1 Mass. Gen. Laws Ann. ch. 111 , § 70E (West 1979).

2 See Legal Problems with S. 425—The Patients’ Bill of Rights—As Amended (unpublished memorandum, available from the office of Am. J. L. & Med.).

3 105 C.M.R. §§ 150.000-150.020 (1977).

4 940 C.M.R. § 4.00-4.09 (1975).

5 Massachusetts regulations, such as the AG Regulations and the DPH Regulations, have the force and effect of law. Individuals who violate state regulations may be subject to both civil and criminal penalties. Code Guide, 20 C.M.R. i (1978).

6 See Mass. Gen. Laws Ann. ch. 111 , § 70E cl. 3 (West 1979) (freedom of choice in selection of a facility); 105 C.M.R. § 150.008(A) (1977) (freedom to choose a pharmacy); Mass. Gen. Laws Ann. ch. 111 , § 70E cl. 5(f) (West 1979) (right to receive information on financial assistance and free health care); Mass. Gen. Laws Ann. ch. 111 , § 70E cl. 5(e) (West 1979) (right to receive a copy of the regulations of the facility); 940 C.M.R. § 4.02 (3) (1975) (right to receive a copy of the regulations of the nursing home); Mass. Gen. Laws Ann. ch. 111 , § 70E cl. 2 (West 1979) (right to receive a copy of the Act); 940 C.M.R. § 4.02(4) (1975) (right to receive a copy of the AG Regulations); 940 C.M.R. § 4.07 (3) (1975) (right not to be transferred).

7 See Mass. Gen. Laws Ann. ch. 111 , § 70E cl. 5(1) (West 1979) (right to an informed consent); Mass. Gen. Laws Ann. ch. 111 , § 70E cl. 6(d), 5(i) (West 1979) (right to refuse to serve as a research subject); Mass. Gen. Laws Ann. ch. 111 , § 70E cl. 5(j) (West 1979) (right to privacy during treatment); 940 C.M.R. § 4.06(1) (1975) (right to privacy during treatment); 940 C.M.R. § 4.04(1) (1975) (right to private communications); 940 C.M.R. § 4.05(6) (1975) (right to retain personal possessions); 940 C.M.R. § 4.04(1-2) (1975) (right to private communication with any person); 940 C.M.R. § 4.05(1) (1975) (right to manage own financial affairs); 940 C.M.R. § 4.04(3) (1975) (right to private visits with the patient’s spouse).

8 See Mass. Gen. Laws Ann. ch. 111 , § 70E cl. 4 (West 1979) (right to an itemized bill); Mass. Gen. Laws Ann. ch. 111 , § 70E cl. 5(g) (West 1979) (right to inspect and copy medical records); 940 C.M.R. § 4.06(2) (1975) (right to inspect medical records).

9 See Mass. Gen Laws Ann. ch. 111 , § 70E cl. 2 (West 1979) (patients’ rights must be posted and distributed to patients); 940 C.M.R. § 4.02(2) (1975) (home must tell patients in writing that the AG Regulations exist and must give the patient a copy of the AG Regulations upon the patient’s written request); 940 C.M.R. § 4.02(4) (1975) (home must post a copy of the AG Regulations).

10 For example, freedom of choice in selection of a facility may be more helpful for a patient choosing a hospital than for a nursing home patient.

11 For example, both the Act and the AG Regulations grant privacy during treatment as a patients’ right.

12 For example, the right to an informed consent is afforded “to the extent provided by law.“

13 105 C.M.R. § 150.000 (1977).

14 The AG Regulations were promulgated under the Massachusetts Consumer Protection Law. See Mass. Gen. Laws Ann. ch. 93A (West 1972). The consumer protection statute grants the patient and third parties a private cause of action. Mass. Gen. Laws Ann. ch. 93A, § 9 (West 1972). While the AG Regulations do not contain a standing provision, the Attorney General’s Office interprets the Regulations as granting standing as described in the enabling statute, the consumer protection law.

15 Mass. Gen. Laws Ann. ch. 111 , § 70E (West 1979).

16 In 1939, there were 1200 nursing homes in the United States. By 1968, there were 19,000 and in 1975, the number had grown to 26,000. Ainsworth, T., Quality Assurance in Long Term Care 15 (1977)Google Scholar.

17 Social Security Act Title XVIII, 42 U.S.C. § 1395 (1965).

18 Social Security Act Title XIX, 42 U.S.C. § 1396(1965).

19 See T. Ainsworth, supra note 16, at 20 (discussing psychological impact of life in the nursing home on the patient); Gottesman, & Bourestom, , Why Nursing Homes Do What They Do, 14 The Gerontologist 501, 504 (1974)Google Scholar (discussing factors determining the amount of care a nursing home patient receives).

20 Subcommittee on Long Term Care of the Senate Special Committee on Aging, Nursing Home Care in the United States: Failure in Public Policy, Introductory Report, S. Rep. NO. 93-1420, 93d Cong., 2d Sess. 16-17 (1974). [hereinafter Introductory Report].

21 Introductory Report supra note 20, at 6.

22 See note 20 supra, at 16-17.

23 Subcommittee on Long Term Care of the Senate Special Committee on Aging, 93d Cong., Nursing Home Care in the United States: Failure in Public Policy, Supporting Paper #2, Drugs in Nursing Homes: Misuse, High Costs, and Kickbacks XIII (Comm. Print 1975) [hereinafter Supporting Paper #2 ] .

24 When patients first enter Massachusetts nursing homes, 52 percent are on Medicaid and 37 percent are on Medicare. After the patients have resided in the nursing home, 63 percent receive Medicaid and 0.43 percent receive Medicare. “Nursing & Rest Home Annual Report, Patient Summary Section, 1977 Survey” (unpublished, available at the Massachusetts Department of Public Health, Boston, MA).

25 Supporting Paper # 2 , supra note 23, at XIII; Gottesman & Bourestom, supra note 19, at 505.

26 See Gottesman & Bourestom, supra note 19, at 504.

27 H.E.W.’s Health Standards & Quality Bureau has proclaimed that a nursing home’s receipt of Medicare or Medicaid reimbursement entitles H.E.W. inspectors to inspect a sample of all patient records in the facility, including both Medicare or Medicaid and private paying. See State Agency Bulletin No. 79-31 (unpublished; available from pathe office of Am. J. L. & Med.). H.E.W. interprets nursing home receipt of Medicare and Medicaid funds as requiring that the home comply with federal regulations throughout the facility, not just in the areas where Medicare and Medicaid patients reside.

28 Under federal regulations, skilled nursing homes must provide patients with the following rights: (1) right to know of services available in the ; facility and related charges; (2) right to be informed by a physician-ofrhis medical condition; (3) “right to participate in planning his medical treatment; (4) right to refuse to participate in experimental research; (5) right to be transferred only for medical reasons or his own or other patients’ welfare; (6) right to voice grievances and recommend changes in home policy; (7) right to manage personal finances; (8) right to be free from mental and physical abuse and free from chemical and physical restraints; (9) right to confidential treatment of personal and medical records and right to restrict their release; (10) right to be treated with dignity and privacy in treatment; (11) right not to perform non-therapeutic services for the facility; (12) right to communicate privately with persons of his choice; (13) right to participate in social, religious, and community groups of his choice; and (14) right to private visits with spouse and to share a room if both are in the same facility. (These rights can be restricted for medically necessary reasons.) 20 C.F.R. § 405.1121(k) (1977).

29 In Massachusetts, 535 nursing homes participate in Medicaid and 116 nursing homes participate in Medicare (out of total of 570 nursing homes). Letter from Massachusetts Department of Public Welfare, Boston, to the author (May 21, 1980).

30 Other sanctions available to the government include: conditional certification with automatic cancellation after a certain amount of time, 42 C.F.R. §§ 405.1908(a), 442.111(b) (1979); certification of facility with a plan to correct the deficiencies within a reasonable period of time as determined by the Secretary. 42 C.F.R. §§ 442.110, 405.1907 (1979).

31 Transfer of patients causes severe and traumatic effects. The patient often experiences depression or regressive behavior and even may die. Hitov, , Transfer Trauma: Its Impact on the Elderly, 8 Clearinghouse Rev. 846, 846-47 (Apr. 1975)Google Scholar; Bourestom, & Tars, , Alterations in Life Patterns Following Nursing Home Relocation, 14 The Gerontologist 506, 508 (1974).Google Scholar

32 Compare Fuzie v. Manor Care, Inc., 461 F.Supp. 689, 696 (N.D. Ohio 1977); Wagner v. Sheltz, 471 F.Supp. 903 (D. Conn. 1979) (no private cause of action for violation of Medicaid statute) with Robertson v. Wood, 464 F.Supp. 983 (E.D. 111. 1979); Berry v. First Healthcare Corp., [1977] Medicare & Medicaid Guide (CCH) ¶ 28,693 (D.N.H. Oct. 26, 1977) (private cause of action for violation of Medicaid statute upheld).

33 N.C. Gen. Stat. § 130-275 (Cum. Supp. 1979).

34 Md. Ann. Code art. 43, § 565D (1980).

35 105 C.M.R. § 150.000 (1977). [

36 See Legal Problems with S.425—The Patients’ Bill of Rights—As Amended, supra note 2.

37 It is unclear whether patients have standing (see note 30 supra) but no court has held that other parties would have standing.

38 The following states have promulgated patients’ rights laws that apply to nursing home patients exclusively or in combination with other patients: Colo. Rev. Stat. § 25-1-120 (Supp. 1978) (applies to patients in nursing homes); Conn. Gen. Stat. Ann. § 19-622 (West 1975) (applies to patients in nursing homes); Fla. Stat. § 400.022 (Supp. 1980) (applies to patients in nursing homes); Ky. Rev. Stat. Ann. § 216.515 (Baldwin Supp. 1978) (applies to patients in long term care facilities); Md. Ann. Code art. 43, § 565C (1980), (applies to patients in nursing homes); Minn. Stat. Ann. § 144.651 (West Supp. 1980) (applies to patients in health care facilities); N.J. STAT. ANN. § 30.13-5 (West Supp. 1979) (applies to patients in nursing homes); N.Y. Pub. Health Law art. 28, § 2803-c (McKinney 1975) (applies to patients in nursing homes and in facilities providing health related services); N.C. Gen. Stat. § 130-266 (Cum. Supp. 1979). (applies to nursing home patients); Pa. Admin. Code 28 § 201.34 (1976) (applies to patients and employees of nursing homes); R.I. Gen. Laws § 23-16-19.1 (Supp. 1978) (applies to patients in health care facilities); Va. Code § 32.1-138 (1979) (applies to nursing home patients); Wis. Stat. Ann. § 50.09 (West Supp. 1979) (applies to patients in nursing homes and to persons in a community-based residential facility).

While Colorado, Connecticut, Florida, Kentucky, Maryland, New Jersey, North Carolina and Virginia have promulgated statutes that deal exclusively with the rights of the nursing home patient, several other states have set forth Patients’ Bills of Rights that address solely patients in mental institutions. See Cal. Welf. & Inst. Code §§ 5325-5328.9 (West Supp. 1980); Mich. Stat. Ann. §14.800 (1974); Wash. Rev. Code Ann. § 71.05.370 (1974).

39 Mass. Gen. Laws Ann. ch. 111 , § 70E (West 1979).

40 Id.

41 See 940 C.M.R. § 4.00-4.09 (1975); 150 C.M.R. §§ 150.000-150.020 (1977).

42 See 150 C.M.R. §§ 150.000-150.020 (1977).

43 See note 14 supra.

44 The least restrictive environment theory, as applied to mental patients in Wyatt v. Stickney, 344 F. Supp. 373, 379 (M.D. Ala. 1972) has not yet been applied to nursing home patients. The theory of least restrictive environment as enunciated in that case is that the conditions in the facility should restrict the patient as little as possible while achieving the goals of commitment. Id. at 379.

45 There are four different levels of care in Massachusetts nursing homes. A particular home may provide one or more of these levels of care. The most intensive nursing care is given in the Intensive Nursing & Rehabilitative Care Facility (Level I), where continuous skilled nursing care and a restorative services program are available. 105 C.M.R. § 150.001(b)(l) (1977). There are no homes held to the standards of a Level I facility in Massachusetts. 105 C.M.R. § 150.000 (1977) (Introduction to February 1977 Compilation). The Level II homes, known as skilled nursing facilities (SNFs) provide continuous skilled nursing care and some restorative and therapeutic services. 105 C.M.R. § 150.001(B)(2) (1977). Level III facilities are intermediate care facilities (ICFs) that provide routine nursing sevices, periodic skilled nursing services, restorative and therapeutic services. 105 C.M.R. § 150.001(B)(3).(1977). The Level IV homes, called Resident Care Facilities, provide supervision but no routine nursing or other medically related services. 105 C.M.R. | § 150.001(B)(4) (1977).

46 Mass. Gen. Laws Ann. ch. 111 , § 70E cl. 3 (West 1979).

47 105 C.M.R. § 150.008(A) (1977).

48 Mass. Gen. Laws Ann. ch. 111 , § 70E cl. 5(£) (West 1979).

49 See note 24 supra.

50 Mass. Gen. Laws Ann. ch. 111 , § 70E cl. 2 (West 1979).

51 940 C.M.R. § 4.02(4)(1975).

52 Mass. Gen. Laws Ann. ch. 111 , § 70E cl. 5(e) (West 1979); 940 C.M.R. § 4.02(3) (1975).

53 940 C.M.R. § 4.07(3) (1975).

54 See note 31 supra.

55 A patients’ advocate in Connecticut stated that a patient in one of his nursing homes was transferred after making a complaint to the advocate. After that time, no other patients in that nursing home have confided their problems to the advocate. Klonoff, , The Problems of Nursing Homes: Connecticut’s Non-Response, 31 Ad. L. Rev. 1, 10–11(1979)Google Scholar.

56 940 C.M.R. § 4.07(3) (1975).

57 Medicare and Medicaid nursing home patients do not have a right to a hearing prior to their home’s decertification from Medicare and Medicaid participation. O’Bannon v. Town Court Nursing Center, 48 U.S.L.W. 4842 (1980). Thus, while Medicare and Medicaid nursing home patients may receive notice of transfer, they often are unable to avoid transfer.

H.E.W. plans to develop regulations that consolidate Medicare and Medicaid regulations on survey and certification of health care facilities. 45 Fed. Reg. 13,477 (1980). H.E.W. indicated that one of the objectives of the new regulations will be to include patients and consumers as participants in the survey and certification process. Id. Such participation will necessarily require notice to patients before decertification of a facility and subsequent transfer of the patients in the facility.

58 See Bernhardt, Real Property in a Nutshell 110-111 (West 1975).

59 Mass. Gen. Laws Ann. cti. 111 , §§ 70E cl. 6(d), 5(i) (West 1979).

60 Mass. Gen Laws Ann. ch. 111 , § 70E cl. 5(1) (West 1979).

61 In Schroeder v. Lawrence, 372 Mass. 1, 359 N.E.2d 1301 (1977), a negligence action by a patient against a surgeon for failing to obtain an informed consent, the court commented on the doctrine as follows:

Id. at 5, 359 N.E.2d at 1303. The court did, however, go on to discuss the doctrine as applied in Canterbury v. Spence, 464 F. 2d 772 (D.C. Cir. 1972).

A few months later, the Supreme Judicial Court, in Superintendant of Belchertown State School v. Saikewicz, 373 Mass. 728, 370 N.E.2d 417 (1977), once more had the opportunity to recognize the doctrine in Massachusetts and again, did not choose to do so. The Saikewicz court mentioned informed consent in passing and then went on to decide the case based on the patient’s right to privacy and self-determination. Id. at 759, 370 N.E.2d at 435. The court mentioned Schroeder as standing for the fact that informed consent has not been recognized in Massachusetts. Id. at 739, 370 N.E.2d at 424. The court noted that “while the doctrine … has not been formally recognized by this court … it is one of widespread recognition.”

Id. Earlier Versions of the Patients’ Rights Law contained a more comprehensive statement of the informed consent provision than the bill that was eventually enacted in 1979. Massachusetts House Bill No. 1116 (Jan. 1975) denned informed consent as “the right to be informed by the physician responsible for his care of all major, reasonably foreseeable risks involved in any medical procedure or treatment being suggested or recommended by any of the facility’s medical personnel before any such procedure or treatment is instituted.“

Another early version of the provision had an even more detailed description of what is necessary for an informed consent:

Mass. S. 1948 (proposed but not passed, June 1975). California’s informed consent provisions, contained in its mental patients’ rights law, define consent and differentiate between written and oral consent. Cal. Welf. & Inst. CODE §§ 5326.2-5326.5 (West Supp. 1980).

62 Mass. Gen. Laws Ann. ch. 111 , § 70E cl.5(j) (West 1979); 940 C.M.R. § 4.06(1) (1975).

63 940 C.M.R. § 4.04(3) (1975).

64 940 C.M.R. § 4.05(6) (1975).

65 940 C.M.R. § 4.04(1-2) (1975).

66 940 C.M.R. § 4.05(1) (1975).

67 940 C.M.R. § 4.05(7) (1975).

68 Mass. Gen. Laws Ann. ch. 111 , § 70E cl.5(g) (West 1979) (right to inspect and copy medical records); 940 C.M.R. § 4.06(2) (1975) (right to inspect medical records).

69 Mass. Gen. Laws Ann. ch. 111 , § 70E cl.4 (West 1979).

70 940 C.M.R. § 4.03(8) (1975).

71 Mass. Gen. Laws Ann. ch. 111 , §70 (West 1979).

72 See 940 C.M.R. §§ 4.00-4.09 (1975).

73 See Md. Ann. Code art. 43, § 565C (1980); N.C. Gen. Stat. §§ 130-270 (Cum. Supp. 1979).

74 See 105 C.M.R. § 150.000 (1977).

75 Mass. Gen. Laws Ann. ch. 111 , § 70E (West 1979).

76 See note 14 supra.

77 There currently is a nursing home ombudsman program in Massachusetts. The ombudsman program, formulated in 1978 in response to a federal mandate (Comprehensive Older Americans Act Amendments of 1978, Pub. L. No. 95-478, 92 Stat. 1513), investigates complaints by elderly citizens. Staff members from the Nursing Home Ombudsman’s Office visit nursing home patients regularly to solicit quality of care complaints.

78 A guardian cannot be appointed in Massachusetts until a court has determined that an individual is incompetent. Mass. Gen. Laws Ann. ch. 201, § 34 (West Supp. 1980).

79 The temporary conservator statute provides that the court may appoint a conservator upon the petition of a person of advanced age or mental weakness, a friend of such a person, or the Department of Public Welfare. The temporary conservator has the same duties and is subject to the same laws as a permanent conservator. Mass. Gen. Laws Ann. ch. 201, § 21 (West Supp. 1980).

80 See note 23 supra.

81 However, a temporary conservator may be appointed for such an individual. See note 79 supra.

82 Mass. Gen. Laws Ann. ch. 231, § 60B (West Supp. 1980). This screening tribunal has survived constitutional attack. Paro v. Longwood Hosp., 373 Mass., 639, 654, 369 N.E.2d 985, 990 (1977). The tribunal is designed to eliminate frivolous medical malpractice claims and thereby to reduce the cost of providing medical malpractice insurance. See generally Salem Orthopedic Surgeons, Inc. v. Quinn, 1979 Mass. Adv. Sh. 661, 664-665, 386 N.E.2d 1268 (1979); Little v. Rosenthal, 1978 Mass. Adv. Sh. 2793, 2797, 382 N.E.2d 1037 (1978). .

83 Mass. Gen. Laws Ann. ch. 231, § 60B (West Supp. 1980).

84 Id.

85 Mass. Gen. Laws Ann. ch. 231, § 60B (West Supp. 1980). See also Salem .Orthopedic Surgeons, Inc. v. Quinn, 1979 Mass. Adv. Sh. 661, 670, 386 N.E.2d 1268, 1270 (1979).

86 Health care providers include nursing homes, physicians, and nursing home staff members who are acting within the scope of their employment; Mass. Gen. Laws Ann. ch. 231, § 60B (West Supp. 1980).

87 DiGiacomo, & Wyman, , Medical Malpractice Tribunals, Part I: Practice & Procedure, 62 Mass. L. Q. 101 (1977)Google Scholar.

88 Mass. Gen. Laws Ann. ch. 111 , § 70E els. 6(d), 5(i) (West 1979).

89 see Note, The Massachusetts Medical Malpractice Statute: A Constitutional Perspective, 11 Suff. L. Rev. 1289, 1313 (1977).

90 Mass. Gen. Laws Ann. ch. 231, § 60B (West Supp. 1980).

91 For example, the patient may sue for violation of the right to be free from abuse, free from battery, or the right to permanent care at the nursing home if the patient has a lifecare contract with the facility.

92 For example, violation of the right to an itemized bill would not lead to an action in tort or contract. ‘

93 The statute requires that the third member of the tribunal be a member of a “field of medicine.” Mass. Gen. Laws Ann. ch. 231, § 60B (West Supp. 1980).

94 Id.

95 There have been problems in determining the identity of the panel members when there is more than one type of defendant. Giacomo & Wyman, supra note 87, at 103.

96 See Note, supra note 89.

97 The nursing home patient who brings a civil suit against the home can sue under a number of different theories. For instance, the patient can sue in contract or in tort; if the patient is a Medicare or Medicaid recipient, he or she may argue on a third party beneficiary theory, claiming to be the beneficiary of the financial agreement between the nursing home and the federal government. See Brown, , An Appraisal of the Nursing Home Enforcement Process, 17 Ariz. L. Rev. 304 (1975)Google Scholar; Callen, , Patients’ Rights and Informed Consent: An Emergency Case for Hospitals? 12 Cal. West. L. Rev. 406, 415 (1976)Google Scholar; Weatherby, , Regulation of Nursing Homes—Adequate Protection for the Nation’s Elderly? 8 St. Mary’s L. J. 309, 323 (1976)Google Scholar.

98 A patient who sues under the AG Regulations can receive up to treble damages. Mass. Gen. Laws Ann. ch. 93A, § 11 (West Supp. 1980). See note 86 supra.

99 Mass. Gen. Laws Ann. ch. 93A (West 1972).

100 Mass. Gen. Laws Ann. ch. 93A, § 4 (West 1972); see Baldassari v. Public Finance Trust, 369 Mass. 33, 40-41, 337 N.E.2d 701, 703, (1975),

101 See 105 C.M.R. § 150.000 (1977).

102 Introductory Report, supra note 20, at 76.

103 The DPH Regulations, in effect, require the nursing home to be habitable by including the requirement that the patient accomodations in nursing homes be cheerful, homelike, clean and maintained in good repair. 105 C.M.R. § 150.015(f) (1977).

104 Several other states have enacted Patients’ Bills of Rights. See note 38 supra.

105 See Mass. Gen. Laws Ann. ch. 111 , § 70E (West 1979); 940,C.M.R. § 4.02(4) (1975).

106 For instance, both the AG Regulations and the Act give nursing home patients the right to privacy during treatment and the right to inspect their medical records. See Mass. Gen. Laws Ann. ch. 111 , § 70E cl. 5(j) (West 1979) (right to privacy during treatment); 940 C.M.R. § 4.06(1) (1975) (right to privacy during treatment); Mass. Gen. Laws Ann. ch. § 70E cl. 5(g) (West 1979) (right to inspect and copy medical records); 940 C.M.R. § 4.06(2) (1975) (right to inspect medical records).

107 For instance, the Act provides for a right to an informed consent “to the extent provided by law.” Mass. Gen. Laws Ann. ch. 111 , § 70E cl. 5(1) (West 1979). See note 52 supra and accompanying text.

108 Mental patients may have a constitutionally protected right to treatment. Spece, Preserving the Right to Treatment: A Critical Assessment and Constructive Development of Constitutional Right to Treatment Theories, 20 Ariz. L. Rev. 1 (1978); see Wyatt v. Stickney, 344 F. Supp. 373 (M.D. Ala. 1972) (holding that involuntarily commited mental patients have a constitutional right to rehabilitative treatment). Prisoners have a statutory right to treatment in Minnesota. Hines v. Anderson, 439 F. Supp. 12 (D. Minn. 1977). While the right to rehabilitative treatment has not yet been formally recognized for nursing home patients, some states do give the nursing home patient a statutory right to adequate treatment. See Md. Ann. Code art. 43, § 565C (2), (4), (10) (1980); N.Y. Pub. Health Law art. 28, § 2803-c(3)(e) (McKinney 1975).

109 Nursing home patients are in need of rehabilitative treatment in order to counteract their inactive lives at the nursing home. Much of the nursing home patients’ time during the day is spent doing little or nothing. See Gottesmah & Bourestom, supra note 19, at 503. Furnishingnursing home patients with rehabilitative therapy also would help to reverse the patients’ perception of the nursing home as a last stop before death. See Supporting Paper #2, supra note 23, at XIII; Bourestom & Tars, supra note 31, at 505.

110 See Supporting Paper # 2 , supra note 23, at XIII; Bourestom & Tars, supra note 31, at 505.

111 See T. Ainsworth, supra note 16, at 20.

112 See note 109 supra. ‘ ,

113 Several other states statutorily provide nursing home patients with this information. See Minn. Stat. Ann. § 144.651(9) (West Supp. 1980); N.C. Gen. Stat. § 130-266(3) (Cum. Supp. 1979).

114 See Panel, Task, Mental Health and Human Rights: Report of the Task Panel on Legal and Ethical Issues, 20 Ariz. L. Rev. 49, 136 (1978)Google Scholar.

115 See Minn. Stat. Ann. § 144.651(19) (West Supp. 1980).

116 An example of taking the concept of patients’ rights beyond the point of reasonableness can be found in the Rhode Island Patients’ Rights Law, which specifies the type of television set the patient can use in the nursing home. R.I. Gen. Laws § 23-16-19.1(15) (Supp. 1978).

117 In Little v. Rosenthal, 1978 Mass. Adv. Sh. 2793, 2796, 382 N.E.2d 1037, 1040 (1978), the Massachusetts Supreme Judicial Court held that medical malpractice tribunals apply to all “treatment related” claims.