Nursing Home Regulations

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In 1965, Medicare and Medicaid came into existence and along with it came federal nursing home regulations. Nursing homes that qualify and voluntarily elect Medicare and Medicaid to their facility must follow a set of nursing home regulations put forth by federal standards. The Health Care Finance Administration that is part of the United States Department of Health and Human Services enforces these nursing home regulations. Congress authorized the first set of standards that were to be met by nursing facilities in 1967 and created classifications for the Skilled Nursing Facilities and Intermediate Care Facilities. In 1980 and again in 1987, these nursing home regulations were updated with the most current standards imposed under the Omnibus Budget Reconciliation Act of 1987. Omnibus Budget Reconciliation Act of 1987 (OBRA 87) OBRA 87 requires that the facility provide each patient with care that will enable the patient "to attain or maintain the highest practicable physical, mental and psychosocial well-being." Quality of life for patients is the goal. The facility must allow patient choice in activities, schedules and health care decisions. OBRA 87 requires that SNFs and ICFs provide 24-hour licensed practical nurse care seven days a week, and have at least one RN on duty at least 8 hours per day, seven days a week. Nurse's aides are required to undergo special training. OBRA 87 makes it the State's responsibility to establish, monitor and enforce state licensing and federal standards. States are required to maintain investigatory units and Ombudsman units, and to fund and staff them adequately. Omnibus Budget Reconciliation Act of 1990 (OBRA 90) The Patient Self Determination Act covers all long-term care facilities that participate in Medicare or Medicaid. At the time of admission to a hospital or nursing home, at the time of enrollment with an HMO, Hospice, or Home Health Care Agency, the following must happen: The facility must provide the patient written information concerning the patient's rights under state law to participate in decisions concerning medical care, including the right to accept or refuse medical or surgical treatment, the right to formulate advance directives.

  • The facility must provide a written statement of its policy regarding implementation of these rights.
  • The facility must document in its records whether the patient has executed an advance directive. Note: the facility is not required to provide advance directives to patients.
  • The facility is forbidden to discriminate in the provision of medical care on the basis of whether a patient has or has not executed an advance directive.
  • The facility is required to comply with all state laws regarding advance directives.
  • The facility must provide for staff and community education on issues related to advance directives.
Most states have an Adult Protection Service agency responsible for investigating reported cases of nursing home abuse and to provide the victims and their families with treatment as well as protective services. This agency handles all adult abuse cases, but around 70% of their investigations are instances of elder abuse. In addition, law enforcement agencies can respond to reported cases of nursing home abuse. If you suspect your loved one has suffered nursing home abuse or neglect from their healthcare provider failing to observe these rights, contact a nursing home abuse lawyer today.

Nursing Home Abuse

Any physical, sexual, verbal, psychological, or financial abuse perpetrated against residents of a residential care facility or nursing home is considered nursing home abuse. One study suggests that around 25% of vulnerable older adults will report abuse in the previous month, totaling up to 6% of the general elderly population. However, some consistent themes are beginning to emerge from interaction with abused elders, and through limited and small-scale research projects. Children of the elderly place their trust in nursing home to care for their parent when they need a level of support they cannot provide. Although laws and procedure have been put in place, nursing home abuse still happens. Filing a lawsuit for elderly abuse isn't about financial damages as much as it is about preventing the institution for abusing another resident.

Nursing Home Neglect

Nursing Home Neglect is depriving a person of food, heat, clothing or comfort or essential medication and depriving a person of needed services to force certain kinds of actions, financial and otherwise. The deprivation may be intentional (active neglect) or happen out of lack of knowledge or resources (passive neglect). While specifying abuse or neglect may seem trivial, it is important from a legal perspective. An experienced nursing home neglect attorney can determine the most advisable legal action need to help your loved one receive financial damages for their medical treatment and to ensure the facility is penalized for their negligent actions.

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Clore Law Group welcomes your questions about any issues concerning a serious personal injury, car accident, medical malpractice, nursing home neglect, business tort, or workplace injury. If you have a viable claim, we’ll explain the legal process. Since consultations are always free, there’s no cost in learning your legal options.