Federal law gives every resident of a Medicare- or Medicaid-certified nursing home the same core rights, in every state. Those nursing home residents' rights cover dignity, visitors, privacy, medical records, money, and freedom from abuse and restraints, and the rules come with deadlines you can hold a nursing home to. Here's what each right means in practice, and who to call when a nursing home ignores one.,

In This Guide

Which Nursing Homes Have to Follow These Rights?

Any nursing home that takes Medicare or Medicaid. Federal rules at 42 CFR Part 483 set the requirements a skilled nursing facility must meet to take part in Medicare and a nursing facility must meet to take part in Medicaid, and state survey agencies inspect nursing homes against those requirements for the Centers for Medicare & Medicaid Services (CMS). So a certified nursing home in Ohio owes its residents the same federal floor as one in Arizona.

The resident-rights rules sit in two sections of that part: 42 CFR 483.10, "Resident rights," and 42 CFR 483.12, "Freedom from abuse, neglect, and exploitation." The Medicaid statute for nursing facilities, 42 U.S.C. 1396r, writes many of the same rights into federal law.,

Assisted living is a different story. According to the federal health department's planning office, ASPE, residential care settings like assisted living are licensed and regulated at the state level, and state requirements vary considerably. So if your parent lives in assisted living, the federal nursing home rights in this guide don't apply there; check your state's assisted living rules instead. Our assisted living guides by state are a good starting point, and our comparison of assisted living vs. nursing homes by state lays out the other differences.

Nursing Home Residents' Rights at a Glance

Here's the short version. Each right in the table comes from the federal nursing home rules at 42 CFR 483.10 and 483.12, and the sections below explain what each one means when you're standing in the hallway trying to get something fixed.,

The right What it means day to day Federal rule
Dignity and self-determination Your parent is treated with respect and chooses daily schedules, activities and health care providers, consistent with the care plan 42 CFR 483.10
No reprisal The nursing home can't punish your parent for using any of these rights 42 CFR 483.10
A say in care Your parent can join care-plan meetings, ask for changes, see the plan and refuse treatment 42 CFR 483.10(c)
Choice of doctor Your parent picks the attending physician, who must be licensed 42 CFR 483.10(d)
Visitors Your parent chooses who visits and when, and can say no to any visitor 42 CFR 483.10
Privacy Privacy in care, visits, mail and phone calls, but not a guaranteed private room 42 CFR 483.10
Medical records See records within 24 hours (excluding weekends and holidays), copies on 2 working days' notice 42 CFR 483.10(g)(2)
Money Your parent manages their own money, and the nursing home can't require a deposit 42 CFR 483.10(f)(10)
Grievances Complain without reprisal and get a written decision 42 CFR 483.10(j)
Freedom from abuse and restraints No abuse, neglect, involuntary seclusion, or restraints for discipline or convenience 42 CFR 483.12

Dignity, Choice and a Say in Your Parent's Care

Under 42 CFR 483.10, a nursing home resident "has a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility." The nursing home must treat each resident with respect and dignity, recognizing each resident's individuality, and must protect and promote the resident's rights.

What does that look like on a Tuesday? Under the federal rule, a nursing home resident has a right to choose activities, schedules (including sleeping and waking times), health care and health care providers, consistent with the resident's interests, assessments and plan of care. So if Dad has gone to bed at midnight for 50 years, a 7 p.m. lights-out that suits the night shift isn't automatically the rule he has to live by.

Two more protections under 42 CFR 483.10 back up everything else in this guide:

  • No reprisal. A nursing home must make sure a resident can exercise the resident's rights without interference, coercion, discrimination or reprisal from the nursing home.
  • Same care, whoever pays. A nursing home must provide equal access to quality care regardless of diagnosis, severity of condition, or payment source, so a resident on Medicaid can't be steered to lesser care than a private-pay resident.

A nursing home also has to tell your parent about these rights, both orally and in writing, in a language your parent understands. If nobody walked your family through them at admission, ask for the written notice.

Care-plan meetings, refusing treatment and choosing a doctor

Your parent gets a seat at the table. A nursing home resident can ask for a care-plan meeting, name who else should take part (you, a sibling, a close friend), ask for changes to the care plan, and see the plan itself, under the federal resident-rights rule at 42 CFR 483.10(c). The same rule requires that a nursing home resident be fully informed of the resident's total health status, in language the resident can understand.

Your parent can also say no. A nursing home resident has the right to request, refuse or discontinue treatment, to refuse to take part in experimental research, and to make an advance directive, under 42 CFR 483.10(c). What the federal rule doesn't do is create a right to treatment or services that are medically unnecessary or inappropriate, so it isn't a way to insist on a test or a drug the doctor judges unnecessary.

Your parent picks the doctor, too. A nursing home resident has the right to choose the attending physician, who must be licensed to practice, under 42 CFR 483.10(d). If that physician won't or doesn't meet the federal nursing home requirements, the nursing home may look for another physician to take part in your parent's care.

What about a parent with dementia? A diagnosis doesn't, by itself, hand your parent's rights to someone else. Under 42 CFR 483.10(b), a nursing home resident's rights pass to a representative appointed under state law when a court of competent jurisdiction has adjudged the resident incompetent, and even then the nursing home must, to the extent practicable, keep giving the resident chances to take part in care planning. Short of that court ruling, a resident representative can exercise a nursing home resident's rights to the extent those rights have been delegated to the representative. Our guide to guardianship vs. power of attorney explains how that kind of authority is set up.

Visitors, Privacy and Staying in Touch

Can a nursing home restrict visitors? Only within limits, and the key thing to know is that the visiting right belongs to your parent. Under the federal resident-rights rule at 42 CFR 483.10, a nursing home resident has a right to receive visitors of the resident's choosing at the time of the resident's choosing, subject to the resident's right to deny visitation, and in a way that doesn't impose on another resident's rights.

Here's how the federal rule splits it:

  • Family. A nursing home must give immediate family and other relatives immediate access to a resident, subject to the resident's right to deny or withdraw consent at any time.
  • Everyone else your parent wants to see. A nursing home must give immediate access to other visitors who come with the resident's consent, subject to reasonable clinical and safety restrictions and the resident's right to say no.
  • Written policies. A nursing home must have written visitation policies that spell out any clinically necessary or safety-based restriction it may place on visits.

So if a nursing home tells you visits are "by appointment only," ask to see the written visitation policy and the clinical or safety reason behind the restriction.

On privacy, 42 CFR 483.10 gives a nursing home resident a right to personal privacy and to confidentiality of personal and medical records. Personal privacy covers accommodations, medical treatment, written and telephone communications, personal care, visits, and meetings of family and resident groups. The federal privacy right in 42 CFR 483.10 does not require a nursing home to give each resident a private room.

Staying in touch is protected too. A nursing home must respect a resident's right to send and promptly receive unopened mail. A nursing home resident has the right to reasonable access to a telephone and a place to make calls without being overheard, including the right to keep and use a cell phone at the resident's own expense.

Seeing and Copying Medical Records

This is the right with the clearest clock. Under 42 CFR 483.10(g)(2), a nursing home must give a resident access to the resident's own personal and medical records within 24 hours of an oral or written request, excluding weekends and holidays.

Copies run on a separate clock. A nursing home must let a resident get a copy of the records, or any part of them, on request with 2 working days' advance notice.

A nursing home may charge a reasonable, cost-based fee for copies, but the federal rule limits that fee to three things:

  • labor for copying the records,
  • supplies for the paper copy or portable electronic media, and
  • postage, when the resident asks for the copy to be mailed.

So a nursing home that makes your parent wait several business days just to look at the chart isn't meeting the federal standard. Put the request in writing, date it, and keep a copy. The Medicaid nursing facility statute (42 U.S.C. 1396r) gives the same 24-hour access to current clinical records on request by the resident or the resident's legal representative, so if you're the one asking, bring the paperwork that shows your authority.

Who Controls Your Parent's Money?

Your parent does. Under 42 CFR 483.10(f)(10), a nursing home resident has a right to manage his or her own financial affairs, including the right to know in advance what charges a nursing home may take out of the resident's personal funds.

A nursing home must not require residents to deposit their personal funds with it. Only if a resident chooses to deposit money with the nursing home, and gives written authorization, does the nursing home act as a fiduciary that must hold, safeguard, manage and account for those funds.

So a nursing home can offer to hold your parent's spending money, but it can't require a deposit. Our nursing homes by state guides cover costs and Medicaid coverage in each state.

Freedom From Abuse, Neglect and Restraints

Under 42 CFR 483.12, a nursing home resident has the right to be free from abuse, neglect, misappropriation of resident property and exploitation. That right includes freedom from corporal punishment, involuntary seclusion, and any physical or chemical restraint not required to treat the resident's medical symptoms.

The federal rule turns that right into specific duties. Under 42 CFR 483.12, a nursing home must not use verbal, mental, sexual or physical abuse, corporal punishment or involuntary seclusion, and must not employ people who have been found guilty of abuse, neglect, exploitation, misappropriation of property or mistreatment by a court, or who have such a finding on the state nurse aide registry.

Can a nursing home use restraints?

Only in narrow circumstances, and never for discipline or convenience. Under 42 CFR 483.12, a nursing home must make sure a resident is free from physical or chemical restraints imposed for discipline or convenience and not required to treat the resident's medical symptoms. When restraints are indicated, the nursing home must use the least restrictive alternative for the least amount of time and document ongoing re-evaluation of the need for them.

The Medicaid nursing facility statute adds two conditions. Under 42 U.S.C. 1396r, restraints may be imposed only to ensure the physical safety of the resident or other residents, and only on a physician's written order that says how long and under what circumstances they may be used, except in emergency circumstances until such an order can reasonably be obtained.

So if staff say a lap belt or bed rail is "just to keep Mom from wandering at night," ask two questions: what medical symptom is it treating, and where is the physician's written order?

How fast a nursing home must report alleged abuse

Under 42 CFR 483.12(c), a nursing home must report every alleged violation involving abuse, neglect, exploitation or mistreatment, including injuries of unknown source and misappropriation of resident property. Two deadlines apply:

  • 2 hours. Under 42 CFR 483.12(c), a nursing home must report an alleged violation within 2 hours of the allegation when the events involve abuse or result in serious bodily injury.
  • 24 hours. Under 42 CFR 483.12(c), a nursing home must report an alleged violation within 24 hours when the events don't involve abuse and don't result in serious bodily injury.

Those reports go to the nursing home's administrator and to state officials, including the State Survey Agency and, where state law gives it jurisdiction in long-term care facilities, adult protective services. Then the nursing home has to investigate, protect residents from further harm while it does, and report the results to the administrator and state officials, including the State Survey Agency, within 5 working days of the incident, under the same federal rule.

What does that mean for your family? If you raise a concern that an unexplained bruise or injury might be abuse or neglect, that is an allegation, and 42 CFR 483.12(c) says a nursing home must report all alleged violations, including injuries of unknown source, with the reporting clock running from when the allegation is made. So ask the nursing home who it reported your concern to, and when.

Individual staff are on the hook too. Under section 1150B of the Social Security Act (42 U.S.C. 1320b-25), each owner, operator, employee, manager, agent or contractor of a long-term care facility that received at least $10,000 in federal funds the year before must report any reasonable suspicion of a crime against a resident to local law enforcement and to the State Survey Agency. Under section 1150B of the Social Security Act, a long-term care facility worker's report of a reasonable suspicion of a crime against a resident is due within 2 hours of forming the suspicion when the events result in serious bodily injury, and within 24 hours otherwise.

Your family can raise a concern directly, too. Our guide on how to report nursing home abuse or neglect walks through who to call, and how to recognize and report elder abuse covers the warning signs.

What to Do When a Nursing Home Violates a Resident's Rights

Start inside the building, and go outside it when that doesn't work.

Step 1: File a grievance with the nursing home

Under 42 CFR 483.10(j), a nursing home resident has the right to voice grievances without discrimination or reprisal, and without fear of either. That covers care that was given and care that wasn't, the behavior of staff and other residents, and other concerns about the stay. The nursing home must make prompt efforts to resolve the grievance.

Every nursing home must have a grievance policy and give your parent a copy on request. Under 42 CFR 483.10(j), the policy must tell residents that they can file grievances orally or in writing and anonymously, who the grievance official is and how to reach that person, the expected time frame for the review, and that they can get a written decision. The nursing home must keep evidence of the results of every grievance for at least 3 years.

The federal rule doesn't set a fixed number of days to resolve a grievance; it requires the policy to state a reasonable expected time frame. So ask for the policy, note the time frame it promises, and ask for the written decision when it's done.

Step 2: Call the Long-Term Care Ombudsman

The Long-Term Care Ombudsman program is a free, confidential advocate for nursing home residents in every state, and it works on the resident's behalf and at the resident's direction. Under 42 CFR 483.10, a nursing home must give ombudsman representatives immediate access to any resident and must not prohibit or discourage a resident from contacting the ombudsman. To find your state's program, the federal Administration for Community Living points to the Consumer Voice state directory. Our long-term care ombudsman guide explains what to expect when you call.

Step 3: File a complaint with the State Survey Agency

The State Survey Agency is the state office that inspects nursing homes. Under 42 CFR 483.10, every nursing home must post the names, addresses and phone numbers of state agencies and advocacy groups, including the State Survey Agency and the ombudsman program, along with a statement that residents may file a complaint with the State Survey Agency about any suspected violation of state or federal nursing facility regulations, including abuse and neglect.

Before you file, look at the home's record. Federal rules require a nursing home to post the results of its most recent inspection and to make reports on surveys and complaint investigations from the past 3 years available to anyone who asks. Our guide to nursing home star ratings explains how to read those inspection results.

What About Transfers and Discharges?

Transfers and discharges have their own federal rules, which are beyond this guide. One thing is worth knowing now: when a nursing home transfers or discharges a resident, it must send a copy of the written notice to the Long-Term Care Ombudsman program, and the notice must list the ombudsman office's name, address and phone number. If your parent gets a discharge notice, call the ombudsman right away; our long-term care ombudsman guide covers how the ombudsman can help.

Frequently Asked Questions

What rights do nursing home residents have?

Under federal rules at 42 CFR 483.10 and 483.12, a resident of a Medicare- or Medicaid-certified nursing home has rights to dignity and self-determination, a say in care planning, choice of doctor, visitors of the resident's choosing, privacy, access to medical records, control of personal money, grievances without reprisal, and freedom from abuse, neglect and restraints used for discipline or convenience., When one of those rights is being ignored, start with the nursing home's grievance official, then go to the Long-Term Care Ombudsman or the State Survey Agency, the two outside offices federal nursing home rules specifically name.

Is there a nursing home bill of rights?

The closest federal equivalent is 42 CFR 483.10, titled "Resident rights," together with 42 CFR 483.12 on abuse, neglect and exploitation. A nursing home must explain those rights to each resident, both orally and in writing, in a language the resident understands.

Can a nursing home take a resident's money?

A nursing home can't require it. If admission paperwork asks your parent to leave spending money with the nursing home, treat that as an offer your parent can turn down: under 42 CFR 483.10(f)(10), a nursing home must not require a resident to deposit personal funds with it, and it holds a resident's money only with the resident's written authorization. Before signing, ask for the list of charges the nursing home may take out of those funds, which federal rules give your parent the right to know in advance.

Can a nursing home resident refuse medication or treatment?

Yes, and the decision is your parent's to make. Say the doctor wants to add a new sedative: under 42 CFR 483.10(c), the physician or other practitioner must first explain the risks and benefits of the proposed care and the treatment alternatives, and a nursing home resident then has the right to choose the option he or she prefers, including refusing or stopping the treatment. If a court has adjudged your parent incompetent, those rights pass to the representative appointed under state law.

Do these rights apply in assisted living?

No. The federal residents' rights in 42 CFR Part 483 bind nursing homes that take Medicare or Medicaid. Assisted living is licensed and regulated by each state, and the federal health department's planning office notes that state requirements vary considerably, so an assisted living resident in one state can have different protections than a resident one state over. If your parent is weighing assisted living, ask the community for a written copy of the resident rights it follows before signing anything.

Learn More

Care TypesThe Long-Term Care OmbudsmanEvery state has a free, confidential long-term care ombudsman for nursing home and assisted living residents. What they do, whose side they're on, how to call. CaregiverHow to Report Nursing Home Abuse or NeglectHow to report nursing home abuse or neglect: call 911 for immediate danger, then the Long-Term Care Ombudsman and your State Survey Agency. Signs and steps. Care TypesHow to Choose a Nursing HomeHow to choose a nursing home step by step: use Medicare Care Compare correctly, read all four star ratings, check the Special Focus list, and tour. Care TypesWhat Medicare Nursing Home Star Ratings Really MeanMedicare nursing home star ratings blend three scores, and two are self-reported. Here's how the 5-star rating is built and how much to trust it. Care TypesNursing Homes by StateWhat a nursing home costs, how Medicaid pays for it, and how facilities are rated all share a federal floor but vary by state. See yours, with a 50-state guide. Care TypesTypes of Senior CareFrom a few hours of help at home to 24-hour nursing care: the types of senior care, what each costs in 2026, whether Medicare or Medicaid pays, and how to pick.

Find personalized help standing up for your parent's rights in a nursing home at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.