The Federal Regulations, which are found at 42 CFR part 483, have become the basis of much of the litigation concerning nursing home abuse and neglect claims. Prior to 1990, there was much more limited nursing home litigation. However, with the adoption of these regulations by the Federal Government and with nursing home statutes in many of the states, including Florida, there has been a substantial growth in litigation based on claims of neglect or abuse of nursing home residents.

The Federal Regulations must be complied with by all nursing homes which receive federal money. These regulations begin with certain definitions and then discuss residents’ rights in great detail. For example, there are regulations concerning the protection of the funds of residents; there are regulations that discuss grievances, mail, and even work done by residents; and there are even regulations as to how to notify residents of their rights under the regulations.

Probably the most important regulation in terms of litigation is found in Section 483.25 This regulation directs that nursing homes must do certain things to prevent accidents; must properly nourish and hydrate residents; and also mandates certain standards regarding pressure sores.

If the regulations are not comprehensive enough to try to ensure the well-being of residents in nursing homes, the Federal Government has also issued “Guidance to Surveyors”, which discusses the intent of many of the regulations and also provides guidelines on how to interpret the regulations.

The pertinent Florida Statutes begin with Florida Statute Section 400.021. A critically important statute in terms of the implementation of the Federal Regulations is Florida Statute 400.023. In section 2 of that statute, the point is made that, if a violation of rights of residents specified in any applicable administrative standard or guideline of a Federal Regulatory Agency occurs, it shall be considered evidence or negligence. That should be considered as including these Federal Regulations. Therefore, this abundant set of regulations represent not only the well-intentioned recommendation of the Institute of Medicine but, if a regulation is violated by a nursing home and it results in harm to a resident, that violation, in and of itself, establishes a cause of action for negligence.

President Reagan had a goal of reducing what he considered to be the pervasiveness of federal regulations. However, the statute passed during his presidency led to these regulations which have become the standard by which all nursing homes must comply.