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What If My Nursing Home Was Found Noncompliant With Federal Requirements?

The remedies imposed if a nursing home is found noncompliant with federal requirements depend on the infraction itself and the nursing home’s general history.

Every nursing home that accepts Medicare and Medicaid payments is subject to federal regulations under the Nursing Home Reform Act of 1987. The reform law was adopted to ensure that each resident receives quality care free of neglect, abuse, and mistreatment.

The law not only requires federal oversight of nursing homes but also for states to regularly inspect nursing homes for violations. Criteria the state use when it inspects houses include whether a deficiency is an isolated incident and whether a deficiency causes immediate harm to a resident.  

Understanding Federal Nursing Home Regulations

According to federal nursing home regulations, nursing homes must:

  • Conduct comprehensive, accurate assessments of each individual’s functional capacity
  • Provide the necessary assistance needed for a resident to carry out regular daily activities, such as good hygiene, grooming, and healthy nutrition
  • Prevent a resident’s ability to bathe, groom, dress, groom, move around, use the bathroom, eat, and communicate from deteriorating
  • Ensure residents receive proper treatment and supportive devices to maintain their vision and hearing
  • Work to prevent residents from developing bed sores and pressure sores by prevention infection and encouraging mobility
  • Have an adequate amount of trained nursing staff
  • Develop a comprehensive care plan for each resident, which must involve the resident
  • Ensure residents receive adequate supervision to prevent slips and falls in nursing homes
  • Help residents avoid dehydration and malnutrition
  • Ensure that residents receive adequate medical attention and medication, limiting medical mistakes

Additionally, nursing homes are required to treat every resident with dignity, courtesy, and respect and to keep records about their progress and any regressions.

Punishment for Noncompliance

Any nursing home that fails to comply with federal regulations set forth by the Centers for Medicare and Medicaid (CMS) can be subject to sanctions.

CMS and state agencies can punish any nursing home that fails to meet compliance, as well as those that regularly perform poorly during inspections. Sanctions are based on the seriousness of offenses and may include:

  • Appointing temporary managers for facilities
  • Hosting training and other workshops for staff members
  • Creating directed plans of correction
  • Imposing a sliding scale of fines
  • Removing homes from Medicare and Medicaid

Under federal guidelines, homes in violation can be terminated from Medicare and Medicaid if they fail to remedy issues within six months. Being removed from the program means that nursing homes can no longer accept patients who pay with Medicare and Medicaid.

Notifications Nursing Homes Receive When They Are Noncompliant

When nursing homes are not in compliance, CMS or the state must give the home notice of the remedy, including:

  • The nature of the noncompliance
  • The type of remedy imposed
  • The effective date of the remedy
  • The home’s right to appeal the determination that led to the remedy

Get Legal Help for a Nursing Home Case

If you or a loved one has suffered a medical condition or an injury due to nursing home abuse or neglect, you may be entitled to compensation. Call 1-800-516-4783 for more information about how a nursing home abuse lawyer may able to help you.