Doctor talking to patient

Laws & Regulations

“The resident has the right to ‘reside and receive services in the facility with reasonable accommodation of individual needs and preferences, except when the health or safety of the individual or other residents would be endangered” WAC (Washington Administrative Code): 388-97-08010.

OBRA Interpretive Guideline at F-253: “Reasonable Accommodations” requirement means ‘those adaptations of the facility’s physical environment and staff behaviors to assist residents in maintaining independent functioning, dignity, well being and self-determination.

The Omnibus Budget Reconciliation Act (OBRA), also known as the Nursing Home Reform Act of 1987, has dramatically improved the quality of care in the nursing home over the last twenty years by setting forth federal standards of how care should be provided to residents. This Act is interpreted with the U.S. Code of Federal Regulations (42 CFR Part 483). Such improvements include less use of antipsychotic drugs, a reduction in chemical and physical restraint use,

A resident should not be transferred or discharged on grounds that the facility cannot meet his or her needs unless the resident’s condition is so acute as to require hospitalization. A Medicaid or Medicare certified skilled nursing facility should be able to meet resident needs that are less intensive than hospitalization.  56 Fed Regulations 48839.

“Often the basis for a transfer or discharge can be eliminated by close attention to medical problems, changes in the environment or alterations in staff interventions.”

Under OBRA, the facility, ‘must have sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident, as determined by resident assessments and individual plans of care. 42 CFR 483.30.

Freedom from Chemical Restraint:
Residents have the right to be free from physical or mental abuse, corporate punishment, involuntary seclusion, and any physical or chemical restrains imposed for purposes of discipline or convenience and not required to treat the resident’s medical symptoms.
WAC 388-97-075  42 CFR 483.13(a).

Download information on Chapter 70.129 RCW – Long-term care resident rights

Download information on Chapter 388-97 WAC:  Nursing Homes – Resident Rights, Care and Related Services