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Quality of Life

 

Federal Requirements

Federal Regulations sections & related F-tags

F241(a)  Dignity

F242(b)  Self-determination and

             participation

F243(c)  Participation in resident and

             family groups

F245(d)  Participation in other activities

F246(1) - F247(2)  Accommodation of

                           needs

F248(1) - F249(ii)  Activities

F250(1) - F251(2)  Social Services

F252(1) - F255(4)  Environment
F256(5) - F257(7)  Lighting, temperature
Applicable Federal Regulation:

483.15 Quality of Life

483.10 Resident Rights

483.70 Physical Environment
 

Under the federal regulation, 483.15, the facility must care for residents in a manner and an environment that promote maintenance or enhancement of each resident’s quality of life.  This includes (a) treating the resident with dignity and respect for his or her individuality; (b) permitting self-determination and participation, including choice of activities and associations within or outside the facility consistent with the resident’s preferences and interests; and (c) participation in resident and family groups, for which the facility must provide private space, staff assistance for arrangements and follow up, and to which the residents may invite guests as they choose.  The facility must act on grievances expressed through those groups.  The resident has (d) the right to participate in social, religious, and community activities that do not interfere with others; and (e) the right to receive services with reasonable accommodation of needs and preferences, and the right to receive notice of changes of room or roommate.

Under (f), the facility must provide an activities program designed to meet the individual needs and interests of each resident.  The program must be directed by a qualified recreational therapist or activities professional, eligible for State licensure; or a person with 2 years experience in a social or recreational program in the facility; or an occupational therapist or occupational therapist assistant; or a person who has completed a training course approved by the state.

Under (g), the facility must provide medically-related social services “to attain the highest practicable physical, mental, and psychosocial well-being of each resident, and facility with more than 120 beds must employ a qualified social worker full-time.  A qualified social worker is a person with a bachelor’s degree in social work or a human service field, and one year supervised social work experience in a health care setting working directly with individuals.

Finally, under (h), the facility must provide a safe, clean, comfortable environment, allowing the resident to use his or her belonging to the extent possible; housekeeping and maintenance needed for a sanitary, orderly, and comfortable environment; clean bed and bath linens in good condition; private closet space; adequate and comfortable lighting levels; comfortable and safe temperatures; and comfortable sound levels.

Related regulations are found in the Residents Rights regulation, 483.10, and in the regulation for physical environments, 483.70, which in several sections emphasizes comfort and cleanliness, sanitation, closet space, lighting, and temperature. 

 

Using the sections on Comparisons of State Regulations

a Each narrative highlights how States differ from Federal regulations on a specific topic. 
a Italics are used for signed NHRegsPlus comments on the relevance of these variations for resident autonomy, quality
     of life, or culture change. 
a Examples are illustrative not comprehensive; always check specific State language. 
a See a table with links to each State’s regulatory language at the bottom of the page.


At this time, several states have chosen not to address the Quality of Life category in their statutes. Occasionally there is an item under the Quality of Life category that is more often found within other categories of both Federal and state regulations: Minnesota and South Dakota address Spiritual Needs, West Virginia addresses Privacy and Resident Rights.

For the states that do address Quality of Life, the primary areas of focus are Activities and Social Services.

Under Activities, the state-level focus is primarily on the credentials of the Activities staff (education and training) – Vermont, Virginia. Several states specify minimum requirements (content and physical space) of Activities programs- Idaho , Massachusetts . Most states that address pet therapy do so under the Activities subcategory of Quality of Life.

Under Social Services, the state-level focus, like Activities, is primarily on the credentials of the Social Services staff (education and training) – Indiana, Wisconsin , as well as specific job duties and recordkeeping requirements related to the delivery of Social Services – Maine, New Mexico.

[Summarized: May 2006]

Table Comparing States  [TOP]

Note: If the States in this table are not hyper-linked, their provisions do not appear to address the topic, and therefore, do not alter the Federal Regulatory scope.  The Table summarizes content on Administration by State (with a link to each State's specific language). Link to a downloadable PDF document containing  all State regulation on Administration is at the bottom of the Table.

 
483.15 Quality of Life
State Goes beyond Federal Regulations? Subjects Addressed
Alabama Yes Pets (under Activities)
Alaska Yes Responsibilities of Social Worker
Arizona No No separate Quality of Life category in the Arizona statutes
Arkansas Yes Social Work Services and Activities Programming; Policies and Procedures; Recordkeeping; Program Operations; Pet Therapy
California Yes Activity Program Requirements; Social Work Services Unit
Colorado Yes Social Work Services and Staff
Connecticut No No separate Quality of Life category in the Connecticut statutes
Delaware No No separate Quality of Life category in the Delaware statutes
District of Columbia Yes Social Work Services and Activities Programming
Florida No No separate Quality of Life category in the Florida statutes
Georgia Yes Social Services Responsibilities; Recreation
Hawaii Yes Activities Program; Social Work Services
Idaho Yes Activities Program; Social Services; Staff; Records; Physical Requirements
Illinois Yes Activity Program; Activity Director and Consultation
Indiana Yes Activities Program; Social Services Staff Credentials
Iowa Yes Social Services Program; Resident Activities Program; Coordination of Activities Program; Supplies, Equipment and Storage
Kansas No No separate Quality of Life category in the Kansas statutes
Kentucky Yes Qualifications of Social Worker
Louisiana Yes Activities Program; Activity Service Personnel; Social Service Personnel; Rehabilitation Services
Maine Yes Social Services Staff; Staff Hours; Responsibility of Staff; Activities Coordinator; Staffing Hours; Responsibilities; Equipment and Supplies; Activities Areas
Maryland Yes Social Work Services; Patient Activities; Staffing; Objective; Space, Supplies
Massachusetts Yes Social Work Staffing and Credentials in Different Level Facilities; Social Services Requirements; Activities and Recreation; Functions of the Activity Director; Special Activities and Services
Michigan No No separate Quality of Life category in the Michigan statutes
Minnesota Yes Activity and Recreation Program Requirements; Spiritual Needs; Social Services Requirements
Mississippi Yes Social Services Program, Records, Training, Personnel and Office Space; Resident Activities, Coordinator, and Program; Supplies and Equipment; Activities Area
Missouri No No separate Quality of Life category in the Missouri statutes
Montana No  
Nebraska Yes Social Services Staffing; Resident Activity Staffing
Nevada Yes Development of Program of Activities; Daily Activities of Patient; Participation in Activities; Provision of Social Services
New Hampshire Yes Activities Director Credentials
New Jersey Yes Mandatory Resident Activities; Pet Therapy; Mandatory Social Work Staff Qualifications; Mandatory Social Work Services
New Mexico Yes Provision of Social Services (Admission, Care Planning); Activities Program; Activities Staff
New York Yes Religious Worship and Counseling Opportunities; Activities Staff; Activities Program Requirements
North Carolina Yes Accountability of Activities and Social Services Directors/Departments
North Dakota Yes Activities Director Credentials; Program Content Requirements
Ohio Yes Chaplain Services; Visiting Hours; Telephone Service; Pets
Oklahoma Yes Activities Director Responsibilities; Activities Program Requirements; Social Services Requirements
Oregon Yes Activity Program Requirements; Activity Director Credentials; Activities Staffing; Activities Plan; Documentation; Social Services Director; Social Services Program; Social Services Staffing; Social Services Plan, Social Services Documentation; Pets
Pennsylvania Yes Pet Therapy
Rhode Island Yes Social Services Director Credentials; Records; Policies and Procedures; Resident Activities Program Contents and Administration
South Carolina Yes Social Services Requirements; Resident Activities Requirements; Space and Supplies; Pets
South Dakota Yes Pets; Supportive Services; Activities Program; Spiritual Needs
Tennessee Yes Responsibilities of Social Worker
Texas Yes Continuing Education for Activity Directors; Social Services Process;
Utah No No separate Quality of Life category in the Utah statutes
Vermont Yes Privacy; Activities Director Job Skills; Social Services Director Job Skills
Virginia Yes Social Services Director Credentials; Activities Director Credentials
Washington Yes Sound Levels (Environment); Pets
West Virginia Yes Privacy; Resident Rights; Access; Administration; Activities; Director's Duties
Wisconsin Yes Social Services Staff Credentials; Required Services; Activities Program; Activities Staff Credentials and Time
Wyoming Yes Records; Policies and Procedures; Staff; Space; Activities Program Contents

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Complete Transcript of State Regulations on Quality of Life
 
In this website, state and federal regulations are dated from the time they were extracted. Please consult the relevant state office for updates.
Summaries of regulations and regulatory processes are the work of project staff and do not reflect official positions of any federal or state agencies.
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