Library of Long-Term Care Laws & Regulations

Older Americans Act

Older Americans Act of 1965, as Amended Through P.L. 116-131 (March 25, 2020)

• Overview

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Long-Term Care Ombudsman Program Final Rule

42 C.F.R. Part 1324, Subpart A – State Long-Term Care Ombudsman Program (February 2024)

42 C.F.R. Part 1321 – Grants to State and Community Programs on Aging (February 14, 2024)​

Resources Produced by AoA/ACL

• How to Implement the Older Americans Act
• Long-Term Care Ombudsman Program FAQs

Resources Produced by NORC

• OAA Final Regulations – 45 CFR § 1321 Summary of Select Provisions, Including Provisions Relating to the LTC Ombudsman Program
• OAA Final Regulations – 45 CFR § 1324 State Long-Term Care Ombudsman Program

LTCOP Rule Charts
The following charts outline the LTCOP Rule language by section alongside a blank column for notes or inserting corresponding state regulations or policy language. The charts are intended to assist states in identifying changes in the LTCOP Rule and implementing the requirements.

• § 1324.1 Definitions and § 1324.17 Responsibilities of agencies hosting LOEs
• § 1324.11 Establishment of the Office of the SLTCO
• § 1324.13 Functions and Responsibilities of the SLTCO
• § 1324.15 State agency responsibilities related to the LTCOP
• § 1324.19 Duties of Representatives of the Office 
• § 1324.21 Conflicts of Interest

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Federal Nursing Home Regulations

• Requirements for States and Long-Term Care Facilities: 42 C.F.R. Part 483
• Requirements for Long-Term Care Facilities: 42 C.F.R. Part 483, Subpart B
  • Ombudsman References in the Federal Nursing Home Requirements
  • Highlights of Federal Nursing Facility Requirements and Guidance Regarding Transfer and Discharge Notices
  • Issue briefs
• Survey and Certification of Long-Term Care Facilities: 42 C.F.R. Part 488, Subpart E
• Enforcement of Compliance for Long-Term Care Facilities with Deficiencies: 42 C.F.R. Part 488, Subpart F
• Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency: 42 C.F.R. Parts 438, 442, 483
  • Summary
• Disclosure of Ownership and Additional Disclosable Parties Information for Skilled Nursing Facilities and Nursing Facilities; Medicare Providers’ and Suppliers’ Disclosure of Private Equity Companies and Real Estate Investment Trusts: 42 C.F.R. Parts 424 and 455
  • Overview

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Home and Community Based Services Federal Regulations

• Home and Community Based Services Settings Rule – for HCBS provided under sections 1915(c), 1915(i), and 1915(k) of the Medicaid statute.
• Overview

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Federal Guidelines

State Operations Manual – Appendix PP – Guidance to Surveyors for Long-Term Care Facilities

• Full State Operations Manual
• Consumer Voice Summary of CMS’s Revised Guidance for Nursing Home Surveyors

CMS Quality Safety & Oversight memoranda, guidance, clarifications, and instructions to State Survey Agencies and CMS Locations – Policy & Memos

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State Regulatory Resources

• Assisted Living State Regulatory Review

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