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:
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Promote each resident's quality of life. (42 CFR
§483.15)
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Maintain dignity and respect of each resident.
(42 CFR §483.15)
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Conduct initially a comprehensive and accurate
assessment of each resident's functional capacity. (42 CFR
§483.20)
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Develop a comprehensive care plan for each
resident. (42 CFR §483.20)
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Prevent the deterioration of a resident's ability
to bathe, dress, groom, transfer and ambulate, toilet, eat, and to
communicate. (42 CFR §483.25)
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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)
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Ensure that residents receive proper treatment
and assistive devices to maintain vision and hearing abilities.
(42 CFR §483.25)
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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)
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Provide appropriate treatment and services to
incontinent residents to restore as much normal bladder
functioning as possible. (42 CFR §483.25)
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Maintain acceptable parameters of nutritional
status. (42 CFR §483.25)
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Ensure that the resident receives adequate
supervision and assistive devices to prevent accidents. (42 CFR
§483.25)
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Provide each resident with sufficient fluid
intake to maintain proper hydration and health. (42 CFR §483.25)
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Ensure that residents are free of any significant
medication errors. (42 CFR §483.25)
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Have sufficient nursing staff. (42 CFR §483.30)
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Ensure that the resident has the right to choose
activities, schedules, and health care. (42 CFR §483.40)
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Provide pharmaceutical services to meet the needs
of each resident. (42 CFR §483.60)
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Be administered in a manner that enables it [the
nursing home] to use its resources effectively and efficiently.
(42 CFR §483.75)
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Maintain accurate, complete, and easily
accessible clinical records on each resident . (42 CFR §483.75)
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