Substandard care, abuse, and neglect are longstanding concerns for nursing home residents. Decades of federal reports have documented widespread and persistent issues in nursing homes nationwide, from inadequate infection control practices to low staffing to inappropriate antipsychotic drug use. However, in recent years, it has become evident that residents are increasingly at risk of experiencing poor care due to fundamental problems in the management, ownership, or financing arrangements under which an increasing number of nursing homes operate.

To address these problems, LTCCC undertook an assessment of state practices for evaluating the fitness and competency of individuals and companies that wish to purchase or build a nursing home. This page provides the results of this analysis, including the report of our findings and recommendations, a chart of the promising state practices we identified, and an outline of essential principles for nursing home licensure. We hope that these materials are useful to all stakeholders, particularly the state and federal leaders who are responsible for ensuring that residents are safe and receive the care and services to which they are entitled.