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Federal Nursing Home Laws

Understanding National Nursing Home Laws

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Federal nursing home laws and programs have gradually evolved since the 1960s when the government first set out to improve conditions nationwide. Today, nursing homes across the country must meet specific standards of care or face fines, penalties, or closure. Families should stay up-to-date on federal nursing home laws to keep their loved ones safe from abuse and neglect.

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What Are Federal Nursing Home Laws?

National or federal nursing home laws ensure that all long-term care facilities in the United States meet the same standard of quality.

Throughout the last 60 years, laws surrounding health care — and nursing homes — have evolved dramatically to meet the needs of seniors.

While today’s seniors are still at risk of nursing home abuse or neglect, the standard of living in nursing homes has increased drastically thanks to federal nursing home laws.

Important federal nursing home laws include:

  • Nursing Home Reform Act
  • Elder Justice Act
  • Older Americans Act
  • Violence Against Women Act

Other federal nursing home laws established national programs to benefit and protect nursing home residents. These programs include Medicare and Medicaid, which allow seniors to access health care benefits at reduced or no cost.

Further, certain groups of seniors may qualify for additional health care benefits under national programs from agencies like the Department of Veterans Affairs (VA).

By understanding these laws, nursing home residents and their families can learn their legal rights and take action if a senior falls victim to abuse.

Types of Federal Nursing Home Laws

As of 2019, a few different federal laws have impacted how nursing homes operate. Below, find information about some of the most important federal nursing home laws.

Nursing Home Reform Act (1987)

The Nursing Home Reform Act set a new benchmark for nursing home care. Lawmakers introduced the act after a study from the Institute of Medicine (IoM) found that nursing home residents frequently suffered from abuse and neglect.

Under the Nursing Home Reform Act, facilities must: 

  • Assess each resident’s health status and individual needs
  • Develop a written plan specific to each resident
  • Ensure residents can be active and choose activities
  • Keep residents as healthy as possible
  • Maintain accurate and accessible resident records
  • Maintain the right amount of staff to meet residents’ needs
  • Provide proper nutrition, hydration, and hygiene
  • Provide adequate supervision and devices to prevent falls

If the nursing home fails to meet these requirements, they may lose government funding.

Nursing Home Residents’ Bill of Rights

The Nursing Home Reform Act also established a bill of rights for nursing home residents, which specifically outlines the benefits residents may receive.

Under the Residents’ Bill of Rights, nursing home residents can expect:

  • Proper health care and treatment from the staff
  • Privacy
  • To make their own decisions, if they are mentally capable
  • To voice their concerns or complaints without fear of harassment

All nursing homes governed by the Nursing Home Reform Act must protect their residents’ rights or face legal consequences, including fees or lawsuits.

Elder Justice Act

According to the U.S. Administration for Community Living, the Elder Justice Act was one of the first federal nursing home laws specifically designed to combat elder abuse and neglect. First drafted in 2002, the act went into effect in 2010.

Under this act, nursing home staff members must report possible incidents of abuse and neglect. It also provides funding to Adult Protective Service programs across the country.

Additionally, the Elder Justice Act established: 

  • A 60-day closure window: If a nursing home has to close, its staff must notify the state and the Secretary of Health and Human Services. The staff must also explain how their residents will find new places to live.
  • An employee background check database: This allows nursing homes to hire the most qualified people to their staff, with the hopes of preventing abusers from entering the industry.
  • The Elder Justice Coordinating Council: This group meets twice a year to discuss new ways to keep seniors safe. The council periodically issues recommendations and reports to Congress on how they can make improvements.

By addressing the problem of nursing home abuse from multiple angles, the Elder Justice Act broke new ground, and its programs continue to fight for seniors’ rights today.

Older Americans Act (OAA)

The OAA is a group of federal nursing home laws dating back to 1965 that guarantees certain services for the elderly, including senior centers.  The OAA helps approximately 20,000 service providers, 685 local and state agencies, and 244 tribal agencies access important service programs.

The OAA supports:

  • At-home care services
  • Elder abuse prevention services
  • Legal resources
  • Meals and medication for seniors
  • Social services and community planning

This act also established the Administration on Aging (AoA). This agency runs over 25 programs designed to help seniors, as designated by the OAA.

The OAA is still in place today but must be periodically reauthorized by U.S. lawmakers so that its programs can take effect. As of October 2019, a bill to reauthorize the act was passed by the House of Representatives and is awaiting action by the U.S. Senate.

Violence Against Women Act

The Violence Against Women Act helps women who are victims of domestic violence and sexual assault. While not specifically a federal nursing home law, this act is very important as women are more likely to suffer from elder abuse than men, according to the Office on Women’s Health.

Women can suffer abuse from:

  • Caregivers (including nursing home staff members)
  • Family members (such as spouses or children, who may be their primary caregivers)
  • Other nursing home residents

The act first went into effect in 1994, and with it came laws that defined sexual abuse and domestic violence as crimes. Since that period, it has been updated and reauthorized several times by the U.S. government.

According to the New York Times, a 2000 reauthorization of the act created new programs specifically designed to help senior women. A 2019 reauthorization of the bill is still in progress.

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National Programs That Help Protect Elders

Other federal nursing home laws established national programs to keep seniors safe from abuse or help them maintain a healthy standard of living.

Federal programs that address nursing homes include:


Medicare is the federal health insurance program that helps seniors over the age of 65 afford medical treatments and covers nursing home care in some cases.

Medicare has four parts:

  • Part A, which is free and covers hospital and short-term stays in a skilled nursing facility.
  • Part B, which has a monthly fee and covers extended medical services.
  • Part C, known as Medicare Advantage, includes partial private insurance and covers some stays in a nursing home.
  • Part D, which covers prescription medication.

Seniors looking to pay for their nursing home stay through Medicare should contact the nursing home directly to see if they qualify. However, Medicare will usually not cover a long-stay in a nursing home.


Medicaid allows people to receive health care at little to no cost to them. According to a 2017 report from the Kaiser Family Foundation, Medicaid frequently covers long-term stays in nursing homes — particularly for seniors who cannot afford it — provided the facility is Medicaid certified.

Did You Know

Medicaid covers 62% of all stays in a nursing home.

That being said, there are strict conditions guiding who is eligible for Medicaid. Those who qualify must have “spent down” their personal assets and have no other means of health coverage.

Department of Veterans Affairs (VA)

Veterans who have been honorably discharged from the U.S. military may qualify for nursing home care through the VA. There are a few different types of VA nursing homes that veterans may live in.

VA nursing home options include:

  • VA Community Living Centers

    These nursing homes are typically designed for short-term stays. As of 2019, there are over 100 of these centers in the U.S.

  • State Veterans Homes

    Veterans can receive full-time care or daycare at these facilities. These homes are managed by the individual states, not the VA itself.

  • Community Nursing Homes

    Through this program, the VA contracts with local nursing homes to provide care to veterans who need it.

Spouses and family members may also live in VA-affiliated nursing homes in some cases.

Long-Term Care Ombudsman Program

The Long-Term Care Ombudsman program gives nursing home residents a voice. Through the program, ombudsmen — officials who investigate complaints on behalf of someone else — help seniors resolve their nursing home-related concerns or issues.

In 2017, over 7,900 ombudsmen helped nursing home residents throughout the U.S. These officials successfully resolved 73% of complaints, according to the Administration for Community Living (ACL).

Although the program was created by federal nursing home laws, each state administers its own Long-Term Care Ombudsman program.

Adult Protective Services (APS)

APS collects and investigates reports about elder abuse, neglect, and exploitation. Every state has its own department that administers adult protective service programs that serve to protect the elderly from neglect and abuse.

While APS programs vary with each state, many branches have a hotline where people can report possible elder abuse. Local authorities investigate the case and intervene if violations of federal or state laws are found.

Local APS branches also work with the National Adult Protective Services Association (NAPSA), a non-profit organization that bolsters local reporting efforts.

Federal Nursing Home Laws Protect Your Loved Ones

While it is not possible to prevent all cases of nursing home abuse and neglect, federal nursing home laws help reduce the risks and keep seniors safe. By staying up-to-date with these laws, families can understand which actions to take if their loved ones fall victim to nursing home abuse.

To learn more about federal nursing home laws, get a free case review today. Our team can connect you with crucial legal and medical information about nursing home abuse.

Nursing Home Abuse Support Team
Julie Rivers HeadshotReviewed by:Julie Rivers, MBA

Eldercare Advocate & Expert

  • Fact-Checked
  • Editor

Julie Rivers is an eldercare advocate with over 15 years of dedicated service to victims of nursing home abuse and neglect. Her journey in this field became deeply personal when she assumed the role of an unpaid caregiver during her mother’s battle with Alzheimer’s disease.

The Nursing Home Abuse Center (NHAC) was founded to bring justice to those affected by nursing home and elder abuse. Our mission is to educate and empower victims of abuse and their families to take a stand against this unlawful mistreatment. We work to return dignity back to those who have been broken down by nursing home abuse and neglect.

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