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The Protections of Nursing Home Regulations


Along with the establishment of federal programs known as Medicaid and Medicare, also came the legislation for federal nursing home regulations in 1967. Federal legislation mandated regulations for nursing homes to comply with various nursing home standards in order to meet levels of high quality care if they were to continue to receive federal funding. All long term care facilities that qualify and voluntarily elect to use Medicaid and Medicare as a revenue source for their services must stay in compliance with these laws as carried out by the Health Care Finance Administration, a division of the United States Department of Health and Human Services.

The first set of nursing home legislation was initiated in 1967, with revisions in 1980 and 1987. Though all states must comply with these laws at a minimum, some states have chosen to adopt tougher laws in order to raise the level of nursing home services.

These assisted living facilities laws require each patient in assisted living settings and all types of nursing homes facilities have the potential and opportunity to be provided with care that enables them to attain or maintain the best and most highest level of practical mental, physical and psycho-social well-being. In order to remain compliance, aged care facilities must give patients the ability to make their own choices regarding schedules, activities and other health-care related issues. 24 hour licensed practical nurse care must be provided every day with one RN (registered nurse) on duty at least 8 hours per day. This was enacted due to the widespread reports of nursing home abuse and neglect in the 1980's. In response, the federal government enacted the Omnibus Budget Reconciliation Act of 1987 (OBRA 1987), also known as the Nursing Home Reform Act. This bill required facilities who were participating in the Medicaid and Medicare programs to comply with certain nursing home requirements.

Although federal nursing home regulations mandate that the State enforce the federal standards and state licensing, many states and local authorities have adopted their own nursing homes legislation to protect residents. Violations of these state or federal standards can lead to fines and even lead to shutting down the facility.

Any violation of these nursing home regulations can lead to compensation for nursing home residents for pain and suffering, the cost of transferring to another care facility and for punitive fines. Please consult an attorney should you feel a facility is not meeting the proper nursing home regulations. He or she can guide you in the law and with taking the proper action.

According to the U.S. Code of Federal Regulations, in order for long term care facilities to participate in the Medicare and Medicaid programs, they must be in compliance as prescribed:

Nursing home regulation states preventative measures shall be taken as well as provisionary actions:

  • The facility must provide sufficient nursing staff.

  • An in-depth care plan must be developed for each resident.

  • An accurate and detailed assessment of each residents functional capacity be made.

  • Provide the necessary services to maintain good hygiene, nutrition and grooming if residents are unable to carry out these activities by themselves.

  • Provide the appropriate services and treatment to incontinent residents to restore as bladder functioning as normally as possible.

  • Provide pharmaceutical services as necessary to meet each residents needs.

  • Provide each resident with sufficient fluid intake to maintain proper hydration and health.

Preventative must be taken such as:

  • Ensuring the resident's ability to groom, dress, bathe, communicate, eat, toilet, transfer and ambulate.

  • Ensure safety and that the resident receives the proper supervision and devices to prevent accidents.

  • Ensure that there are no medication errors.

  • Ensure that the resident has the freedom of choice between schedules, activities and health care.

  • Ensure residents receive proper treatments and devices to maintain vision and hearing abilities.

  • Ensure residents do no develop pressure sores. In the event one has developed, to provide the best care as possible to further promote and prevent healing, infection and new sores from developing.

Other areas include:

  • Proper parameters of nutritional status.

  • Promoting overall quality of life.

  • Maintaining the dignity and respect of each resident.

  • Maintain accurate, complete and easily accessible clinical records on each resident.

As nursing home regulations are set in place to protect the elderly in these facilities, when choosing a nursing home, it is still wise to look into issues such as the nursing home safety policies and issues such as nursing home activities before making a decision.

The best news is that we have ranked long term care facilities across the nation to help become informed when choosing the place that is right for you.

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