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Federal Nursing Home Regulations Cheat Sheet by

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Introd­uction

Congress enacted legisl­ation in 1987 requiring nursing homes partic­ipating in Medicare and Medicaid to comply with certain quality of care rules. This law, known as the Nursing Home Reform Act, says that nursing homes “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 Medicare and Medicaid, nursing homes must comply with the federal requir­ements for long term care facili­ties.

Federal Regula­tions

Regu­lat­ion
Desc­rip­tion
42 CFR §483.30
Have sufficient nursing staff
42 CFR §483.20
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 §483.25
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
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 §483.1
Promote each resident’s quality of life.
42 CFR §483.15
Maintain dignity and respect of each resident.
42 CFR §483.40
Ensure that the resident has the right to choose activi­ties, schedules, and health care
42 CFR §483.60
Provide pharma­ceu­tical services to meet the needs of each resident
42 CFR §483.75
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 .
Nursing homes receiving Medicare or Medicaid funds must, at a minimum, comply with federal nursing home regula­tions. Some states, however, have adopted tougher laws. Check with your local health department for specific regula­tions in your state. Here is a good source for regula­tions: http:/­/ww­w.h­pm.u­mn.ed­u/n­hre­gsp­lus­/NH­Reg­s_b­y_S­tat­e/B­y%2­0St­ate­%20­Mai­n.html

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