University of Minnesota Long Term Care Resource Center

Quality of Life


Description of Federal Requirements
Comparison of State Requirements
Table Comparing States
Complete Transcript of State Requirements on Quality of Life

Federal Regulations & Related F-tags for 483.15 Applicable Federal Regulation
(a) Dignity | F241
(b)Self-determination and participation | F242
(c)Participation in resident and family groups | F243
(d) Participation in other activities | F245

(1-2) Accommodation of needs | F246
(1)-(i) Activities | F248-F249
(1-2) Social Services | F250-F251
(1-4) Environment | F252-F255
(h)(5-6) Lighting, temperature | F256-F257
483.15 Quality of Life
483.10 Resident Rights
483.70 Physical Environment


Description of Federal Requirements    (TOP)    (NEXT)

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.

Comparison of State Requirements    (TOP)    (NEXT)

All states and the District of Columbia address the Quality of Life category in their state regulations. 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.

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 Quality of Life by State (with a link to each State's specific language).  Link to a downloadable PDF document containing all State requirements on Quality of Life.

483.15 Quality of Life

State Goes beyond Federal Regulations? Subjects Addressed: How State Differs From or Expands On Federal Regulations
Alabama Yes Pets, advance directives, dignity, accommodation of needs, social services
Alaska Yes Responsibilities of Social Worker, activities, resident rights
Arizona Yes Social work, resident rights
Arkansas Yes Social Work services and activities programming, policies and procedures, recordkeeping, program operations, pet therapy, program for special care units, resident rights
California Yes Activity program requirements, activity leader, Social Work Services unit, dietetic services, special treatment program resident rights, provisions for privacy
Colorado Yes Social Work services and staff, dietary, grooming, problem resolution, resident socialization, resident activities, rights, rights of relocation, secure units admission
Connecticut Yes Therapeutic Recreation, social work
Delaware Yes Social services, Bill of Rights, privacy for married couples, personal choice, personal property
District of Columbia Yes Social Work Services and Activities Programming, Restorative nursing care program,
Florida Yes Advance directives, resident rights
Georgia Yes Social Services Responsibilities, recreation, resident rights
Hawaii Yes Activities Program, Social Work Services, patient rights
Idaho Yes Activities Program; Social Services, Staff, Records, religious activities, admission policies, activities program, pet therapy
Illinois Yes Activity Program, Activity Director and Consultation, resident council, life sustaining treatment, free exercise of religion, married couples rights, communication and visitation, admission criteria for dementia special care unit, ability centered care for special care unit, variances to enhance resident's quality of life
Indiana Yes Activities program, Social Services Staff Credentials, exercising rights, visiting rights, living arrangements, pet policies
Iowa Yes Social Services Program, Resident Activities Program, Coordination of Activities Program, Supplies, Equipment and Storage, dietary, animals, resident rights in general, dignity preserved, communication, family visits,
Kansas Yes Activity director requirements, social services designee, resident rights, quality of care, quality of life
Kentucky Yes Qualifications of Social Worker, resident rights, privacy, married couples,
Louisiana Yes Activities Program, Activity Service Personnel, Social Service Personnel, Rehabilitation Service, rights and responsibilities, cultural food habits
Maine Yes Social Services Staff, Staff Hours, Responsibility of Staff, Activities Coordinator, Staffing Hours, Responsibilities, Equipment and Supplies, Activities Areas, privacy, married couples, activity coordinator hours, therapeutic activities
Maryland Yes Social Work Services, Patient Activities, Staffing, Objective, Space, Supplies, care planning
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, pets
Michigan Yes Resident rights and responsibilities, access to nursing home patients, visiting, diversional activities, patient councils, social services
Minnesota Yes Activity and Recreation Program Requirements, Spiritual Needs, Social Services Requirements, policies concerning residents, smoking in bed, visiting, room assignments, dietary, beauty and barbershop,
Mississippi Yes Social Services Program, Records, Training, Personnel and Office Space; Resident Activities, Coordinator, and Program, Supplies and Equipment, Activities Area, married couples, therapeutic activities for special care unit
Missouri Yes Alzheimer's demonstration project, social model of care, live animals, resident rights, room transfers, married couples
Montana Yes Rights of residents, if clothing is provided to residents it must fit properly, staff training to support resident's rights, pets on premises
Nebraska Yes Social Services Staffing, Resident Activity Staffing, privacy, written communication, visitors, pets
Nevada Yes Development of Program of Activities, Daily Activities of Patient, Participation in Activities, Provision of Social Services, rights of residents, privacy, advance directives, daily activities not to diminish
New Hampshire Yes Activities Director Credentials, resident rights, required services
New Jersey Yes Mandatory Resident Activities, Pet Therapy, Mandatory Social Work Staff Qualifications, Mandatory Social Work Services, resident rights, intimate and social interaction rights, dietary services, extensive regulations on pets in-house and visiting pets
New Mexico Yes Provision of Social Services (Admission, Care Planning), Activities Program, Activities Staff, privacy, personal possessions, transfer within facility, dietary
New York Yes Religious Worship and Counseling Opportunities, Activities Staff, Activities Program Requirements, dietary, animals, share a room with spouse, receive upon request kosher food
North Carolina Yes Accountability of Activities and Social Services Directors/Departments, pets
North Dakota Yes Activities Director Credentials, Program Content Requirements, dietary requests
Ohio Yes Chaplain Services, Visiting Hours, Telephone Service, Pets, activity program
Oklahoma Yes Activities Director Responsibilities, Activities Program Requirements, Social Services Requirements, room location, advisory council, residential and visiting pets
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, involuntary reassignment of rooms, resident rights with visitor access, problem resolution and prevention
Pennsylvania Yes Pet Therapy, social worker requirements
Rhode Island Yes Social Services Director Credentials; Records, Policies and Procedures, Resident Activities Program Contents and Administration, privacy for visits by spouse or partner, family councils, dietetic services, dental services
South Carolina Yes Social Services Requirements, Resident Activities Requirements, Space and Supplies, Pets, services be resident centered and person directed to the fullest extent possible, rights and assurance, resident and family councils, resident compatibility in shared rooms
South Dakota Yes Pets, Supportive Services, Activities Program, Spiritual Needs, privacy and confidentiality
Tennessee Yes Responsibilities of Social Worker, pets, special services dementia, resident rights, married couples
Texas Yes Continuing Education for Activity Directors, Social Services Process, quality of life, resident rights, family council, duties of institution, visiting, free choice, personal property, advance directives, refuse to transfer, authorized electronic monitoring, resident group and family council
Utah Yes Resident rights, quality of life definition, social services, recreation therapy, pet policy
Vermont Yes Privacy, Activities Director Job Skills, Social Services Director Job Skills, resident rights, self determination and participation
Virginia Yes Social Services Director Credentials, Activities Director Credentials, resident recreation
Washington Yes Pets, resident rights, free choice, resident decision making, advance directives, privacy and confidentiality, personal properties, rooms and roommates, self determination and participation, participation in resident and family groups, activities, social services, office space
West Virginia Yes Privacy; Resident Rights; Access, Administration; Activities, Director's Duties, animals, behavior management,
Wisconsin Yes Social Services Staff Credentials, Required Services, Activities Program, Activities Staff Credentials and Time, transfer within facility
Wyoming Yes Records; Policies and Procedures; Staff, Space, Activities Program Contents

Complete Transcript of State Requirements on Quality of Life    (TOP)