visitors
70
Vote
20 Consideration
45
Dignity
9
Manage Own Finances
1
Adequate Lighting
22
Trained Nurses Aids
64
Sexuality
6
Information About Rights
32
Freedom from Physical Abuse
8
Discharge Planning
50
Only Certain reason for Transfer
26
Examine
Survey Results
73
Written Notice of Right to Appeal
53
Unopened Mail
40
Clean Bed Linens
75
Protection of Funds
66
Privacy
4
Have Visitors
55
Freedom from Verbal Abuse
71
Freedom of Discrimination
