Additional Resources


1. Healthcare-Associated Infections

CMS Definition: An infection that residents acquire, that is associated with a medical or surgical intervention (e.g., podiatry, wound care debridement) within a nursing home and was not present or incubating at the time of admission. (click here to read more)




CMS Memo: 10-18-NH

CMS Memo: 14-25-NH

CMS Memo: 13-09-NH

CMS Memo: 21-06-NH

State Operations Manual-Appendix PP: §483.80-Infection Control

    -Pg. 673-714 requiring facilities to develop an Infection Prevention and Control Program.

Tennessee Department of Health's Report on Healthcare-Associated Infections for Professionals 

Tennessee Department of Health's Report on Healthcare-Associated Infections for Consumers

National Action Plan to Prevent Health Care-Associated Infections

CDC’s National Healthcare Safety Network – Tracking Infections in Long-Term Care Facilities

CDC's 2019 Healthcare-Associated Infections Progress Report

CDC's Core Elements of Antibiotic Stewardship for Nursing Homes

Toolkit to reduce CAUTI and other HAIs in Long-Term Care Facilities - AHRQ

AHRQ's Nursing Home Antimicrobial Stewardship Guide

Quality Improvement Organizations Nursing Home Training Sessions

2. Distressed and At-Risk Counties

Transparent Tennessee - Distressed Counties and At-Risk Counties

Press Release - Governor Lee Announces Fewest Distressed Counties in Tennessee since 2007

3. Preventable Hospitalizations




CMS Memo: 12-23-ALL

CMS Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents

State Operations Manual: §483.21(c)(1) Discharge Planning Process

     - Requiring a facility to develop and implement an effective discharge planning process.

Florida Atlantic University’s Decision Guide, “Go to the Hospital or Stay Here?”

Florida Atlantic University’s Tennessee CMP Reinvestment Program’s Final Report


OPTIMISTIC: Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care

Institute for Healthcare Improvement


4. Person-Centered Care and Trauma-Informed Care

CMS Definition of Person-Centered Care: to focus on the resident as the locus of control and support the resident in making their own choices and having control over their daily lives.

According to CMS’ State Operations Manual: §483.25(m), facilities must ensure that residents who are trauma survivors receive culturally competent, trauma-informed care in accordance with professional standards of practice and accounting for residents’ experiences and preferences in order to eliminate or mitigate triggers that may cause re-traumatization of the resident.




CMS Memo 12-44-NH

State Operations Manual: 

§483.25(m) Trauma-Informed Care - pg. 401

§483.21 Person-Centered Care - Pgs. 216 - 243

Ohio Trauma-Informed Care PowerPoint

Resources to Support Trauma-Informed Care for Persons in Post-Acute and Long-Term Care Settings

National Long-Term Care Ombudsman Resource Center - Trauma-Informed Care

National Long-Term Care Ombudsman Resource Center - Person-Centered Care

SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach

The Things They Carry: Advancing Trauma-Informed Responses to Elder Abuse

Overview of Phase 3 Nursing Home Regulations: A Look Ahead  


5. Residents' Rights

    a. Elder Abuse, Neglect, and Exploitation

    b. Alzheimer's disease and other dementias

National Ombudsman Definition of Residents’ Rights: Residents’ Rights are guaranteed by the federal 1987 Nursing Home Reform Law. The law requires nursing homes to “promote and protect the rights of each resident” and places a strong emphasis on individual dignity and self-determination. Nursing homes must meet federal residents’ rights requirements if they participate in Medicare and Medicaid. Some states have residents’ rights in state law or regulation for nursing homes, licensed assisted living, adult care homes, and other board and care facilities. A person living in a long-term care facility maintains the same rights as an individual in the larger community. Please click here to view the Code of Federal Regulations, CMS Requirements for Long-term Care Facilities, 42 CFR § 483.10 – Residents rights.

CMS Definition of Elder Abuse: A deliberate act that results in physical harm, pain, or mental anguish. It can be physical, verbal, sexual, or mental. Abusers can be staff, residents, or visitors.

CMS Definition of Elder Neglect: The failure by the nursing home, its staff, or outside service providers to provider services and goods to a resident that are necessary to avoid physical harm, pain, mental anguish, or emotional distress. 




CMS Memo 12-44-NH

CMS Memo 16-33-NH

State Operations Manual – Appendix PP – §483.10

    -Pg. 6 – 10 – Resident has a right to a dignified existence, self-determination, and communication and access to people and services outside the facility.

Elderly and Vulnerable Adult Protection Act

Elderly and Vulnerable Adult Financial Exploitation and Prevention Act

HB304 – Senior exploitation and reporting record

HB0249 (SB0199) – Elder Abuse Task Force (In the Health Subcommittee)

 National Center on Elder Abuse:

Elder Rights Resources

Educational and Training Materials

State Resources

STEAP Initiative

2021 STEAP Initiative Outreach Calendar


Justice Clearinghouse:

Elder Abuse Webinars

Elder Abuse Infographic