Nursing homes which receive federal funding must comply with a set of federal regulations which dictate a standard of minimum care to be given (Federal, 2005). Some states impose their own regulations on top of the federal regulations. Congress enacted legislation in 1987 which requires nursing homes participating in Medicare and Medicaid programs to comply with a set of requirements in response to widespread abuse of patients in nursing homes during the 1960s. The law is included in the Omnibus Budget Reconciliation Act of 1987 (OBRA 1987), which is also known as the Nursing Home Reform Act. It specifies that nursing homes "must provide services and activities to attain or maintain the highest practicable physical, mental and psychosocial well-being of such residents in accordance with a written plan of care."
Nursing homes must be in compliance with federal regulations for long-term care facilities, as prescribed by the U.S. Code of Federal Regulations Act (42 CFB Part 483) to participate in Medicare and Medicaid programs (Federal, 2005). There are a list of 18 regulations which must be adhered to, including having sufficient nursing staff, developing a comprehensive care plan for each resident, preventing the deterioration of a residents' ability to take care of daily living functions, providing appropriate treatment and services to incontinent residents, ensuring patients are free of medication errors, and maintaining the dignity and respect of each resident.
State laws must be at least as stringent as federal laws, and some states have adopted laws that are even more stringent than the federal regulations (Federal and, 2005). In California, nursing homes are regulated under Title 22 of the California Code of Regulations. A nursing home must conduct an initial assessment of each resident and periodic quarterly assessments, or as needed if there are significant changes in the patient's status. A plan is then devis...