Nursing-home regulations are standards of facility upkeep and patient care that are designed to protect and empower residents of long-term-care establishments. There are standard federal regulations enforced by national inspectors, as well as individual state regulations that are monitored by local governments.
History
Federal nursing-home regulations were established by Congress in 1987 with the Nursing Home Reform Act, in response to the prolific reports of patient abuse. Patients and nursing-home staff alike were distressed at the amount of mental, physical and verbal abuse patients received from staff members, as well as the amount of theft that was being committed by caregivers and family members. In addition to increased funding, the Reform act laid strict rules regarding patient treatment and care, and also required compliance on the part of institutions that receive federal funding through Medicare and Medicaid.
Federal Regulations
The federal government produced almost 20 regulations specific to the rights of nursing-home residents, in an effort to stem their exploitation and abuse. Several key pieces of legislation require nursing homes and other long-term-care facilities to: be staffed appropriately for the number of patients requiring care; develop personalized treatment plans for each resident and treat patients at their level of competency and functionality. Federal regulations also provide for the proper hygienic and personal-care treatment of patients who are unable to care for themselves.
State Regulations
All 50 states expand on the basic federal regulations with their own, specific requirements for nursing homes. Many of these individual regulations expand on basic principles established by the federal government. For example, Alaska expands on the federal ordinance to promote each resident's quality of life with the regulation that each patient bed must contain access to a personal oxygen hookup, bed light, closet, curtain partition and restroom facility. Some state regulations account for region-specific necessities. For example, due to the dry desert climate, the Arizona government requires all nursing homes to keep their parking lots and walkways clear of dust and sand.
Patient Empowerment
Many state and federal regulations also establish that nursing-home staffers need to help residents maintain independence as long as possible and encourage preventive treatments and exercises. Such measures keep the patient empowered and lessen her chances of being a target for abuse. Several federal regulations stipulate that care providers must do everything in their power to keep residents mentally alert, continent and in control of their vision, breathing, and hearing. West Virginia expands on the topic of independence by regulating that patients have the right to surround themselves with personal possessions, personal clothing and even pieces of personal furniture.
Inspection and Licensing
Both state and federal regulations are monitored by scheduled and surprise inspections. Representatives from the Centers for Medicare and Medicaid Services conduct nursing-home inspections on behalf of the federal government, while local offices and health departments monitor the implementation of state regulations. Nursing homes that do not meet regulations may lose their federal funding or local licensing.
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