Nursing home patient rights

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nursing home patient rights:  federal minimum standards of care

In 1987, Congress enacted the Omnibus Budget Reconciliation Act of 1987 (OBRA 1987), also known as the Nursing Home Reform Act, setting forth certain requirements for quality of care. It demands that a nursing home that receives Medicare and Medicaid funding "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..." States may pass even stricter standards if they choose.

In order to receive Medicare and Medicaid funding, nursing homes must comply with the federal requirements for long term care facilities as prescribed in the U.S. Code of Federal Regulations (42 CFR Part 483).

Under the regulations, the nursing home must:

  • Promote each resident's quality of life. (42 CFR 483.15)
  • Maintain dignity and respect of each resident. (42 CFR 483.15)
  • 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)
  • Maintain acceptable parameters of nutritional status. (42 CFR 483.25)
  • Ensure that the resident receives adequate supervision and assistive devices to prevent accidents. (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)
  • Have sufficient nursing staff. (42 CFR 483.30)
  • 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)