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LawyerLand › Legal Glossary

Nursing Home Residents' Rights

The federal bill of rights every Medicare- or Medicaid-certified nursing home must honor - dignity, choice, freedom from restraints and abuse, notice before transfer or discharge - and the inspection and complaint system that enforces it.

Informational only - this is not legal advice. These definitions explain general legal vocabulary in plain English. They are not advice about your situation, reading them creates no attorney-client relationship, and the law differs from state to state and changes over time. For advice you can rely on, speak to a lawyer licensed in your state.

Looking for a lawyer rather than a definition? Skip to the state-by-state list of Nursing Home Abuse law firms.

What it means

Every nursing home that accepts Medicare or Medicaid - almost all of them - is bound by a federal set of resident rights enacted after a national study documented widespread neglect. A resident has the right to be treated with dignity and to make their own choices about their schedule, activities and care; to be free from physical or chemical restraints used for discipline or convenience rather than to treat a medical symptom; to be free from abuse, neglect and misappropriation of property; to privacy, to their own physician, to see their records, to manage their own money or have it properly accounted for; to participate in their care plan and to refuse treatment; and to voice grievances without retaliation. The facility must give each resident a written statement of these rights.

The transfer and discharge rules are the ones families meet most often. A facility may move a resident out only for reasons the statute lists - the resident's needs cannot be met, their health has improved, the safety or health of others is endangered, non-payment, or the facility closes - and must give written notice, in advance, with the reason, the destination, and the right to appeal to the state. A discharge to a hospital must come with a bed-hold notice explaining the right to return. "Resident dumping" - refusing to readmit a resident after a hospital stay, or discharging a resident whose Medicare coverage has ended - is a recurring subject of enforcement.

Enforcement runs through the state survey agency, which inspects on an unannounced cycle and on complaint, and can impose federal remedies from a plan of correction up to civil money penalties and termination from Medicare. Every state has a long-term-care ombudsman program, created by federal law, that investigates complaints on residents' behalf at no charge. The federal rights supplement, and do not replace, state licensing law and the ordinary law of negligence and elder abuse under which a facility can be sued.

Where this comes from

The Nursing Home Reform Act, part of the Omnibus Budget Reconciliation Act of 1987, is codified at 42 U.S.C. § 1395i-3 (Medicare) and § 1396r (Medicaid); the resident-rights, transfer-and-discharge and quality-of-care requirements are at 42 C.F.R. part 483, subpart B, with the rights at § 483.10 and the transfer and discharge rules at § 483.15. The state long-term-care ombudsman program is required by the Older Americans Act, 42 U.S.C. § 3058g. The federal regulations create no private right of action of their own; suits proceed under state law, and some states allow the federal standards to be used as evidence of the standard of care.

When people hire a lawyer for this

Two situations call for a lawyer quickly. The first is a transfer or discharge notice - the appeal window is short and the facility cannot move the resident while a timely appeal is pending in most circumstances, so the timing of the appeal is the whole case. The second is injury: a fall, a pressure sore, dehydration, an unexplained bruise, a medication error. For those, a complaint to the survey agency and the ombudsman can run alongside a civil claim, and the facility's own incident reports and staffing records, which a lawyer can compel, are the evidence. An arbitration agreement in the admission papers is a separate question with rules of its own.

Worried about the cost? A lawyer can be hired for one part of a case only (limited-scope representation), may be paid from what a claim recovers (contingency fee), or may be free through a pro bono program or legal aid; a court can also waive its own filing fees.

Find Nursing Home Abuse law firms in your state

Choose your state to see Nursing Home Abuse law firms in the city where we list the most; your city may be under “other cities”, A to Z.

  • Alabama (Birmingham)
    +1 other city
    • Montgomery
  • Alaska (Anchorage)
  • Arizona (Chandler)
    +6 other cities
    • Gilbert
    • Glendale
    • Mesa
    • Phoenix
    • Scottsdale
    • Tucson
  • Arkansas (Little Rock)
  • California (Anaheim)
    +18 other cities
    • Chula Vista
    • Fontana
    • Irvine
    • Long Beach
    • Los Angeles
    • Modesto
    • Oxnard
    • Riverside
    • Sacramento
    • San Bernardino
    • Santa Ana
    • Stockton
    • and 6 more with fewer listed firms
  • Colorado (Aurora)
    +2 other cities
    • Colorado Springs
    • Denver
  • Connecticut (Bridgeport)
  • Delaware (Wilmington)
  • District of Columbia (Washington)
  • Florida (Hialeah)
    +5 other cities
    • Jacksonville
    • Miami
    • Orlando
    • St Petersburg
    • Tampa
  • Georgia (Atlanta)
  • Hawaii (Honolulu)
  • Idaho (Boise)
  • Illinois (Chicago)
  • Indiana (Indianapolis)
    +1 other city
    • Fort Wayne
  • Iowa (Des Moines)
  • Kansas (Kansas City)
    +1 other city
    • Wichita
  • Kentucky (Lexington)
    +1 other city
    • Louisville
  • Louisiana (Baton Rouge)
    +2 other cities
    • New Orleans
    • Shreveport
  • Maine (Portland)
  • Maryland (Baltimore)
  • Massachusetts (Boston)
  • Michigan (Detroit)
  • Minnesota (Minneapolis)
    +1 other city
    • Saint Paul
  • Mississippi (Jackson)
  • Missouri (Kansas City)
    +1 other city
    • St. Louis
  • Montana (Billings)
  • Nebraska (Lincoln)
    +1 other city
    • Omaha
  • Nevada (Henderson)
    +3 other cities
    • Las Vegas
    • North Las Vegas
    • Reno
  • New Hampshire (Manchester)
  • New Jersey (Jersey City)
    +1 other city
    • Newark
  • New Mexico (Albuquerque)
  • New York (New York City)
    +2 other cities
    • Buffalo
    • Rochester
  • North Carolina (Durham)
    +5 other cities
    • Charlotte
    • Fayetteville
    • Greensboro
    • Raleigh
    • Winston-Salem
  • North Dakota (Fargo)
  • Ohio (Cleveland)
    +3 other cities
    • Cincinnati
    • Columbus
    • Toledo
  • Oklahoma (Oklahoma City)
    +1 other city
    • Tulsa
  • Oregon (Portland)
  • Pennsylvania (Philadelphia)
    +1 other city
    • Pittsburgh
  • Rhode Island (Providence)
  • South Carolina (Columbia)
  • South Dakota (Sioux Falls)
  • Tennessee (Nashville)
    +1 other city
    • Memphis
  • Texas (Austin)
    +12 other cities
    • Arlington
    • Corpus Christi
    • Dallas
    • El Paso
    • Fort Worth
    • Garland
    • Houston
    • Irving
    • Laredo
    • Lubbock
    • Plano
    • San Antonio
  • Utah (Salt Lake City)
  • Vermont (Burlington)
  • Virginia (Richmond)
    +3 other cities
    • Chesapeake
    • Norfolk
    • Virginia Beach
  • Washington (Seattle)
    +2 other cities
    • Spokane
    • Tacoma
  • West Virginia (Charleston)
  • Wisconsin (Madison)
    +1 other city
    • Milwaukee
  • Wyoming (Cheyenne)

Related terms

Entries on the same subject:

  • Elder Abuse and Adult Protective ServicesWhat the law counts as abuse, neglect or exploitation of an older or dependent adult, who must report it, what Adult Protective Services can and cannot do, and the civil and criminal remedies that follow.

Other entries in the same area of law, each written from the same primary sources.

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  • Hospital Financial Assistance and Medical DebtThe federal rules that make a nonprofit hospital publish a financial assistance policy, limit what it may charge eligible patients, and restrict how it collects - and what a patient with a medical bill can do with them.
  • Informed ConsentA patient's agreement to treatment after being told the risks and alternatives - and a signed form is evidence that the conversation happened, not proof that it was adequate.
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  • Medicaid Estate RecoveryThe federal requirement that a state recover the cost of long-term care Medicaid paid for from the estate of the person who received it after they die - the reason the family home is at stake, and the exemptions and hardship rules that limit it.
  • Medical Malpractice and the Standard of CareA negligence claim against a healthcare provider, judged against what a reasonably competent practitioner in the same field would have done.
  • Medicare AppealsThe five-level process for challenging a Medicare denial - of a claim, a service, a hospital discharge, or a nursing-home stay - with a different deadline at each level and a fast track when the care is about to stop.
  • Mental Health ParityThe federal requirement that a health plan covering mental-health or substance-use treatment cover it on terms no more restrictive than its medical and surgical coverage - in dollars, in visit limits, and in the prior-authorization and network rules that are harder to see.
  • Patient AbandonmentWhen a physician or provider may end a relationship with a patient, what notice and transition care they must give, and when ending it - or refusing to start it - becomes actionable.
  • Psychotherapist-Patient PrivilegeThe rule that keeps what a patient tells a therapist out of court - who it covers, who holds it, how it is waived, and the duty-to-warn and child-abuse exceptions that override it.
  • Refusing Medical TreatmentThe right of a competent adult to refuse any treatment, including one that keeps them alive; what happens when the patient cannot decide; and the limits the law places on it.
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  • SubrogationThe right of an insurer or health plan that paid your bills to be repaid out of your settlement - the reason a recovery is often smaller than it looks.
  • Supplemental Security Income (SSI)The federal needs-based benefit for people who are aged, blind or disabled and have little income or savings: how it differs from Social Security disability, what counts against it, and how to appeal.
  • Surprise Medical Billing (No Surprises Act)The federal protection, since 2022, against a bill from an out-of-network provider the patient did not choose - the emergency room, the anesthesiologist at an in-network hospital, the air ambulance - and the good-faith estimate an uninsured patient can hold a provider to.
  • Surrogate Decision-Maker (Default Surrogate Laws)Who makes medical decisions for a patient who cannot and who never named anyone - the ranked list most state laws supply, the standard the surrogate must apply, and what a surrogate cannot do.
  • Veterans Disability CompensationThe tax-free monthly VA benefit for disabilities connected to military service: what service connection means, how ratings work, and the three ways to challenge a VA decision.

« All glossary terms

Part of the LawyerLand plain-English legal glossary. Definitions are written from primary sources - statutes and court rules - and each entry states the authority it rests on, or says plainly when the doctrine is state law with no national rule.
If you cannot afford a lawyer, civil legal aid programs provide free help with many of these problems: civil legal aid programs by state.
Related free reference tools: statute of limitations for a personal-injury claim, by state, quoted from each state's official text - part of LawyerLand's legal reference tools.
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