Federal Nursing Home Law

Both federal and state laws regulate almost every aspect of nursing home activity. If a patient is abused or neglected, the nursing home probably is violating the strict laws prohibiting improper treatment.

The following are some of the specific sections of the Code of Federal Regulations (CFR), which regulate the nursing home industry:

• Care for its residents in a manner and in an environment that promotes maintenance or enhancement of each resident's quality of life (42 CFR 483.15).
  
• Promote care for residents in a manner and in an environment that maintains or enhances each resident's dignity and respect in full recognition of his or her individuality (42 CFR 483.15).
  
• Ensure that the resident has the right to choose activities, schedules, and health care consistent with his or her interests, assessments, and plan of care (42 CFR 483.15).
  
• Conduct initially (no later than 14 days after admission) and periodically (after a significant change in the resident's physical or mental condition and, in no case, less often than once every 12 months) a comprehensive, accurate, standardized, reproducible assessment of each resident's functional capacity (42 CFR 483.20).
  
• Develop a comprehensive care plan for each resident that includes measurable objectives and timetables to meet the medical, nursing, mental, and psychosocial needs identified in the comprehensive assessment. The care plan must be developed within 7 days after completion of the comprehensive assessment and describe the services that are to be furnished. In addition, qualified persons must review, and if necessary revise, the care plan prepared after each assessment (42 CFR 483.20).
  
• Prevent the deterioration of a resident's ability to bathe, dress, groom, transfer and ambulate, toilet, eat, and to use speech, language or other functional communication systems (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 and 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, must 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 and prevent urinary tract infections and to restore as much normal bladder function as possible (42 CFR 483.25).
  
• Ensure that the resident receives adequate supervision and assistive devices to prevent accidents (42 CFR 483.25).
  
• Ensure that a resident maintains acceptable parameters of nutritional status, such as body weight and protein levels (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 sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psycho-social well-being of each resident, as determined by resident assessments and individual plans of care (42 CFR 483.30).
  
• Ensure that the medical care of each resident is supervised by a physician and must provide or arrange for the provision of physician services 24 hours a day, in case of an emergency (42 CFR 483.40).
  
• Provide pharmaceutical services (including procedures that assure the accurate acquiring, receiving, dispensing, and administering of all prescriptions) to meet the needs of each resident (42 CFR 483.60).
  
• Be administered in a manner that enables it to use its resources effectively and efficiently to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident (42 CFR 483.75).
  
• Maintain clinical records on each resident in accordance with accepted professional standards and practices that are complete, accurately documented, readily accessible, and systematically organized (42 CFR 483.75).

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