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Assisted Living: Guidance for the use of Electronic Recording, Video Monitoring, or Filming Equipment

The purpose of this resource is to offer guidance to providers in adult family homes (AFHs), community based residential facilities (CBRFs), or resident care apartment complexes (RCACs) on the impact of technology, such as electronic recording, electronic video monitoring, or filming on residents' and tenants' right to privacy in facilities regulated by the Division of Quality Assurance (DQA), Bureau of Assisted Living (BAL). This addresses the following:

  • The permissible and impermissible circumstances and locations for provider-initiated technology including electronic video monitoring, electronic recording, or filming under existing Wisconsin Statutes and Administrative Rules.
  • The permissible voluntary uses of technology including electronic video monitoring, electronic recording, or filming when initiated by the resident or tenant, and/or legal representative, including the basis for adding a monitoring device when a person has an activated power of attorney for health care.

Background

Electronic monitoring equipment is ubiquitous in both public and private sectors. Implementation of its use in assisted living facilities has the potential to foster a safer and more secure environment, but it can also create privacy issues that affect the rights of residents or tenants.

In response to questions and concerns that continue to arise during compliance surveys, the Division of Quality Assurance provides the following guidance on the use of electronic recording or video monitoring or filming equipment in BAL regulated facilities. The information presented below recognizes the need to balance the use of emerging technologies with residents' and tenants' rights to privacy in their homes.

Additional educational resources created by the Board on Aging and Long Term Care, Office of the State Long Term Care Ombudsman, can be found on the Department's webpage by clicking on the links below.

Electronic video monitoring

The use of cameras or other equipment to transmit images of residents, tenants, visitors, or staff for possible instant viewing at another location or recording to view at another time.

Filming

The use of cameras or other equipment to record or photograph images of residents, tenants, visitors, or staff for possible viewing at another location at another time.

Electronic recording

The use of a cell phone or use of any device to preserve an audio or video record of residents, tenants, visitors, or staff conversations for possible viewing at another location at another time.

Legal representative

(a) The health care agent under an activated power of attorney for health care under ch. 155, Stats.

(b) A person appointed as a durable power of attorney under ch. 244, Stats.

(c) A guardian as given in s. 54.01 (10) to (12), Stats.

Power of attorney for health care

The designation, by an individual, of another as his or her health care agent for the purpose of making health care decisions on his or her behalf if the individual cannot, due to incapacity under ch. 155, Stats.

Patient

Any individual who is receiving services for mental illness, developmental disabilities, alcoholism or drug dependency, including any individual who is admitted to a treatment facility in accordance with this chapter or ch. 48 or 55 or who is detained, committed or placed under this chapter or ch. 48, 55, 971, 975 or 980, or who is transferred to a treatment facility under s. 51.35 (3) or 51.37 or who is receiving care or treatment for those conditions through the department or a county department under s. 51.42 or 51.437 or in a private treatment facility. See Wis. Stat. § 51.61(1).

Use of electronic recording, video monitoring, filming by the assisted living provider

Privacy is a resident right. Wisconsin Stat. § 50.09 and Wis. Admin. Code DHS §§ 88.10(3) applicable to AFHs and DHS 83.32(3) applicable to CBRFs, are specifically related to preserving resident privacy in many areas. Those areas include:

  • health care;
  • treatment (both physical and emotional);
  • living arrangements;
  • caring for personal needs including toileting, bathing, and dressing;
  • visits by spouse or domestic partner;
  • confidentiality of health and personal information and records;
  • private and unrestricted communications; and
  • the right to not be searched when there is a reasonable expectation of privacy.

In addition to this general right of privacy, Wisconsin statutes have identified statutory privacy rights that are specific to an individual's circumstances.

Wisconsin Stat. ch. 51, Mental Health Act, applies to CBRFs, AFHs, and RCACs if the resident or tenant meets the statutory definition of "patient."

Patient rights are further identified in Wis. Admin. Code DHS ch. 94, which applies to the resident or tenant living in CBRFs, AFHs, and RCACs if the resident or tenant meets the definition of patient.

Human rights laws and regulations protect the rights of persons living in health care settings as they relate to privacy and associations with others. State statutes and administrative rules for AFHs and CBRFs consistently address each resident's right to privacy in care and treatment, accommodations, and communications, namely visitors and phone calls. The use of electronic recording, electronic video monitoring, or filming is not consistent with the provider's obligation to protect and promote each resident's right to privacy when engaged in any of these activities. Such equipment installed in living areas (space used for daily activities such as dining, recreation, sleeping, hosting visitors, etc.) is capable of transmitting images or conversations of residents receiving care and treatment, engaging in activities of daily living, or visiting with guests, staff, or other residents. Whether done deliberately or inadvertently, recording or transmitting images of residents engaging in these types of activities violates their right to privacy.

Due to these privacy protections, BAL has determined that electronic recording or video monitoring and filming in the following locations of AFHs and CBRFs would infringe upon resident privacy rights:

  • Resident bedrooms;
  • Facility or resident bathrooms or shower rooms;
  • Dining rooms;
  • Therapy rooms;
  • Visiting areas, lounges, multipurpose rooms, or activity rooms;
  • Hallways that lead to resident rooms; or
  • Any other space where a resident may be seen meeting with visitors, engaging in an activity (including eating), sleeping, discussing their current condition, or receiving personal care, medical treatment or therapy.

The Department will view electronic recording or video monitoring or filming by the provider in these locations as a violation of resident privacy rights even with the residents' informed, written consent due to concern about violating resident's right to privacy and right to a living environment that is as homelike as possible and the least restrictive.

Provided that the facility posts signs indicating that monitoring or filming is taking place, BAL has determined that electronic recording, video monitoring and filming in the following locations will not infringe upon resident privacy rights in AFHs and CBRFs regulated by BAL:

  • Parking areas;
  • Locations where individuals may enter or exit the building;
  • Areas that are marked for employees only;
  • Storage areas;
  • Hallways or corridors that do not lead to resident rooms or activity areas; and
  • Personnel office that is not accessible to residents.

Relevant laws and rules for RCACs recognize that a tenant has a right to privacy in their independent apartment, when receiving supportive, personal or nursing services, and when using the telephone. Electronic recording, video monitoring and filming are not allowed in the following RCAC locations:

  • The tenant's private apartment.
  • Any other space where a tenant may be seen receiving supportive, personal and/or nursing services.
  • Any other space where a tenant may receive visitors or participate in social activities.

Other guidelines regarding the use of electronic recording, video monitoring, or filming equipment in any assisted living facility

State statutes uniformly afford residents of AFHs, CBRFs, and RCACs the right to privacy, and relevant administrative rules expound upon those rights. Because those rights are statutory in nature, resident and tenant rights are not subject to the waiver or variance procedures that allow exceptions from any administrative rule requirement. Facilities cannot prohibit admissions or require residents or tenants to give up their rights as part of any admission, service, or risk agreement.

Accordingly, the following guidelines on the use of electronic recording or video monitoring and filming are applicable in all AFHs, CBRFs and RCACs regulated by BAL:

  • Electronic recording or video monitoring and filming may be allowed in cooperation with law enforcement on a case-by-case basis, specific to an investigation. Law enforcement must obtain necessary legal permissions, waivers, warrants, or other authorization to proceed.
  • Mandatory consent to the use of electronic recording or video monitoring or filming equipment is not an acceptable condition of admission to any Department-regulated assisted living facility. Similarly, no prospective resident or tenant shall be required by facility policy to give up rights related to a resident's or tenant's desire to operate an electronic recording or video monitoring device within the personal space of the resident's bedroom or tenant's apartment.

Personal use of electronic recording, video monitoring, or filming equipment by the resident, tenant, or legal representative

Guidelines regarding the use of personally owned electronic recording, video monitoring, or filming equipment under the control of the resident, tenant, or legal representative

Residents and tenants have the right to live in a safe environment and to be free from any type of abuse, neglect, or misappropriation. BAL has determined that residents and tenants capable of making their own decisions and/or the legal representatives have the right to install electronic recording or video monitoring or filming equipment within their personal areas of residence and providers cannot prohibit them from doing so.

There are many reasons why a resident, tenant, or legal representative may initiate the use of electronic recording or video monitoring or filming equipment. A provider is encouraged to discuss the reason(s) for use, risks, and benefits from all perspectives, and the possible alternatives to installing the monitoring equipment with the resident or tenant and their legal representative. Consultation with an ombudsman may be helpful in situations where the installation and use of a monitoring device may appear to conflict with a resident's or tenant's exercise of rights.

Within this determination, BAL presents the following guidance for providers:

  • The decision to implement monitoring equipment is that of the resident, tenant, or legal representative. A family member cannot implement its use without the agreement of the resident, tenant, or legal representative.
  • The decision to add a monitoring device when a person has an activated power of attorney for health care should be based on the health care needs of the resident.
  • Any roommate or their legal representative needs to agree to the presence of the monitoring equipment.
  • The resident or tenant and roommate have the right to place conditions on when or where the electronic video monitoring, filming, or electronic recording takes place within the room. Legal representatives should strongly consider a reasonable person's expectation of privacy in bathrooms or shower rooms before placement of a monitoring device in these areas.
  • A resident, tenant, or legal representative who installs a monitoring device should post a sign at the entrance to the room stating the room is electronically monitored by the resident.
  • The provider cannot obstruct the image or sound of the device when desired recording is occurring.
  • A provider cannot refuse to admit or to discharge a resident or tenant because of a desire to monitor the room or refuse to provide care because a monitoring device is present.
  • The continued use of monitoring devices should be reviewed, with all parties involved in the decision-making process, when there is a change in needs, abilities, or condition, and at least annually.

Guidelines regarding the use of facility owned electronic recording, video monitoring, or filming equipment under the control of the facility to meet an assessed resident or tenant need

The use of electronic recording or video monitoring or filming equipment in assisted living facilities will not be, by default, universally implemented for all residents in the facility. However, there may be cases in which an individual resident or tenant may benefit from or request the use of electronic recording, video monitoring, or filming equipment (e.g., cases where the use is indicated by a therapeutic treatment plan or where a decisional resident or tenant initiates a request). A provider is encouraged to discuss the reason(s) for use, risks and benefits from all perspectives, and the possible alternatives to installing the monitoring equipment with the resident or tenant and their legal representative.

Residents and tenants have the right to live in a safe environment and to be free from any type of abuse, neglect, or misappropriation. The use of electronic recording or video monitoring or filming equipment shall be based on person-centered individual assessments and need. The assessment should be documented and retained in the medical record. The individual service plan shall be updated to include the use of electronic monitoring or filming equipment after consent is obtained from the resident or tenant, and/or legal representative.

However, electronic monitoring or filming must never be used as a measure to reduce staffing or to replace staff responsibilities for monitoring resident function and behavior.

Within this determination, BAL presents the following guidance for providers:

  • The decision to implement electronic monitoring or filming equipment is that of the resident, tenant, or legal representative. A facility cannot implement its use without the agreement of the resident, tenant, or legal representative.
  • The decision to add an electronic monitoring or filming device when a person has an activated power of attorney for health care should be based on the health care needs of the resident or tenant.
  • The resident or tenant have the right to place conditions on when or where the electronic video monitoring, filming, or electronic recording takes place within the room. A provider shall not place electronic recording or video monitoring or filming equipment in bathrooms or shower rooms due to a reasonable person's expectation of privacy in these areas.
  • A provider who installs a monitoring device should post a sign at the entrance to the room stating the room is electronically monitored by the facility.
  • The provider cannot obstruct the image or sound of the device when desired recording is occurring.
  • The continued use of electronic monitoring or filming equipment should be reviewed, with all parties involved in the decision-making process, when there is a change in needs, abilities or condition, and at least annually.
  • The provider must ensure the privacy rights of any roommate are protected.

Summary

Generalized electronic recording, video monitoring, or filming initiated by the provider in areas of a facility that would infringe upon resident or tenant privacy rights will result in violations of the residents' or tenants' right to privacy. The department may impose sanctions as a result of these violations. To comply with state statutes and administrative rules and avoid infringing on a resident's or tenant's privacy rights, a provider shall discontinue use of, and remove any electronic recording, electronic video monitoring, or filming equipment in each area included in the list of prohibited locations identified above.

The Department recognizes that there may be unique situations not explicitly covered by the guidance offered, such as:

  • Client groups whose rights are restricted by the Department of Corrections.
  • Religious services, recognition ceremonies, or public speeches that are broadcast to a wider audience than is present in the room.
  • Remote support technology

Questions

If you encounter a unique situation similar to those detailed above, or have any other questions, please contact your Regional Director in the Bureau of Assisted Living to determine if a waiver or variance request is needed. Additional information about the waiver or variance process, and specific to technology, can be found on the Waivers, Approvals, Variances, and Exceptions: Assisted Living webpage.

The Assisted Living Regional Director contacts can be found on our Division of Quality Assurance: Bureau of Assisted Living Regional Offices webpage.

The Board on Aging and Long Term Care (BOALTC) offers resources related to electronic monitoring and residents' and tenants' rights. To consult with an ombudsman or to request written information contact BOALTC at 1-800-815-0015 or visit their webpage.

Providers are also advised to consult with their own legal counsel regarding these issues.

Glossary

 
Last revised July 17, 2025