What Nursing Homes Must Do

» Have sufficient nursing and other staff in order to provide nursing and related services in order to attain or maintain the well-being of each resident, as determined by resident assessments and individual plans of care.

» Be administered in a manner that enables it to use resources effectively and efficiently to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident.

» Perform an initial (within 14 days of admission) and periodic (after significant changes in the resident's physical or mental status and/or at least once every 12 months) comprehensive, accurate, standardized, reproducible assessment of each resident's functional capacity.

» Develop comprehensive individualized care plans for residents that include measurable objectives and schedules to meet each resident's medical, nursing, mental and psychosocial needs as identified in the comprehensive assessment. The care plan must be developed within 7 days after completion of the comprehensive assessment and 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 and biologicals) to meet the needs of each resident.

» Provide that medical care of residents is supervised by a physician; the home must provide or arrange for the provision of physician services 24 hours a day, in case of an emergency.

» Prevent, where possible, the deterioration of a resident's ability to bathe, dress, groom, transfer and ambulate, toilet, eat, and to use speech, language or other functional communication systems.

» Provide any necessary services and assistance to maintain good nutrition, grooming, and personal and oral hygiene if the resident suffers from any impairment in activities of daily living.

» Ensure that residents do not develop pressure sores, where possible; but if a resident has pressure sores, the nursing home must provide the necessary treatment to promote healing, prevent infection and prevent new sores from developing.

» Provide treatment and services to incontinent residents to: (1) restore as much normal bladder functioning as possible; (2) prevent urinary tract infections where possible.

» Ensure that residents receive proper treatment and any devices to maintain vision and hearing abilities.

» Ensure that residents receive adequate supervision and assistive devices to prevent accidents, e.g., falls.

» Ensure that residents maintain acceptable parameters of nutritional status, such as body weight and protein levels where possible.

» Provide residents with enough fluid to maintain hydration and health.

» Prevent medication errors.

» Care for residents in a manner that promotes maintenance or enhancement of quality of life.

» Promote care for residents in a manner and in an environment that maintains or enhances each resident's dignity and respect in full recognition of his or her individuality.

» Ensure that the resident can choose activities, schedules, and health care consistent with his or her interests, assessments and plan of care.

» Maintain clinical records on each resident in accordance with accepted professional standards and practices, and that are complete, accurate, accessible, and systematically organized.

» In addition to federal laws regulating the quality of care in nursing homes, states have enacted laws as well. The state laws must be at least as stringent as the federal laws.