Understanding Federal Nursing Home Regulations & Key Concepts
Section 1: Resident Rights & Facility Responsibilities
1. What is the primary purpose of the Residents' Rights regulations (42 CFR
§483.10)?
ANSWER ✓ To ensure each resident receives care and services in a manner that
maintains or enhances their dignity and respect in full recognition of their individuality,
and to promote their quality of life. Rights include privacy, confidentiality, freedom from
abuse/neglect, and autonomy.
2. Under the right to visitation, when must a facility allow in-person visitation?
ANSWER ✓ The facility must allow in-person visitation at all times, without prior notice,
for any individual chosen by the resident. This includes during communicable disease
outbreaks or public health emergencies, with infection control protocols in place.
3. What are the facility's obligations regarding a resident's right to manage their
own financial affairs?
ANSWER ✓ The facility must allow residents to manage their funds unless deemed
incapable. If the facility manages funds (>$50), it must establish a separate, interest-
bearing account, keep detailed records, provide quarterly statements, and undergo an
annual audit. Residents have the right to access their funds upon request.
4. What action must a facility take immediately upon a reasonable suspicion of
alleged violation of resident rights, abuse, neglect, or misappropriation?
ANSWER ✓ The facility must report the allegation immediately, but no later than 2 hours
after forming the suspicion if it results in serious injury, and within 24 hours for all other
allegations, to the State Survey Agency and other officials as per state law.
5. How does the regulation protect a resident's right to make choices?
ANSWER ✓ Residents have the right to choose their physician, participate in their care
plan, make decisions about their treatment (including the right to refuse), and make
personal choices about their daily life (e.g., wake-up time, clothing, activities) as long as
they do not infringe on others' rights.
6. What is the difference between "informed consent" and "representative
consent"?
ANSWER ✓ Informed consent is obtained directly from a mentally competent resident
, after they are provided all relevant information about a treatment. Representative
consent is obtained from a legally authorized representative (e.g., court-appointed
guardian, healthcare proxy) when a resident is deemed incapable of making informed
decisions.
7. What constitutes "neglect" according to the regulations?
ANSWER ✓ Neglect is the failure of the facility, its employees, or service providers to
provide goods and services necessary to avoid physical harm, mental anguish, or mental
illness. This includes ignoring requests for assistance, failure to provide necessary care,
and poor hygiene care.
8. What is the facility's responsibility regarding a resident's personal possessions?
ANSWER ✓ The facility must provide reasonable efforts to protect resident possessions
from theft or loss. This includes assisting in identifying possessions, labeling clothing,
and maintaining a secure environment. The facility may be liable for missing items if it
failed to take reasonable precautions.
9. When can a facility restrict a resident's right to access their clinical records?
ANSWER ✓ A resident has the right to access their records within 24 hours of a request,
and to purchase copies. The facility cannot restrict this right, but can charge a
reasonable fee for copying. Access may only be denied if a licensed health professional
determines it would cause harm, and even then, the resident's representative must be
given access.
10. What must a facility do to ensure residents can exercise their right to vote?
ANSWER ✓ The facility must provide assistance with voter registration, obtaining
absentee ballots, and arranging for transportation to polling places if needed. Staff must
not influence a resident's vote and must ensure privacy while casting a ballot.
Section 2: Admission, Transfer, and Discharge Rights (§483.15)
11. What are the only permissible reasons for an involuntary transfer or discharge
of a resident?
ANSWER ✓ 1) The resident's needs cannot be met by the facility; 2) The resident's health
has improved so care is no longer needed; 3) The resident's safety or the safety of
others is endangered; 4) The resident has failed to pay after reasonable notice; 5) The
facility ceases to operate.
12. What is the minimum written notice a facility must give for an involuntary
discharge or transfer?
ANSWER ✓ 30 days in advance, in writing, in a language the resident understands. In