Nursing Home Restrictions: What They Can’t Do

Things nursing homes are not allowed to do – Nursing homes are bound by regulations that govern their operations and protect residents’ rights. Understanding these restrictions is crucial for ensuring quality care and safeguarding the well-being of loved ones.

This comprehensive guide delves into the legal obligations, resident rights, medical care limitations, financial management restrictions, staffing requirements, quality of care standards, and end-of-life care considerations that nursing homes must adhere to.

Legal Obligations

Nursing homes are legally bound to provide quality care to their residents. These obligations are Artikeld in federal and state laws and regulations.

The Nursing Home Reform Act (NHRA) of 1987 is the primary federal law governing nursing homes. The NHRA establishes minimum standards of care for nursing homes, including:

  • Adequate staffing levels
  • Proper medical care
  • Safe and sanitary living conditions
  • Respect for residents’ rights

States also have their own laws and regulations governing nursing homes. These laws vary from state to state, but they generally cover the same basic areas as the NHRA.

Enforcement of Legal Obligations

The Centers for Medicare & Medicaid Services (CMS) is responsible for enforcing the NHRA. CMS conducts regular inspections of nursing homes to ensure that they are meeting the minimum standards of care. Nursing homes that fail to meet these standards may be fined or even lose their Medicare and Medicaid funding.

In addition to CMS, state agencies also play a role in enforcing nursing home laws and regulations. State agencies may conduct their own inspections of nursing homes and take action against facilities that are not in compliance.

Consequences of Violating Legal Obligations

Nursing homes that violate the NHRA or state laws and regulations may face a variety of consequences, including:

  • Fines
  • Loss of Medicare and Medicaid funding
  • Closure
  • Criminal charges

In addition to these penalties, nursing homes that violate the law may also be sued by residents or their families.

Resident Rights and Protections

Nursing home residents have fundamental rights that must be respected and protected. These rights include the right to privacy, dignity, and autonomy.

To ensure that these rights are upheld, nursing homes must have policies and procedures in place that address the following:


  • Residents have the right to privacy in their personal space, including their room and belongings.
  • Nursing homes must have policies and procedures in place to protect residents’ privacy, such as requiring staff to knock before entering a resident’s room and obtaining consent before providing personal care.


  • Residents have the right to be treated with dignity and respect.
  • Nursing homes must have policies and procedures in place to promote residents’ dignity, such as providing them with choices in their care and respecting their personal preferences.


  • Residents have the right to make decisions about their own care and treatment.
  • Nursing homes must have policies and procedures in place to support residents’ autonomy, such as providing them with information about their care options and respecting their decisions.

Mechanisms for Voicing Concerns and Filing Grievances

Residents have the right to voice concerns and file grievances about their care. Nursing homes must have policies and procedures in place to ensure that residents can do so without fear of retaliation.

These policies and procedures may include:

  • Establishing a grievance committee to review and investigate complaints.
  • Providing residents with information about their rights and how to file a grievance.
  • Protecting residents from retaliation for filing a grievance.

Medical Care and Treatment

Nursing homes are not equipped to provide all types of medical care and treatment. They are primarily responsible for providing basic care, such as assistance with activities of daily living (ADLs), medication management, and monitoring vital signs. For more complex medical needs, nursing homes must refer residents to outside healthcare providers.

Scope of Medical Care and Treatment

Nursing homes are not allowed to provide the following types of medical care and treatment:

  • Surgery
  • Intravenous (IV) therapy
  • Radiation therapy
  • Chemotherapy
  • Dialysis
  • Complex wound care
  • Emergency medical care

Financial Management

Nursing homes are strictly prohibited from engaging in any practices that could compromise the financial well-being of their residents. This includes misappropriating funds, charging excessive fees, or failing to provide transparent and accountable financial management.

Transparency and Accountability

Nursing homes must maintain accurate and up-to-date financial records and make them available to residents and their families upon request. They must also provide regular financial reports to residents and their representatives, detailing all income and expenses. This transparency helps ensure that residents’ funds are being managed responsibly and in accordance with their wishes.

Staffing and Qualifications

Nursing homes have a legal obligation to provide adequate and qualified staff to ensure the safety and well-being of their residents. Minimum staffing requirements and qualifications vary from state to state, but generally include the following:

  • *Registered nurses (RNs) must have a bachelor’s degree in nursing and be licensed by the state. They are responsible for assessing residents’ needs, developing and implementing care plans, and providing direct care.
  • *Licensed practical nurses (LPNs) must have a diploma or associate’s degree in nursing and be licensed by the state. They can perform many of the same tasks as RNs, but under the supervision of an RN.
  • *Certified nursing assistants (CNAs) must complete a state-approved training program and pass a competency exam. They provide basic care to residents, such as bathing, dressing, and feeding.

It is important for nursing homes to have adequate and qualified staff to ensure that residents receive the care they need. Understaffing can lead to neglect and abuse, while hiring unqualified staff can put residents at risk of harm.

Consequences of Understaffing or Hiring Unqualified Staff

  • *Increased risk of neglect and abuse
  • *Lower quality of care
  • *Increased risk of accidents and injuries
  • *Increased risk of infections
  • *Higher mortality rates

Quality of Care and Inspections

Nursing homes are required to meet certain standards of care to ensure the well-being of their residents. These standards include providing adequate medical care, maintaining a clean and safe environment, and respecting residents’ rights.


Nursing homes are inspected regularly by state and federal agencies to ensure that they are meeting these standards. The inspection process involves reviewing the nursing home’s records, interviewing staff and residents, and observing the overall quality of care.

End-of-Life Care: Things Nursing Homes Are Not Allowed To Do

End-of-life care in nursing homes involves providing compassionate and dignified care to residents approaching the end of their lives. It is guided by ethical and legal considerations that emphasize respecting resident wishes and providing palliative and hospice services.

Ethical considerations include ensuring that residents have the right to make decisions about their care, including end-of-life decisions, and that their wishes are respected. Legal considerations include adhering to state and federal regulations governing end-of-life care, such as the Patient Self-Determination Act and the Affordable Care Act.

Palliative Care and Hospice Services, Things nursing homes are not allowed to do

Palliative care focuses on managing pain and symptoms and improving the quality of life for residents with serious illnesses, including those facing end-of-life. Hospice services provide comprehensive care for residents in the final stages of life, offering support to both residents and their families.

Last Recap

By understanding the boundaries of nursing home operations, families can make informed decisions about care options and advocate for their loved ones’ rights. Regular inspections, resident feedback, and transparency in financial management ensure that nursing homes meet the highest standards of care.


Can nursing homes force residents to take medication?

No, nursing homes must obtain informed consent before administering any medication.

Can nursing homes charge residents for personal care items?

No, nursing homes cannot charge for essential personal care items such as toiletries and incontinence supplies.

Can nursing homes restrict residents’ visitors?

No, nursing homes cannot unreasonably restrict visitation rights unless there are safety or health concerns.