As another election season approaches, CMS is reminding nursing homes and skilled nursing facilities of an important responsibility. They must protect each resident’s Residents’ Right to Vote. A recently released Quality, Safety Special Alert Memo emphasizes that residents retain all of the constitutional and statutory rights enjoyed by every U.S. citizen. This includes both the right to vote and the right to decline participation in elections. The memo does not establish new regulatory requirements. Instead, it reinforces existing federal regulations that require communities to support resident rights while avoiding coercion, interference, discrimination, or reprisal. You can review the memo here.
The reminder follows several highly publicized allegations involving improper voting practices in long-term care settings. In Texas, a social worker was charged with multiple felony counts after allegedly registering residents to vote and obtaining mail ballots without their consent. In Wisconsin, investigators examined whether residents with diminished mental capacity had improperly submitted absentee ballots. These incidents prompted CMS to clarify its expectations. Communities must protect residents’ autonomy throughout the voting process. They must also comply with all applicable federal and state election laws.
Federal regulations already require communities to support residents as they exercise their rights as citizens. Residents must be able to exercise those rights without interference, coercion, discrimination, or reprisal. Communities may not register residents without their knowledge or consent. They also may not complete mail-in ballots on a resident’s behalf without authorization. In addition, they may not engage in any activity that violates federal or state voting laws. When a resident’s legal or civil rights related to voting change, communities are expected to notify the resident’s authorized representative as required by federal regulation.
CMS also reminds providers that residents who need assistance voting should be allowed to choose who helps them. This may include an authorized representative if that is the resident’s preference. Whenever possible, CMS encourages nursing homes to coordinate with state election officials. The goal is to use bipartisan election workers authorized under state law instead of relying solely on community staff. This approach helps protect Residents’ Right to Vote. It also reduces the potential for undue influence during the voting process.
The CMS memo contains a great deal of regulatory language. However, its message is straightforward. It reminds providers to protect every resident’s constitutional right to participate in the democratic process. It also reminds them that residents have the right to decline participation if they choose. The memo does not create new requirements or revise the State Operations Manual. With the upcoming midterm elections likely to generate increased attention, now is a good time to review your community’s policies and procedures. It is also a good opportunity to make certain staff understand both resident rights and their responsibilities.
Stay well and stay informed!
