In Spring 2018, Consumer Voice Executive Director Lori Smetanka, along with Eric Carlson and Nancy Stone, wrote an article published in the National Academy of Elder Law Attorneys (NAELA) Journal entitled “Advocating for Nursing Facility Residents Under the Revised Federal Requirements.” The article provides a comprehensive guide to the revised federal nursing facility regulations, focusing on care planning and person-centered care; admission, transfer, and discharge procedures; grievance procedures; resident rights, choice, safety, and self-determination; staffing, medications, and quality of care; and protections from abuse, neglect, and exploitation. It also discusses advocacy and enforcement issues and further CMS rulemaking activities under the Trump administration which will likely result in changes to the rules.
Nursing Home Requirements and Residents' Rights
Current Federal Requirements
- Requirements for States and Long-Term Care Facilities –
42 U.S.C. Part 483 - Survey and Certification of Long-Term Care Facilities –
42 U.S.C. Part 488, Subpart E - Enforcement of Compliance for Long-Term Care Facilities with Deficiencies –
42 U.S.C. Part 488, Subpart F - State Operations Manual – Appendix PP –
Guidance to Surveyors for Long-Term Care Facilities (with clickable table of contents)
Issue Briefs
Consumer Voice, in partnership with Justice in Aging and the Center for Medicare Advocacy, developed a series of briefs entitled “A Closer Look at the Revised Nursing Facility Regulations.”
Why the Recently-Revised Nursing Home Regulations are Vital for Nursing Home Residents
The revised regulations contain important consumer protections that were not included in the previous regulations.
Assessments, Care Planning, and Discharge Planning
Revised nursing facility regulations broadly affect facility practices, including assessment care planning and discharge planning.
Unnecessary Drugs and Antipsychotic Medications
Regulations about unnecessary drugs and antipsychotic drugs have been moved from the quality of care section to the pharmacy services section.
Involuntary Transfer and Discharge
The involuntary transfer/discharge regulations have changed, but not dramatically.
Nursing Services
Revised nursing facility regulations broadly affect facility practices, including nursing services.
Admission
The revised regulations broadly prohibit facilities from using admission agreements or other documents that waive a resident’s rights.
Visitation Rights
The revised nursing facility regulations affirm the rights of residents to receive visitors of their choosing at the time of their choosing
Rehabilitation Services
The substantive requirements for specialized rehabilitative services are largely unchanged from the prior version of the regulations, with the exception of “respiratory therapy.”
Return to Facility After Hospitalization
Bed hold rights are set by state law. Federal law complements state law by requiring facilities to notify residents of those rights.
Grievances and Resident/Family Councils
Residents have the right to file grievances and the facility must work to resolve those concerns promptly.
Quality of Care
The substantive requirements for quality of care are retained in the revised regulations.
Oppose Weakening and Delay of Federal Nursing Home Rules
Since their release in October 2016, there have been efforts to undermine, repeal, and delay these standards.
