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APPENDIX C GUIDELINES FOR COMPLIANCE OF NURSING HOMES AND SIMILAR FACILITIES WITH TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 Section 601 of Title VI of the Civil Rights Act of 1964 provides: No person in the United States, shall, on the ground of race, color, or national origin, be excluded from partici- pation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance. Nursing homes or similar facilities1 that are in compliance with Title VI of the Civil Rights Act are characterized by an absence of separation, discrimination,2 or other distinction on the basis of race, color, or national origin in any activity conducted by, for, or in the institution affecting the care and treatment of residents. Compliance with Title VI requires adherence to the following policies and practices: 1. Admission to the Nursing Home: a. All residents are admitted to the facility without discrimination and no inquiries are made regarding race, color, or national origin prior to admission. The nursing home utilizes its referral sources in a manner which assures an equal opportunity for admission to persons without regard to race, color, or national origin in relation to the population of the service area or potential service area. Where there is a significant variation between the racial or ethnic composition of the resident census and available population census data for the service area or potential service area, the nursing home has a responsibility to determine the reason for such 1The term "nursing home" as used in this document applies to "extended care facilities, skilled nursing homes and intermediate and domiciliary care homes and similar facilities." 2The word "discrimination" as used throughout this document shall be understood to mean "discrimination on account of race, color, or national origin" as used in Section 601, Title VI of the Civil Rights Act of 1964, Public Law 88-352, approved July 2, 1964. 168
169 variation and take whatever action may be necessary to correct any discrimination. b. Admission is not restricted to members of any group or order which discriminates. c. Nursing home policies regarding deposits, extension of credit and other financial matters are applied uniformly and without regard to race. d. Information regarding the price and availability of accommodations is uniformly made available to all without regard to race, color, or national origin. 2. Records: Records are maintained uniformly without discrimination for all residents. Identification by race, color and national origin on records is not considered to be discriminatory and may be used to demonstrate compliance with Title VI. 3. Services and Physical Facilities Provided by the Nursing Home: a. Residents' privileges and care services such as medical and dental care, nursing, laboratory services, pharmacy, physical, occupational and recreational therapies, social services, volunteer services, dietary service, and housekeeping services are provided on a nondiscriminatory basis. b. Physical facilities including lounges, dining facilities, lavatories and beauty and barber shops are provided and used without discrimination. c. Rules of courtesy are uniformly applied without regard to race, color, or national origin in all situations including face-to- face contact and written records and communications. d. Assignment of staff to residents is not governed by the race, color, or national origin of either resident or staff. e. Nursing homes which formerly had dual facilities (buildings, waiting rooms, entrances, dining facilities, etc.) have a particular responsibility to demonstrate that such facilities are no longer being operated in a discriminatory manner. 4. Room Assignments and Transfers: a. Residents are assigned to rooms, wards, floors, sections, buildings, and other areas without regard to race, color, or national origin. Such assignment will result in a degree of multi-racial occupancy of multi-bed accommodations which reflects the proportion of minority use of the facility. b. Residents are not asked whether they are willing to share accommodations with persons of a different race, color, or national origin. Requests from residents for transfer to other rooms in the same class of accommodations are not honored if based on racial or ethnic considerations. Exceptions may be made only if the attending physician or nursing home administrator certifies in writing that in his judgement there are valid medical reasons or special compelling circumstances in the individual case. However, such certifications may not be used to permit segregation as a routine practice in the facility.
170 5. Attending Physicians' Privileges: Privileges of attending residents in the nursing home are granted to physicans and other health professionals without discrimination. 6. Notification of Availability of Services and Nondiscrimination Policy: a. The nursing home has adopted and where appropriate provided its residents, employees, attending physicians, and others providing services to residents with copies of written statements which set forth the nursing home's nondiscrimination policies and practices. These policies are included in any publication of staff regulations or public information brochures, kept current, and periodically reviewed with employees. b. The nursing home effectively conveys to the community, to hospitals and other referral sources, its nondiscriminatory policy and the nature and extent of services available. 7. Referrals: Nursing home referrals, including but not limited to referrals to other facilities and care programs, are made in a manner which does not result in discrimination. Revised and Issued by: Office for Civil Rights Department of Health, Education, and Welfare Leon E. Panetta, Director November 1969