The vast majority of U.S. nursing homes participate in the Medicare and/or Medicaid programs, deriving most of their income and profits from taxpayers. In order to do so, they are required to meet the minimum standards laid out in the federal Nursing Home Reform Law. Fundamentally, the law requires that residents are provided the care and quality of life services sufficient to attain and maintain their highest practicable physical, emotional, and psychosocial well-being.

Though the law and regulatory standards are strong, serious nursing home problems are persistent and widespread. With funding from The New York Community Trust, LTCCC undertook an assessment of the expectations and reality of state and federal enforcement of nursing home standards. The following two reports, and accompanying maps and tables, provide the results of our study and resources for stakeholders to improve resident care and the integrity of the Medicare and Medicaid programs.

  • A Guide to Nursing Home Oversight is about the expectations of oversight. It details key aspects of state agency responsibilities for ensuring quality care. LTCCC reviewed and identified key requirements for state agencies in the federal regulatory requirements and the State Operations Manual which lays out detailed expectations and guidance for state surveyors.
  • Broken Promises is about the reality of oversight. It presents an assessment of federal data on important areas of nursing home enforcement including survey citations on antipsychotics, infection control, and staffing.

Access the two reports by clicking the boxes below. Click here to access interactive data.