Nursing Home Laws

Federal nursing home laws are in place to ensure certain services, standards, and levels of care for nursing home residents. The main goal of nursing home lawsfederal nursing home laws is to ensure that nursing home residents maintain or attain the highest practicable mental, physical, and psychosocial well being. These standards should be met in accordance with a plan of care written for each individual resident.

In addition to operational and staffing requirements, federal nursing home laws implement inspections that each nursing home facility must comply with. Annual surveys and federal complaint investigations allow the federal government the ability to oversee nursing homes and ensure that patients are receiving adequate care.

The Nursing Home Reform Act

The Nursing Home Reform Act is the main policy outlining federal nursing home laws. The act was first implemented by the U.S. Congress in 1987. The Nursing Home Reform Act created guidelines for long-term care nursing homes that receive federal Medicaid and Medicare funding.

Federal nursing home laws under the Nursing Home Reform Act cover several aspects of nursing home care, from resident rights to staffing and operational requirements. Under federal nursing home laws, the health and wellbeing of residents may not decline unless medically unavoidable.

Nursing Home Resident Rights

Federal nursing home laws grant all nursing home residents the rights to maintain and receive adequate nutrition, personal hygiene, mental and emotional support, and social involvement. Those who are incapable of daily living activities such as grooming and using the restroom are entitled to personalized care from nursing home staff.

Federal nursing home laws state that residents are entitled to receive:

  • Medically-related social services
  • Proper health care, such as primary and dental care
  • Accurate dispensing, receipt, and administration of medicines and drugs
  • Dietary services that meet daily nutritional needs of each patient
  • Special services for mentally ill or retarded residents
  • Personal, material, and financial privacy when requested
  • Treatment that does not violate the resident’s dignity or respect


Personal Plan of Care

Upon admission into a nursing home, each resident is required to receive a personalized written plan of care. Federal nursing home laws state that this plan of care should outline the resident’s nursing, medical, and psychosocial needs. Additionally, the plan of care should discuss exactly how the facility plans to meet these goals.

The resident’s family, a registered nurse, and physician should prepare the plan of care. The plan should assess the resident’s functional capacity and ability to carry out daily life activities. If the resident experiences any significant changes in mental or physical condition, the plan should be updated.

Federal Nursing Home Staffing Requirements

Each nursing home facility must be sufficiently staffed in order for each resident to maintain and attain the highest possible health level. Federal nursing home laws require that each resident receives adequate care and individual attention. Due to the varying nature of each facility, requirements to meet these federal nursing home laws will differ with each nursing home.

All facilities are required to provide 24-hour services from a licensed nurse. Additionally, a registered nurse must be on duty for a minimum of eight consecutive hours each day. In some cases, waivers of these requirements may be implemented. However, the safety or health of residents may not be negatively affected by these exemptions.

Older Americans Act

The Older Americans Act (OAA) is a group of federal nursing home laws enacted in 1965. This act was implemented in response to policymaker concern over a lack of community-based social services for the elderly. The Older Americans Act was the first federal initiative that aimed to provide comprehensive services for the elderly. Under this act, the U.S. Administration on Aging (AoA) was appointed as the focal point for administering federal grant programs.

The Older Americans Act provides federal grants that may be used for:

  • Funding for nursing homes and other senior centers
  • Community planning and social services
  • Research and development projects
  • Personnel training regarding aging
  • Protection activities for vulnerable elder rights
  • Meals and job training for older Americans



Markenson, Ari. “Nursing Homes: Overview of Federal and State Regulation.” NYSBA Health Law Journal. 9.1 (2004): 17-20. Web. 9 Sep. 2013. <>.

“Nursing Homes: Overview.” Centers for Medicare & Medicaid Services, 3 Aug 2012. Web. 9 Sep 2013. <>.

“Unofficial Compilation of the Older Americans Act of 1965.” Administration on Aging. Administration on Aging. Web. 9 Sep 2013.

Walshe, Kieran. “Regulating U.S. Nursing Homes: Are We Learning From Experience?.” Health Affairs. 20.6 (2001): 128-144. Web. 9 Sep. 2013. <>.