Federal Nursing Home Regulations and State Laws

Numerous federal and state laws protect nursing home and assisted living facility patients from abuse and neglect. Additionally, patients are entitled to privacy, security and other rights.

Federal Nursing Home Regulations

In response to reports of widespread neglect and abuse in nursing homes, Congress enacted legislation in 1987 requiring nursing homes participating in Medicare and Medicaid to comply with certain quality of care rules. This law, known as the Nursing Home Reform Act, says that  nursing homes “must provide services and activities to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident in accordance with a written plan of care.” To participate in Medicare and Medicaid, nursing homes must comply with the federal requirements for long term care facilities.

Under federal nursing home regulations, nursing homes must:

  • Have sufficient nursing staff. (42 CFR §483.30)
  • Conduct initially a comprehensive and accurate assessment of each resident’s functional capacity. (42 CFR §483.20)
  • Develop a comprehensive care plan for each resident. (42 CFR §483.20)
  • Prevent the deterioration of a resident’s ability to bathe, dress, groom, transfer and ambulate, toilet, eat, and to communicate. (42 CFR §483.25)
  • Provide, if a resident is unable to carry out activities of daily living, the necessary services to maintain good nutrition, grooming, and personal oral hygiene. (42 CFR §483.25)
  • Ensure that residents receive proper treatment and assistive devices to maintain vision and hearing abilities. (42 CFR §483.25)
  • Ensure that residents do not develop pressure sores and, if a resident has pressure sores, provide the necessary treatment and services to promote healing, prevent infection, and prevent new sores from developing. (42 CFR §483.25)
  • Provide appropriate treatment and services to incontinent residents to restore as much normal bladder functioning as possible. (42 CFR §483.25)
  • Ensure that the resident receives adequate supervision and assistive devices to prevent accidents. (42 CFR §483.25)
  • Maintain acceptable parameters of nutritional status. (42 CFR §483.25)
  • Provide each resident with sufficient fluid intake to maintain proper hydration and health. (42 CFR §483.25)
  • Ensure that residents are free of any significant medication errors. (42 CFR §483.25)
  • Promote each resident’s quality of life. (42 CFR §483.15)
  • Maintain dignity and respect of each resident. (42 CFR §483.15)
  • Ensure that the resident has the right to choose activities, schedules, and health care. (42 CFR §483.40)
  • Provide pharmaceutical services to meet the needs of each resident. (42 CFR §483.60)
  • Be administered in a manner that enables it [the nursing home] to use its resources effectively and efficiently. (42 CFR §483.75)
  • Maintain accurate, complete, and easily accessible clinical records on each resident . (42 CFR §483.75)

State Nursing Home Regulations

Nursing homes receiving Medicare or Medicaid funds must, at a minimum, comply with federal nursing home regulations. Some states, however, have adopted tougher laws. Check with your local health department for specific regulations in your state. Information about each state’s laws can also be found online.