The form for the authorization of installation and use of a monitoring device shall provide for all of the following: (1) Consent of the resident or his legal representative authorizing the installation and use of the monitoring device. (2) Notice to the nursing home of the resident's installation of a monitoring device and specifics as to the type, function, and use of the device. (3) Consent of any other resident sharing the same room, or that resident's legal representative, to the installation and use of a monitoring device. (4) Notice of release from liability for violation of privacy through the use of the monitoring device. (5) Waiver of the resident's right to privacy in connection with the use of the monitoring device.
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