Rights & compliance
The rules every nursing home has to follow, and the phone numbers that actually get action. This section changes automatically based on the facility's state.
Federal
- · 42 CFR §483 — Requirements for Long-Term Care Facilities: quality of care, care planning, sufficient staffing.
- · Nursing Home Reform Act (OBRA '87) — right to be free from abuse, neglect, and unnecessary restraints or drugs.
- · Residents' Rights: dignity, privacy, own physician, participation in care planning, grievance without retaliation.
- · HIPAA Privacy & Security Rules — only authorized people may see this record; every view and entry is logged.
- · 45 CFR §164.524 — right to a copy of the record within 30 days, in the format you request.
- · CMS Discharge & Transfer Notice rules — 30-day written notice except in emergencies; appeal rights included.
- · Medicare SNF benefit: 100 days per benefit period, days 1–20 no coinsurance, expedited QIO appeal rights.
- · Patient Self-Determination Act — advance directives must be asked about and documented at admission.
- · 42 CFR §483.15 — admission agreement may not require a third-party guarantee of payment or waive rights.
- · 42 CFR §483.70(n) — arbitration agreements are voluntary, must be explained, and may be rescinded in 30 days.
- · 42 CFR §483.100–138 — PASRR Level I screening before any admission to a Medicaid-certified facility.
- · 42 CFR §483.21 — baseline care plan within 48 hours; comprehensive person-centered plan within 21 days.
- · 42 CFR §483.20 — MDS 3.0 assessment on admission, quarterly, annually and on significant change.
- · 42 CFR §483.80 — infection prevention, outbreak reporting and vaccine education for every resident.
- · 42 CFR §483.10(f)(10) — written authorization before the facility holds resident funds; quarterly statements.
- · ADA & Section 504 — accessible communication, interpreters and accommodations.
- · 42 CFR §483.10(g)(14) — family must be notified promptly of injury, significant change, or medication change.
- · Elder Justice Act — suspected crimes against residents reported to law enforcement within 2 or 24 hours.
- · 21st Century Cures Act information-blocking rules — records released electronically without delay.
State (configurable per state)
- · Texas: HHSC 26 TAC Chapter 554 licensing standards; complaint line 1-800-458-9858.
- · State Long-Term Care Ombudsman — free advocacy, Texas 1-800-252-2412.
- · State-specific minimum staffing ratios and posted daily staffing sheets.
- · State abuse/neglect mandatory reporting timelines (immediate to 24 hours) and APS contact.
- · State Medicaid long-term care eligibility, applied income and personal needs allowance amounts.
- · State-specific advance directive, POLST/MOST, out-of-hospital DNR and guardianship forms.
- · State medical-record retention period and copy-fee caps.
- · State background check, registry clearance and license verification for every employee charting here.
- · State residents' bill of rights, which in many states exceeds the federal minimum.
- · This module swaps automatically to the correct state rules when a facility signs up.
County / City & facility
- · Local health department inspection results and last survey date, posted publicly.
- · County emergency management, evacuation and shelter-in-place plan for the facility.
- · City fire marshal inspection, sprinkler and life-safety certificate on file.
- · County or city food-service permit and kitchen inspection score.
- · Facility grievance officer, response timeline, and escalation path.
- · Resident and Family Council meeting schedule (federally protected right to organize).
- · Infection prevention and outbreak notification policy.
- · Visitation policy including federally protected right to 24-hour visitation.
- · Facility abuse prevention program, staffing plan and quality assurance (QAPI) summary.
If something is wrong right now
- 1. Tell the charge nurse and file a grievance in the "Ask a question" section — it starts a clock.
- 2. Ask for the Director of Nursing or Administrator, in writing.
- 3. Call your state Long-Term Care Ombudsman (free advocate).
- 4. Call the state survey agency complaint hotline — anonymous reports are accepted.
- 5. For suspected abuse or neglect, call Adult Protective Services and 911 first.
Retaliation against a resident or family for filing a complaint is prohibited by federal law.
Compliance built into the app
- · HIPAA-aligned access controls, encryption, minimum-necessary sharing and breach logging.
- · Signed HIPAA authorization required before any family member is given a code.
- · 42 CFR §483 care-plan participation: family invited to every care conference.
- · Automatic notification for injuries, falls, significant changes and medication changes.
- · Immutable audit trail suitable for state surveys and CMS documentation requests.
- · Advance directive, POLST/DNR and code-status displayed on every clinical screen.