Our parents once gave us all the care we needed to grow healthy and strong. For better or for worse, the roles often reverse as they age, and adult children frequently find themselves tasked with caring for their aging parents. Making care decisions can be overwhelming for anyone—and even extra challenging for busy moms.
Often, the decision must be made to place an aging parent into a residential care facility, especially if they are suffering from medical conditions or severe cognitive decline caused by Alzheimer’s disease or dementia. For those unfamiliar with the process, it can be deeply confusing. Nursing homes also vary extensively from state to state, making it essential for caregivers to gather as much information as possible before deciding what’s best for their loved ones.
A Brief Overview of Federal Nursing Home Regulations
Today, federal nursing home regulations are dictated mainly by the Nursing Home Reform Act of 1987. The law requires facilities to maintain standards of care that ensure aging adults receive a minimum level of physical, mental, and emotional protection. This includes guaranteeing residents a right to privacy, dignity, and freedom from abuse of restraint.
Under federal regulations, nursing homes are also subject to regular inspections to ensure they comply with the law—failing to meet lawful standards of care could result in penalties, fines, and even loss of funding. All nursing homes must comply with baseline federal regulations. Compliance and enforcement of these rules, however, may vary by state.
Photo by Yaroslav Shuraev
State-by-State Nursing Home Regulations
Federal regulations serve as a foundation for nursing homes across the U.S., but each state has its own rules. Some state regulations enhance federal standards; some merely uphold base standards. State regulations cover a variety of operations, such as staff ratios, quality of care, and resident rights. Some states, for example, require high staff-to-resident ratios, while others have less strict requirements.
Some states require nursing homes to develop detailed care plans for their residents, examining everything from medical history to dietary preferences. Other states focus on a facility’s design or administrative responsibilities. All states have regulations that protect residents from abuse—only the structure for detecting or preventing abuse varies.
Medicare & Medicaid Funding Regulations
Many—if not most—nursing homes receive funding from Medicare or Medicaid programs. This funding is essential for keeping nursing homes operational and accountable. To receive funding, facilities must follow the Nursing Home Reform Act guidelines.
State representatives for Medicare and Medicaid are responsible for conducting random inspections. The goal of these assessments is to check for signs of neglect or elder abuse, including but not limited to bedsores, unexplained injuries, and underdeveloped care plans.
Prospective residents and their families can check the Five-Star Quality Rating System developed by the Centers for Medicare & Medicaid Services (CMS) to determine where facilities in each state/region fall regarding quality of care.
Which state has some of the best ratings regarding quality of care? According to a 2019 report, New Hampshire has the lowest number of substandard care complaints per nursing home facility. Which state fairs are the worst? Arizona had the most complaints about poor quality of care in nursing homes.
State Ombudsman Service
Each state has its own Long-Term Care Ombudsman Program (LTCO), which advocates for nursing home residents’ rights and investigates reports of abuse or neglect. A 1971 Presidential Directive by former President Richard Nixon helped establish the LTCO as it is today. At its core, the LTCO is an advocate ombudsman, taking into account the unique perspective of residents in long-term care facilities.
Each state has a list of contacts available depending on region, in case a report needs to be filed or an investigation opened. While a local ombudsman may work with a facility to provide a higher standard of care, each ombudsman is independent of long-term care facilities in the state. Ombudsman services also conduct inspections to ensure homes follow state and federal regulations.
Photo by Andrea Piacquadio
As a mom, it can be very emotionally and physically challenging to see parents transition from caregivers and supporters to those who need help themselves. Naturally, you want them to receive the same treatment and attention they gave you as a child. The decision to transfer a parent to a long-term care facility is already hard enough, not to mention having to wade through all of the different options, levels of care, and different state regulations. The best thing you can do for yourself and your family is to arm yourself with as much information as possible. It may be challenging, but you can do it!
Our parents once gave us all the care we needed to grow healthy and strong. For better or for worse, the roles often reverse as they age, and adult children frequently find themselves tasked with caring for their aging parents. Making care decisions can be overwhelming for anyone—and even extra challenging for busy moms.
Often, the decision must be made to place an aging parent into a residential care facility, especially if they are suffering from medical conditions or severe cognitive decline caused by Alzheimer’s disease or dementia. For those unfamiliar with the process, it can be deeply confusing. Nursing homes also vary extensively from state to state, making it essential for caregivers to gather as much information as possible before deciding what’s best for their loved ones.
A Brief Overview of Federal Nursing Home Regulations
Today, federal nursing home regulations are dictated mainly by the Nursing Home Reform Act of 1987. The law requires facilities to maintain standards of care that ensure aging adults receive a minimum level of physical, mental, and emotional protection. This includes guaranteeing residents a right to privacy, dignity, and freedom from abuse of restraint.
Under federal regulations, nursing homes are also subject to regular inspections to ensure they comply with the law—failing to meet lawful standards of care could result in penalties, fines, and even loss of funding. All nursing homes must comply with baseline federal regulations. Compliance and enforcement of these rules, however, may vary by state.
State-by-State Nursing Home Regulations
Federal regulations serve as a foundation for nursing homes across the U.S., but each state has its own rules. Some state regulations enhance federal standards; some merely uphold base standards. State regulations cover a variety of operations, such as staff ratios, quality of care, and resident rights. Some states, for example, require high staff-to-resident ratios, while others have less strict requirements.
Some states require nursing homes to develop detailed care plans for their residents, examining everything from medical history to dietary preferences. Other states focus on a facility’s design or administrative responsibilities. All states have regulations that protect residents from abuse—only the structure for detecting or preventing abuse varies.
Medicare & Medicaid Funding Regulations
Many—if not most—nursing homes receive funding from Medicare or Medicaid programs. This funding is essential for keeping nursing homes operational and accountable. To receive funding, facilities must follow the Nursing Home Reform Act guidelines.
State representatives for Medicare and Medicaid are responsible for conducting random inspections. The goal of these assessments is to check for signs of neglect or elder abuse, including but not limited to bedsores, unexplained injuries, and underdeveloped care plans.
Prospective residents and their families can check the Five-Star Quality Rating System developed by the Centers for Medicare & Medicaid Services (CMS) to determine where facilities in each state/region fall regarding quality of care.
Which state has some of the best ratings regarding quality of care? According to a 2019 report, New Hampshire has the lowest number of substandard care complaints per nursing home facility. Which state fairs are the worst? Arizona had the most complaints about poor quality of care in nursing homes.
State Ombudsman Service
Each state has its own Long-Term Care Ombudsman Program (LTCO), which advocates for nursing home residents’ rights and investigates reports of abuse or neglect. A 1971 Presidential Directive by former President Richard Nixon helped establish the LTCO as it is today. At its core, the LTCO is an advocate ombudsman, taking into account the unique perspective of residents in long-term care facilities.
Each state has a list of contacts available depending on region, in case a report needs to be filed or an investigation opened. While a local ombudsman may work with a facility to provide a higher standard of care, each ombudsman is independent of long-term care facilities in the state. Ombudsman services also conduct inspections to ensure homes follow state and federal regulations.
As a mom, it can be very emotionally and physically challenging to see parents transition from caregivers and supporters to those who need help themselves. Naturally, you want them to receive the same treatment and attention they gave you as a child. The decision to transfer a parent to a long-term care facility is already hard enough, not to mention having to wade through all of the different options, levels of care, and different state regulations. The best thing you can do for yourself and your family is to arm yourself with as much information as possible. It may be challenging, but you can do it!
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