This post was written by Lacey Buck, an undergraduate student majoring in gerontology.
Nursing Home Rules & Regulations
Who do Nursing Home Laws and Regulations Protect?
A nursing home is a form of long-term care for people who need intense care and help with everyday living on a 24-hour basis.2 People of all ages are currently in nursing homes around the country for various reasons. The organization and set up of nursing homes are similar to a hospital, with many rooms, different units, medical care and a nurses’ station.
Early Nursing Home Laws and Regulations
The first Act that really impacted nursing homes was the Social Security Act of 1935. The Social Security Act made a federal-state public decision to provide assistance to older adults, which was called Old Age Assistance.1 This led to the growth of nursing homes across the country; in 1954 there were 9,000 in the United States.1 As time progressed, federal involvement in nursing homes increased significantly. In 1950 there was a law passed that required nursing homes to have certain standards and rules. The nursing homes that followed the rules and met the standards of expectations, were awarded money from the Hill-Burton Act in 1954.
There were a few changes until 1963, which is when the final standards and procedure were written in the Nursing Home Standards Guide. In 1987, these regulations and procedures became the Nursing Home Reform Act of 1987. This is when nursing homes really started to follow these procedures and standards. After that, nursing homes rules and regulations were expected to be followed by each one.
Rules and Regulations
There are many rules and regulations that nursing homes must follow in order to be in business. Nursing homes must be inspected to make sure they have the appropriate certifications, licensures, training, sanitary standards and residents’ rights.4 Certification is very important in running a successful nursing home. The nursing home must be meet certain standards by the state of Missouri to run and operate.
The one most important thing they must do in order to stay certified is participate in the Medicaid or Medicare programs.1 Next is licensure, which is a little different than certification. Licensure is obtained by completing a form (MO 580-2631 (8-07)) and sent to the Department of Health and Senior Services. Next is training nursing assistants, which is essentially a training that all nursing assistants must go through in order to work there. The training program consists of a total of 175 hours that is split up between in-class learning and on the job learning. Some of the things that nursing assistants learn in the training are how to make beds, maintain hygiene for residents, safety measures, fire/safety procedures, communication skills and charting.4
The next major regulation is sanitation. Sanitation is very important in general, and especially when it comes to nursing homes. This regulation states that nursing homes must have surfaces that are easy to clean, one-time use cups and utensils, an area where food can be prepared with a drain, materials that are not going to get corroded and sealed food kept at the right temperature.3 The last major regulation is residents’ rights. The nursing home should tell both the resident and family of all the rights that the resident has. This includes the mandatory reporting if someone sees abuse happening to the resident, room transferring if there are any issues, being free from physical restraints or wellbeing restraints, protection from abuse/neglect, allowing residents to freely practice any religion, open their own mail, and many other things. Making sure that nursing homes around the country are following these regulations is very important to do to avoid bad situations that could lead to a lawsuit, illness or even death.
How are nursing homes inspected?
The nursing home administrator is in charge of making sure that all employees are doing what they should be doing and fixing anything that is not in line with the regulations and rules. The Department of Health and Senior Services in the state of Missouri also monitors nursing homes. They first look back and see how the nursing home has previously been scored based on the regulations, and then there is an unplanned visit to the facility.1 An unplanned visit from DHSS is when they show up at the facility without anyone knowing of the visit. When they are in the facility, they can interview residents and workers, inspect quality of life, cleanliness, safety and anything that has to do with the regulations of nursing homes. After they inspect the facility, they record it and see if there are any violations based off the manual. If there are violations, they let the administrator know and the facility can be fined and/or asked to make changes. To report a nursing home that brings up a concern regarding safety, cleanliness, neglect, or any other wrong doing, it can be done at https://health.mo.gov/safety/abuse/.
- “Nursing Homes Inspections.” Nursing Home Inspections , Missouri Department of Health & Senior Services, health.mo.gov/safety/nursinghomesinspected/.
- Nursing Homes. (2019, July 25). Retrieved October 19, 2019, from https://medlineplus.gov/nursinghomes.html
- “Laws, Regulations & Manuals.” Laws, Regulations & Manuals , Missouri Department of Health & Senior Services, health.mo.gov/seniors/nursinghomes/lawsregs.php#Regs.
- Institute of Medicine (US) Committee on Nursing Home Regulation. “History of Federal Nursing Home Regulation.” Improving the Quality of Care in Nursing Homes., U.S. National Library of Medicine, 1 Jan. 1986, www.ncbi.nlm.nih.gov/books/NBK217552/
- “Nursing Home Reform Act – Background & Regulations.” Nursing Home Abuse Guide, Nursing Home Abuse Guide, 2019, nursinghomeabuseguide.com/resources/nursing-home-reform-act/.