Nursing & Residential Care Home Regulations
According to the Centers for Medicaid and Medicare Services, over 1.5 million people can be found in nursing homes and residential care facilities on any given day in the United States, and the number of individuals who use nursing homes at some point during the year is double that figure. With 16,000 nursing homes in the United States, regulating these facilities is a daunting but necessary task. Federal regulations govern any facility that uses Medicare and Medicaid funds, while many states have added to these regulations.
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History
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In 1987, Congress passed a series of legislative reforms that became known as the Nursing Home Reform Act in response to widespread complaints of abuse in nursing homes and residential care facilities throughout the 1980s. This legislation provided a series of regulations for nursing homes to abide by, and empowered states to enforce the regulations and terminate the Medicaid and Medicare funding of any institution not adequately meeting quality standards.
Administration
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State personnel conduct surveys of all nursing homes at least once every 15 months on over 150 total standards established by the Centers for Medicaid and Medicare Services. At least one registered nurse is assigned to each survey team, and surveys are typically unannounced.
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Staff
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Federal regulations target specific quality standards for staffing of nursing homes, and require an adequate number of staff in addition to a certain level of training. Staff must also provide any services that residents require for maintaining their nutrition, hydration, hygiene and overall health, and actively work to prevent residents from having accidents, developing bedsores or making medication errors.
Facilities
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Residential care facilities are required to contain everything necessary to provide residents with the ability to choose their own schedule and activities, and to maintain their dignity. Facilities must allow residents to take care of their own daily needs as much as residents are able, and cannot limit the self-sufficiency of residents or allow the deterioration of residents' abilities to care for themselves. Facilities must present all residents with the tools to maintain their physical, mental and social abilities and well-being to fullest extent each resident is able.
Records and Operations
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Federal regulations dictate that nursing homes have a written care plan for each patient, maintain each patient's clinical records and conduct their own internal quality assessments on a regular basis.
Outcomes
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Nursing homes and residential care facilities that do not adequately adhere to regulations and standards can have their Medicaid and Medicare funding terminated, or can have their operations entirely shut down if they are state-operated facilities. If a facility fails to comply with federal regulations, all residents who receive Medicare or Medicaid benefits are removed from the facility and reassigned to a facility that is in compliance with regulations. Each state also has the ability to supplement the federal regulations with their own, more detailed standards and penalties for non-compliance, which can be obtained from each state's public health department.
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- Photo Credit Image by Flickr.com, courtesy of Jo Guldi
