C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER G—STANDARDS AND CERTIFICATION › PART 483—REQUIREMENTS FOR STATES AND LONG TERM CARE FACILITIES › Subpart B—Requirements for Long Term Care Facilities

42 C.F.R. § 483.1

Basis and scope

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(a) Statutory basis. (1) Sections 1819(a), (b), (c), (d), and (f) of the Act provide that—

(i) Skilled nursing facilities participating in Medicare must meet certain specified requirements; and

(ii) The Secretary may impose additional requirements (see section 1819(d)(4)(B)) if they are necessary for the health and safety of individuals to whom services are furnished in the facilities.

(2) Section 1861(l) of the Act requires the facility to have in effect a transfer agreement with a hospital.

(3) Sections 1919(a), (b), (c), (d), and (f) of the Act provide that nursing facilities participating in Medicaid must meet certain specific requirements.

(4) Sections 1128I(b) and (c) require that—

(i) Skilled nursing facilities or nursing facility have in operation a compliance and ethics program that is effective in preventing and detecting criminal, civil, and administrative violations.

(ii) The Secretary establish and implement a quality assurance and performance improvement program for facilities, including multi-unit chains of facilities.

(5) Section 1150B establishes requirements for reporting to law enforcement crimes occurring in federally funded LTC facilities.

(b) Scope. The provisions of this part contain the requirements that an institution must meet in order to qualify to participate as a Skilled Nursing Facility in the Medicare program, and as a nursing facility in the Medicaid program. They serve as the basis for survey activities for the purpose of determining whether a facility meets the requirements for participation in Medicare and Medicaid.

[56 FR 48867, Sept. 26, 1991, as amended at 57 FR 43924, Sept. 23, 1992; 60 FR 50443, Sept. 29, 1995; 81 FR 68848, Oct. 4, 2016]
Notes of Decisions
Cited in 55 cases (13 in the last 5 years), 1994–2025 · leading case: Estate of Martha S. French v. Stratford House
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Estate of Martha S. French v. Stratford House (2011) tenn · cites it 2× “1 (2009) (“The provisions of this part contain the requirements that an institution must meet in order to qualify to participate as a [skilled nursing facility] in the Medicare program, and as a nursing facility in the Medicaid program. They serve as the basis for survey…”
Harvey v. Mohammed (2012) dcd · cites it 4× “Count IV: Negligence Per Se In Count IV, plaintiff alleges that Symbral and the Mohammeds violated 42 C.F.R. § 483.1 et seq., D.C.Code § 44-501 et seq.”
Wirth v. Sun Healthcare Group, Inc. (2016) nmctapp · cites it 2× “See 42 C.F.R. § 483.1 (b) (2015). Its somewhat cryptic language requires a nursing home to either employ a qualified professional to furnish a specific service to residents or to have that service furnished .”
Bedell v. Williams (2012) ark “” 42 C.F.R. § 483.1 (b). While this court has not addressed this issue before, the Court of Appeal of Louisiana did in Satterwhite v.”
Golden Living Center-Frankfort v. Secretary of Health & Human Services (2011) ca6 “§ 1395Í-3; 42 C.F.R. § 483.1 et seq. Those pertinent here include requirements that: (a) the facility provide each resident with sufficient fluid intake, 42 C.”
Brogdon Ex Rel. Cline v. National Healthcare Corp. (2000) gand “§ 1395i-3(b)-(d), and the federal regulations found in 42 C.F.R. § 483.1 et seq. To be certified under the Medicaid program, a facility must comply with various requirements set forth at 42 U.”
Cathedral Rock of North College Hill, Inc., D/B/A Beechknoll Convalescent Center v. Donna E. Shalala, Secretary of Healt (2000) ca6 “§ 1396r(a)(3), (b)-(d) (Medicaid); 42 C.F.R. § 483.1 (facilities must comply with the same requirements in order to participate in the Medicare and Medicaid programs).”
CLAIBORNE-HUGHES HEALTH CENTER v. Sebelius (2010) ca6 “§ 1395i-3 and 42 C.F.R. § 483.1 et seq. To determine compliance, the Secretary of the United States Department of Health and Human Services (“Secretary”) contracts with state agencies to conduct inspections known as surveys.”
Earl McLemore v. Elizabethton Medical Investors, Limited Partnership d/b/a Life Care Center of Elizabethton (2012) tennctapp “§ 1395Í-3; 42 C.F.R. § 483.1 et seq.; 42 C.F.R. § 488.”
Beverly Health & Rehabilitation Services, Inc. v. Thompson (2002) dcd “7 The rules containing participation requirements, which are located at 42 C.F.R. §§ 483.1 ^183.75, became fully effective on October 1, 1990.”
Hubbs v. Alamao (2005) cacd “However, in his objections to the Report and Recommendation, plaintiff attempts to correct his pleading by arguing defendant Mayberg violated his constitutional right to privacy and federal regulations, 42 C.F.R. § 483.10 (e) and 45 C.F.R. § 164.”
Hope v. Fair Acres Geriatric Center (2016) paed “, and Omnibus Budget Reconciliation Act of 1987 (“OBRA”) regulations, 42 C.F.R. § 483.1 et seq.; violation of the Medicare Secondary Payer Act (“MSPA”), 42 U.”
Show all 55 citing cases →
— 42 C.F.R. § 483.1(b) — 2 cases
Jones v. Brush Country Nursing and Rehabilitation (2024) txwd
Hickory Heights Health & Rehab, LLC v. Yashika Watson (2025) arkctapp
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