Page:United States Statutes at Large Volume 101 Part 2.djvu/977

 PUBLIC LAW 100-203—DEC. 22, 1987

101 STAT. 1330-183

"REQUIREMENTS FOR NURSING FACILITIES

1919. (a) NURSING FACILITY DEFINED.—In this title, the term 42 USC I396r. 'nursing facility' means an institution (or a distinct part of an institution) which— "(1) is primarily engaged in providing to residents— "(A) skilled nursing care and related services for residents who require medical or nursing care, "(B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or "(C) on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; "(2) has in effect a transfer agreement (meeting the requirements of section 1861(1)) with one or more hospitals having agreements in effect under section 1866; and "(3) meets the requirements for a nursing facility described in subsections (b), (c), and (d) of this section. Such term also includes any facility which is located in a State on an Indian reservation and is certified by the Secretary as meeting the requirements of paragraph (1) and subsections (b), (c), and (d). "SEC.

"(b) REQUIREMENTS RELATING TO PROVISION OF SERVICES.— "(1) QUAUTY OF LIFE.—

"(A) IN GENERAL.—A nursing facility must care for its residents in such a manner and in such an environment as will promote maintenance or enhancement of the quality of life of each resident. "(B)

QuAUTY ASSESSMENT AND ASSURANCE.—A n u r s i n g

facility must maintain a quality assessment and assurance committee, consisting of the director of nursing services, a physician designated by the facility, and at least 3 other members of the facility's staff, which (i) meets at least quarterly to identify issues with respect to which quality assessment and assurance activities are necessary and (ii) develops and implements appropriate plans of action to correct identified quality deficiencies. "(2) SCOPE OF SERVICES AND ACTIVITIES UNDER PLAN OF CARE.—

A nursing facility must provide services and activities to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident in accordance with a written plan of care which— "(A) describes the medical, nursing, and psychosocial needs of the resident and how such needs will be met; "(B) is initially prepared, with the participation to the extent practicable of the resident or the resident's family or legal representative, by a team which includes the resident's attending physician and a registered professional nurse with responsibility for the resident; and "(C) is periodically reviewed and revised by such team after each assessment under paragraph (3). "(3) RESIDENTS' ASSESSMENT.—

"(A) REQUIREMENT.—A nursing facility must conduct a comprehensive, accurate, standardized, reproducible assess-

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