Who Regulates Nursing Homes?

Nursing homes are the most traditional, and remain the most popular, living option for senior citizens who can no longer live independently and who require constant care. As such, there are many state and federal regulations in place to ensure that these facilities meet certain health, safety and care standards.

Federal Regulations

At the federal level, nursing homes are regulated by the U.S. Department of Health and Human Services and the Centers for Medicaid and Medicare Services. Under the Nursing Home Reform Act of 1987, federal regulations establish guidelines for many key topics, including the rights of residents and resident behavior and assessment, nursing, dietary and physician services.

State Regulations

At a minimum, all nursing home facilities are required to comply with federal regulations and state licensing requirements. States are also required to contract with the Centers for Medicaid and Medicare Services to be eligible to provide care to recipients of Medicare and Medicaid. Most states also have their own regulations and laws in place as well.


Both federal and state nursing home regulations are enforced via regular inspections, usually once a year. Facilities that have received poor inspection reports in the past or have recently been investigated for failure to comply with nursing home standards may be inspected more frequently. Individual state governments are responsible for conducting regular inspections, investigating allegations of abuse or code violations, and for reporting their findings to the Centers for Medicaid and Medicare Services, which in turn acts as an agent for the Department of Health and Human Services.

Patient Rights

Nursing home patients and, in most cases, their family members, are entitled to certain rights, including access to accurate information, the ability to make informed choices, privacy and confidentiality, respect and dignity, the right to be transferred or discharged, and the right to file concerns and complaints. Additionally, all nursing homes are required to respond to complaints made against them, whether internally from residents or externally, in a timely fashion.


While all nursing homes are required to comply with the same federal regulations, state regulations and rules vary. Before you or someone you know enters a nursing home facility or files a complaint against one, you should be sure to familiarize yourself with your rights and the specific nursing home regulations in place for your state.