What Are Regulatory Issues for Nursing Homes?

According to the U.S. Department of Health and Human Services, the Center for Medicare and Medicaid Services (CMS) regulates and certifies nursing homes. Because states are responsible for licensing nursing homes, CMS contracts with states to ensure homes meet quality standards. CMS inspectors monitor nursing homes by conducting interviews, searching records and performing visual inspections. There are several nursing home aspects that CMS investigates to ensure a high quality of life for the residents.

Resident Care Practices

• The Center for Medicare and Medicaid Services oversees practices in resident care. The CMS examines patient medical records, interviews patients and staff members, makes periodic assessments of particular patients and interviews patient families. Findings help ensure whether a nursing home is performing high quality, routine care for residents. Nursing homes must ensure they address resident pain management, mobility, mental health, exercise and vaccines. The CMS also checks that patients maintain healthy weights, receive necessary medical treatments or examinations, bathe regularly and do not suffer from avoidable pressure sores. The agency monitors toileting and feeding practices as well.

Communication and Interactions

• Inspectors observe and record staff and residential interactions in CMS documents. They also record how patients respond to certain staff members, visitors and family members. They examine staff certifications, education levels and ongoing training practices. Inspectors also review medical records for proper documentation. They monitor protocols for resident communication to ensure residents or their families have the opportunity to make their own care decisions. There are steps taken to ensure the keeping of confidential medical records, and that families and patients stay informed on important matters.

Safety and Abuse Prevention

• The CMS also reviews nursing home safety practices. The agency checks facility equipment, cleanliness, food safety, medical waste disposal, sanitation, assistive procedures and equipment. Officials evaluate fire and emergency prevention and procedures for effectiveness. Staff background checks ensure employee records do not include incidences of abuse or criminal activity.

Facilities

• There are nursing home inspections to ensure well-maintained facilities. These include periodic physical inspections of the building's structure, kitchen and dining facilities, along with water and sanitation.