Below is a general overview of nursing homes’ responsibility to abide by federal and state law. Nursing homes that receive medicaid and or medicare are required to comply with federal legislation. Federal legislation calls for a high quality of care. All states must comply with the federal regulations and some states have adopted even tougher laws.
In 1987, Congress enacted legislation requiring nursing homes participating in the Medicare and Medicaid programs to comply with certain requirements for quality of care. This law is included in the Omnibus Budget Reconciliation Act of 1987 (OBRA 1987), also known as the Nursing Home Reform Act. According to OBRA, a nursing home "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 the Medicare and Medicaid programs, nursing homes must also be in compliance with the federal requirements for long term care facilities as prescribed in the U.S. Code of Federal Regulations (42 CFR Part 483).
Below is a list of some regulations with which the nursing home must comply:
- Sufficient nursing staff to meet the needs of the residents. (42 CFR §483.30)
- Conduct comprehensive and accurate assessments 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 activities of daily living (the ability to bathe, dress, groom, transfer and ambulate, toilet, eat) (42 CFR §483.25)
- Provide activities of daily living such at toileting, grooming, feeding and person hygiene if a resident assessment determines . (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)
- 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)