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Nursing Home Regulations

​Nursing homes are inspected annually by the Pennsylvania Department of Health. These surveys help to make sure that nursing homes are following state and federal regulations to be a licensed facility.

State and Federal Regulations

The following regulations apply to nursing homes.

State Nursing Home Regulations


Federal Nursing Home Regulations


Updates to the Regulations

The Department recently made major changes to the state nursing home regulations. As of November 29, 2022, the regulations were approved by the Independent Regulatory Review Commission (IRRC) and the Office of Attorney General. The final regulations will be published by the end of December 2022 in the Pennsylvania Bulletin, which is available online at https://www.pacodeandbulletin.gov/.

The Department will provide additional information and updated interpretive guidance on this web page as it becomes available.

For questions about the amendments to the regulations, contact the Department of Health Bureau of Long-Term Care Programs at RA-DHLTCregs@pa.gov.

Inspection Process

Nursing homes are inspected annually by the department. These surveys help to make sure that nursing homes are following state and federal regulations.

Surveys usually take several days, are unannounced and happen during the day or night. Survey teams:
  • examine how well the nursing home ensures that its residents feel “at home”
  • evaluate how well the nursing home provides care to its residents by meeting minimum regulatory standards
  • use tools to determine the quality of care and quality of life of nursing home residents
During a survey, the team may:
  • observe how the staff and residents talk and interact with each other
  • watch how the staff provides nursing care to residents
  • interview residents and family to see how they feel about the care they are receiving
  • review resident charts to see if necessary services are identified and provided
  • tour the facility to see if the environment is comfortable and safe for the residents
  • observe meals to assure the food is nutritionally balanced, attractive, the right temperature and tastes good
  • observe nurses giving medications and providing treatment to residents
  • meet with groups of residents to determine if there are widespread problems in the nursing home
  • meet with staff and administrators to see if they have developed ways of solving problems in the nursing home 

After a survey is completed, a written report is given to the nursing home. If problems are identified, the surveyors must decide how serious the problems are and the nursing home must submit a plan to correct the problems.

Depending on the seriousness of the deficiencies, different consequences may be given to the facility. Examples include:
  • imposing a ban on admissions and/or re-admissions
  • issuing a provisional license
  • revoking a nursing facility's license
  • losing its right to participate in federal Medicare or state Medicaid programs
  • imposing a civil money penalty
Nursing care facilities have the right to appeal a sanction up to 30 days from the sanction issue date.

Surveys and Sanctions

Temporary Managers

Under section 814(b) of the Health Care Facilities Act (35 P. S. § 448.814(b)), the Department of Health may petition the Commonwealth Court or Court of Common Pleas to appoint temporary management designated as qualified by the Department to assume operation of a facility.

Read the requirements for temporary managers in long-term care facilities.