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have sufficient nursing and other staff 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 (42 CFR 483.30).
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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 (42 CFR 483.75).
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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 (42 CFR 483.20).
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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 (42 CFR
483.20).
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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 (42 CFR 483.60).
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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
(42 CFR 483.40).
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prevent 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
(42 CFR 483.25).
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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 (42 CFR 483.25).
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ensure that residents do not develop pressure sores; 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 (42 CFR 483.25).
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provide treatment and services to incontinent residents to:
(1) restore as much normal bladder functioning as possible;
(2) prevent urinary tract infections and (3) restore as much
normal bladder function as possible (42 CFR 483.25).
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ensure that residents receive proper treatment and any devices
to maintain vision and hearing abilities (42 CFR 483.25).
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ensure that residents receive adequate supervision and assistive
devices to prevent accidents, e.g. falls (42 CFR 483.25).
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ensure that residents maintain acceptable parameters of nutritional
status, such as body weight and protein levels (42 CFR 483.25).
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provide residents with enough fluid to maintain hydration
and health (42 CFR 483.25).
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prevent medication errors (42 CFR 483.25).
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care for residents in a manner that promotes maintenance
or enhancement of quality of life (42 CFR 483.15).
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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 (42 CFR 483.15).
ensure that the resident can choose activities, schedules,
and health care consistent with his or her interests, assessments
and plan of care (42 CFR 483.15).
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maintain clinical records on each resident in accordance
with accepted professional standards and practices, and that
are complete, accurate, accessible, and systematically organized
(42 CFR 483.75).
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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.
