Nursing Home Justice Blog

Who Regulates Nursing Homes in Colorado?

Written By:

Attorney Mac Hester

Date Posted:

August 31, 2023

Nursing homes must jump through several hoops to obtain a license in Colorado. Once they can open their doors, they must follow strict regulations. These regulations ensure that nursing homes remain safe and functional.

If nursing homes fail to comply with these requirements, they could face severe penalties for putting residents at risk for injury or death. Here’s more on the agencies that regulate nursing homes and how they enforce their regulations.

Types of Nursing Home Regulatory Agencies & Their Roles

To maintain quality assurance, nursing homes are regulated by federal and state agencies. These agencies include the Colorado Department of Public Health and Environment (CDPHE) and the Centers for Medicare and Medicaid Services (CMS).

Centers for Medicare & Medicaid Services

The CMS provides regulations and guidance for all nursing homes participating in Medicare and Medicaid services. Their goal is to improve the quality of the United States health care system.

The CMS partners with state agencies to certify nursing homes as Medicare or Medicaid providers. The CMS conducts unannounced surveys to monitor the quality of nursing homes. The agency will enforce any regulations that aren’t being met.

Colorado Department of Public Health and Environment

Federal agencies can’t be everywhere at once. State agencies help federal agencies regulate local nursing homes. The CDPHE ensures that all nursing homes comply with federal requirements and their own regulations. If federal agencies wish to survey a nursing home, they rely on inspectors employed by the state.

Colorado Long-Term Care Ombudsman Program

Colorado’s long-term care ombudsman program is another way the state protects residents and enforces regulations. Ombudsmen are trained advocates who investigate complaints. They can visit nursing homes, stand up for residents’ rights, and resolve abuse and neglect issues.

How Do Agencies Regulate Nursing Homes?

State and federal agencies enforce regulations in the following ways:

Ensuring Proper Licensing & Certification

All nursing homes that provide Medicare and Medicaid services must be certified by the federal government. To be Medicare- and Medicaid-certified, nursing homes must meet several requirements outlined by the Code of Federal Regulations.

All nursing homes in Colorado must have a valid state-approved license. A nursing home can only operate in Colorado after they go through the mandatory licensing process and meet the state’s requirements.

Performing Inspections & Surveys

Surveys are annual nursing home visits conducted by the CDPHE to oversee a facility’s daily operations. These visits are often unannounced. However, they can be in response to a recent complaint. After the survey, investigators will record deficiencies and assign each one a severity level. Nursing home facilities have ten days to develop a correction plan for any deficiencies.

Enforcing Penalties

If nursing homes violate federal or state regulations, the Code of Colorado Regulations states that they could remedy the situation in the following ways:

  • A plan of correction
  • A directed plan of correction
  • Facility monitoring by the state survey agency
  • Full or partial bans on admissions
  • Denial of payment under the state Medicaid plan
  • Money penalties
  • Termination of the facility’s participation under the state plan

Warning Signs of Abuse & Neglect

Even though federal and state agencies heavily regulate nursing home activity, you should still do your due diligence to protect your loved ones. Watch out for these signs of abuse:

  • Unexplained bruises or cuts
  • Mood changes around staff members
  • Sudden decline in health
  • Malnourishment
  • Soiled clothes
  • Cluttered rooms and hallways
  • Loss of mobility

How to Report Abuse in a Nursing Home

If you suspect nursing home abuse or neglect, report it in the following ways:

  • Contact Your Local Ombudsman – You can file a personal complaint against a nursing home with the Colorado long-term care Ombudsman. They will advocate for your loved one’s rights and meet their needs.
  • File a Complaint with the CDPHE – You can report the abuse to the state by filing a complaint with the Colorado Department of Public Health and Environment. Contact the state department and provide them with details of the incident.
  • Reach Out to the Nursing Home – If a staff member or another resident caused the abuse, you might be able to resolve the issue directly with the nursing home. The staff member could be terminated. You may be transferred from the nursing home.

Contact Nursing Home Justice Today

Abuse can still happen in nursing homes despite strict regulations. If you suspect your loved one is being abused, you must report it immediately to protect your loved one. You can help state and federal agencies act against the nursing home so that the incident doesn’t happen again.

Contact Nursing Home Justice today at (970) 493-1866 for a free consultation with a nursing home abuse lawyer so we can start your case.

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