Nursing Home Reform Act of 1987

Elderly person

Nursing homes that receive federal funds must comply with the Nursing Home Reform Act. A basic tenet of the Act is that a nursing home must provide services and care to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident and that this care must be given based on written documentation for each resident, known as an individualized plan of care.

Under the Nursing Home Reform Act, nursing homes must also do the following in order to meet the basic tenet of the Act:

  • Employ sufficient nursing and other staff in order to provide nursing and related services
  • Be administered in a way that enables the nursing home to use resources effectively and efficiently
  • Within 14 days of admission, perform an initial comprehensive, accurate, standardized, reproducible assessment of each resident's functional capacity. After significant changes in the resident's physical or mental status and/or at least once every 12 months, perform such an assessment.
  • Develop comprehensive individualized care plans for residents. Care plans must include measurable objectives and schedules to meet each resident's medical, nursing, mental and psychosocial needs as identified in the comprehensive assessment discussed above. The care plan must be developed within 7 days after completion of the comprehensive assessment. It must detail the services that are to be provided. The care plan must also be periodically reviewed and revised by a team of qualified persons after each assessment.
  • Provide pharmaceutical services (including procedures that assure the accurate acquiring, receiving, dispensing, and administering of all drugs) to meet the needs of each resident.
  • Provide supervised medical care by a physician. The nursing home must provide or arrange for the services of a physician on a 24-hour per day basis in case of an emergency.
  • Prevent the deterioration of a resident's ability to bathe, dress, groom, transfer and ambulate, toilet, eat, speak, or otherwise communicate.
  • Provide necessary services and assistance in order to maintain good nutrition, grooming, and personal and oral hygiene if the resident suffers from any impairment of daily living activities.
  • Ensure that residents do not develop pressure sores. If a resident has pressure sores, the nursing home must provide the necessary treatment to promote healing and prevent infection and development of new sores.
  • Provide treatment and services to incontinent residents to restore as much normal bladder functioning as possible and to prevent urinary tract infections.
  • Ensure that residents receive proper treatment and any devices to maintain hearing and visual abilities.
  • Ensure that residents receive adequate supervision and assistive devices to prevent falls.
  • Ensure that residents maintain acceptable parameters of nutritional status, such as body weight and protein levels.
  • Provide residents with enough fluid to maintain hydration and health.
  • Prevent medication errors.
  • Care for residents in a way that promotes maintenance or enhancement of their quality of life.
  • Promote resident care in a way and in an environment that enhances each resident's dignity and respect in full recognition of individuality.
  • Ensure that residents can choose activities, schedules, and health care consistent with individual interests, assessments, and plans of care.
  • Maintain clinical records on each resident in accordance with accepted professional standards and practices that are complete, accurate, accessible, and systematically organized.
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