[Code of Federal Regulations]
[Title 38, Volume 2]
[Revised as of July 1, 2003]
From the U.S. Government Printing Office via GPO Access
[CITE: 38CFR51.100]

[Page 829-830]
 
            TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF
 
          CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS (CONTINUED)
 
PART 51--PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES--Table 
of Contents
 
                          Subpart D--Standards
 
Sec. 51.100  Quality of life.

    A facility management must care for its residents in a manner and in 
an environment that promotes maintenance or enhancement of each 
resident's quality of life.
    (a) Dignity. The facility management must promote care for residents 
in a manner and in an environment that maintains or enhances each 
resident's dignity and respect in full recognition of his or her 
individuality.
    (b) Self-determination and participation. The resident has the right 
to--
    (1) Choose activities, schedules, and health care consistent with 
his or her interests, assessments, and plans of care;
    (2) Interact with members of the community both inside and outside 
the facility; and
    (3) Make choices about aspects of his or her life in the facility 
that are significant to the resident.
    (c) Resident Council. The facility management must establish a 
council of residents that meet at least quarterly. The facility 
management must document any concerns submitted to the management of the 
facility by the council.
    (d) Participation in resident and family groups. (1) A resident has 
the right to organize and participate in resident groups in the 
facility;
    (2) A resident's family has the right to meet in the facility with 
the families of other residents in the facility;
    (3) The facility management must provide the council and any 
resident or

[[Page 830]]

family group that exists with private space;
    (4) Staff or visitors may attend meetings at the group's invitation;
    (5) The facility management must provide a designated staff person 
responsible for providing assistance and responding to written requests 
that result from group meetings;
    (6) The facility management must listen to the views of any resident 
or family group, including the council established under paragraph (c) 
of this section, and act upon the concerns of residents, families, and 
the council regarding policy and operational decisions affecting 
resident care and life in the facility.
    (e) Participation in other activities. A resident has the right to 
participate in social, religious, and community activities that do not 
interfere with the rights of other residents in the facility. The 
facility management must arrange for religious counseling by clergy of 
various faith groups.
    (f) Accommodation of needs. A resident has the right to--
    (1) Reside and receive services in the facility with reasonable 
accommodation of individual needs and preferences, except when the 
health or safety of the individual or other residents would be 
endangered; and
    (2) Receive notice before the resident's room or roommate in the 
facility is changed.
    (g) Patient Activities. (1) The facility management must provide for 
an ongoing program of activities designed to meet, in accordance with 
the comprehensive assessment, the interests and the physical, mental, 
and psychosocial well-being of each resident.
    (2) The activities program must be directed by a qualified 
professional who is a qualified therapeutic recreation specialist or an 
activities professional who--
    (i) Is licensed or registered, if applicable, by the State in which 
practicing; and
    (ii) Is certified as a therapeutic recreation specialist or as an 
activities professional by a recognized accrediting body.
    (h) Social Services. (1) The facility management must provide 
medically related social services to attain or maintain the highest 
practicable mental and psychosocial well-being of each resident.
    (2) A nursing home with 100 or more beds must employ a qualified 
social worker on a full-time basis.
    (3) Qualifications of social worker. A qualified social worker is an 
individual with--
    (i) A bachelor's degree in social work from a school accredited by 
the Council of Social Work Education (Note: A master's degree social 
worker with experience in long-term care is preferred), and
    (ii) A social work license from the State in which the State home is 
located, if offered by the State, and
    (iii) A minimum of one year of supervised social work experience in 
a health care setting working directly with individuals.
    (4) The facility management must have sufficient support staff to 
meet patients' social services needs.
    (5) Facilities for social services must ensure privacy for 
interviews.
    (i) Environment. The facility management must provide--
    (1) A safe, clean, comfortable, and homelike environment, allowing 
the resident to use his or her personal belongings to the extent 
possible;
    (2) Housekeeping and maintenance services necessary to maintain a 
sanitary, orderly, and comfortable interior;
    (3) Clean bed and bath linens that are in good condition;
    (4) Private closet space in each resident room, as specified in 
Sec. 51.200(d)(2)(iv) of this part;
    (5) Adequate and comfortable lighting levels in all areas;
    (6) Comfortable and safe temperature levels. Facilities must 
maintain a temperature range of 71-81 degrees Fahrenheit; and
    (7) For the maintenance of comfortable sound levels.

(Authority: 38 U.S.C. 101, 501, 1710, 1741-1743)