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. § 483.12

Freedom from abuse, neglect, and exploitation

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The resident has the right to be free from abuse, neglect, misappropriation of resident property, and exploitation as defined in this subpart. This includes but is not limited to freedom from corporal punishment, involuntary seclusion and any physical or chemical restraint not required to treat the resident's medical symptoms.

(a) The facility must—

(1) Not use verbal, mental, sexual, or physical abuse, corporal punishment, or involuntary seclusion;

(2) Ensure that the resident is free from physical or chemical restraints imposed for purposes of discipline or convenience and that are not required to treat the resident's medical symptoms. When the use of restraints is indicated, the facility must use the least restrictive alternative for the least amount of time and document ongoing re-evaluation of the need for restraints.

(3) Not employ or otherwise engage individuals who—

(i) Have been found guilty of abuse, neglect, exploitation, misappropriation of property, or mistreatment by a court of law;

(ii) Have had a finding entered into the State nurse aide registry concerning abuse, neglect, exploitation, mistreatment of residents or misappropriation of their property; or

(iii) Have a disciplinary action in effect against his or her professional license by a state licensure body as a result of a finding of abuse, neglect, exploitation, mistreatment of residents or misappropriation of resident property.

(4) Report to the State nurse aide registry or licensing authorities any knowledge it has of actions by a court of law against an employee, which would indicate unfitness for service as a nurse aide or other facility staff.

(b) The facility must develop and implement written policies and procedures that:

(1) Prohibit and prevent abuse, neglect, and exploitation of residents and misappropriation of resident property,

(2) Establish policies and procedures to investigate any such allegations, and

(3) Include training as required at paragraph § 483.95.

(4) Establish coordination with the QAPI program required under § 483.75.

(5) Ensure reporting of crimes occurring in federally-funded long-term care facilities in accordance with section 1150B of the Act. The policies and procedures must include but are not limited to the following elements.

(i) Annually notifying covered individuals, as defined at section 1150B(a)(3) of the Act, of that individual's obligation to comply with the following reporting requirements.

(A) Each covered individual shall report to the State Agency and one or more law enforcement entities for the political subdivision in which the facility is located any reasonable suspicion of a crime against any individual who is a resident of, or is receiving care from, the facility.

(B) Each covered individual shall report immediately, but not later than 2 hours after forming the suspicion, if the events that cause the suspicion result in serious bodily injury, or not later than 24 hours if the events that cause the suspicion do not result in serious bodily injury.

(ii) Posting a conspicuous notice of employee rights, as defined at section 1150B(d)(3) of the Act.

(iii) Prohibiting and preventing retaliation, as defined at section 1150B(d)(1) and (2) of the Act.

(c) In response to allegations of abuse, neglect, exploitation, or mistreatment, the facility must:

(1) Ensure that all alleged violations involving abuse, neglect, exploitation or mistreatment, including injuries of unknown source and misappropriation of resident property, are reported immediately, but not later than 2 hours after the allegation is made, if the events that cause the allegation involve abuse or result in serious bodily injury, or not later than 24 hours if the events that cause the allegation do not involve abuse and do not result in serious bodily injury, to the administrator of the facility and to other officials (including to the State Survey Agency and adult protective services where state law provides for jurisdiction in long-term care facilities) in accordance with State law through established procedures.

(2) Have evidence that all alleged violations are thoroughly investigated.

(3) Prevent further potential abuse, neglect, exploitation, or mistreatment while the investigation is in progress.

(4) Report the results of all investigations to the administrator or his or her designated representative and to other officials in accordance with State law, including to the State Survey Agency, within 5 working days of the incident, and if the alleged violation is verified appropriate corrective action must be taken.

[81 FR 68855, Oct. 4, 2016]
Notes of Decisions
Cited in 59 cases (11 in the last 5 years), 1994–2025 · leading case: Keup v. Wisconsin Dep't of Health & Fam. Servs., 2004 WI 16 (Wis. 2004).
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Keup v. Wisconsin Dep't of Health & Fam. Servs., 2004 WI 16 (Wis. 2004). · cites it 12× “§ 1396r(c)(4)(B)(i) and 42 C.F.R. § 483.12 (c)(2) (1999), [4] medical assistance providers may charge private pay patients any rate they deem appropriate, provided that the patient has notice as to the amount of the charge.”
Schutt v. Melmark, Inc., 186 F. Supp. 3d 366 (E.D. Pa. 2016). · cites it 4× “42 CFR § 483.12 (a)(3), when a facility transfers or discharges a resident under any of the circumstances specified in paragraphs (a)(2)(i) through (5) of this section, the resident’s clinical record must be documented.”
Owens v. Nat'l Health Corp., 263 S.W.3d 876 (Tenn. 2008). · cites it 2× “42 C.F.R. § 483.12 (d)(3) (2006) (emphasis added).”
Meadowbrook Ctr., Inc. v. Buchman, 90 A.3d 219 (Conn. App. Ct. 2014). · cites it 2× “48,841 (September 26,1991) Medicare and Medicaid; Requirements for Long Term Care Facilities (amending 42 C.F.R. § 483.12 ). Section V of the agreement, entitled “Responsible Party Control of or Access to Resident’s Funds,” provides that “i[f] the Responsible Party has control…”
Gainesville Health Care Ctr., Inc. v. Weston, 857 So. 2d 278 (Fla. 1st DCA 2003). “42 C.F.R. § 483.12 (d)(3). We have found no authority from any jurisdiction which holds that an arbitration provision constitutes "consideration" in this sense; nor do we believe that the federal regulation was intended to apply to such a situation.”
Bruner v. Timberlane Manor Ltd. P'ship, 2006 OK 90 (Okla. 2006). “Federal regulations, at 42 CFR. § 483.12(a)(2) limit the circumstances under which a facility may discharge or transfer a resident.”
Commonwealth of Pennsylvania D v. United States, 897 F.3d 497 (3rd Cir. 2018). “42 C.F.R. §§ 483.12 (b)(3), 483.95(c). In response to these reforms, Pennsylvania created the Pennsylvania Restraint Reduction Initiative ("PARRI").”
Knight v. John Knox Manor, Inc., 92 So. 3d 111 (Ala. Civ. App. 2012). · cites it 11× “§ 1396r(c)(5)(A)(ii), 42 C.F.R. § 483.12 (d)(2), and Alabama Administrative Code (Alabama Medicaid Agency), Rule 560-X-10-.”
Ricci v. Patrick, 544 F.3d 8 (1st Cir. 2008). “The report also found no violations by DMR of federal regulations, such as 42 C.F.R. § 483.12 , which governs transfer standards for skilled nursing facilities.”
In Re the Involuntary Discharge or Transfer of J.S. Ex Rel. Hall, 512 N.W.2d 604 (Minn. Ct. App. 1994). · cites it 7× “42 C.F.R. § 483.12 (a)(5)®. The notice must contain the reasons for the transfer or discharge and inform the resident of the right to contest the proposed action.”
Beverly Health & Rehab. Servs., Inc. v. Thompson, 223 F. Supp. 2d 73 (D.D.C. 2002). “15 (e)(1); respect the dignity of residents; and provide written notice to residents regarding hospital transfers and/or discharges as required by 42 C.F.R. § 483.12 (a)(4)-(6). (See A.R. at 45-48.”
Paschall v. Dist. of Columbia Dep't of Health, 871 A.2d 463 (D.C. 2005). · cites it 7× “The ALJ assumed, without deciding, “that sufficiently emergent conditions existed in [Paschall’s] case that would warrant an exception to the usual, 30-day advance notice timing requirement set forth in 42 C.F.R. § 483.12 (a)(5),” but ruled that this did not excuse compliance…”
Show all 59 citing cases →
— 42 C.F.R. § 483.12(a) — 2 cases
Ickes v. Nexcare Health Sys., L.L.C., 178 F. Supp. 3d 578 (E.D. Mich. 2016).
Newman v. Kelly, 848 F. Supp. 228 (D.D.C. 1994).
— 42 C.F.R. § 483.12(a)(2) — 1 case
Bruner v. Timberlane Manor Ltd. P'ship, 2006 OK 90 (Okla. 2006). “Federal regulations, at 42 CFR. § 483.12(a)(2) limit the circumstances under which a facility may discharge or transfer a resident.”
— 42 C.F.R. § 483.12(a)(2)(iii) — 1 case
In Re the Involuntary Discharge or Transfer of J.S. Ex Rel. Hall, 512 N.W.2d 604 (Minn. Ct. App. 1994). “42 C.F.R. § 483.12 (a)(5)®. The notice must contain the reasons for the transfer or discharge and inform the resident of the right to contest the proposed action.”
— 42 C.F.R. § 483.12(a)(8) — 1 case
Hyland Assisted Living & Memory Care LLC v. Dhhs (Mich. Ct. App. 2019).
— 42 C.F.R. § 483.12(c) — 1 case
In re Special Grand Jury Investigation, 2019 Ohio 4014 (Ohio Ct. App. 2019).
— 42 C.F.R. § 483.12(c)(1) — 1 case
Bernstein v. Extendicare Health Servs., Inc., 653 F. Supp. 2d 939 (D. Minnesota 2009).
— 42 C.F.R. § 483.12(c)(2) — 1 case
In re Special Grand Jury Investigation, 2019 Ohio 4014 (Ohio Ct. App. 2019).
— 42 C.F.R. § 483.12(d) — 1 case
Alexis Hutchison & Martha Farber, & Trilogy Health Servs., LLC, d/b/a Springhurst Health Campus, 2 N.E.3d 802 (Ind. Ct. App. 2014).
— 42 C.F.R. § 483.12(d)(2) — 1 case
Pioneer Ridge Nursing Facility Operations, L.L.C. v. Ermey, 203 P.3d 4 (Kan. Ct. App. 2009).
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