Long Term Care Legal Resources Library

The Government Law Center and the Committee on Long Term Care Facility Reform of the New York State Bar Association’s Elder Law and Special Needs Section have created this resource library.  It is provided strictly for informational purposes with no guarantees of completeness, accuracy, usefulness or timeliness.  Its authors are not responsible for the use of the information contained in or linked from these web pages.

For additional information, contact Rose Mary Bailly, Esq. - Government Law Center at Albany Law School - at rbail@albanylaw.edu.

    Federal Law & Regulations: Nursing Homes

    New York Law and Regulations

    Oversight and Enforcement

    U.S. Dept. of Health and Human Services

    Selected Case Law on Enforcement of Federal Laws

    • Valdivia v. California Department of Health Services - Federal district court orders California to enforce federal nursing home standards and investigate complaints in compliance with federal procedures, and subsequently approved settlement agreement.
    • Estate of Smith v. Heckler (10th Cir. 1984) – Tenth Circuit holds that U.S. Dept. of Health & Human Services has a duty to establish a system to determine whether facilities receiving federal money are complying with federal requirements.
    • Beverly Health & Rehabilitation v. Thompson (D.D.C. 2002) –  Federal district court upheld Health Care Financing Administration’s (now Centers for Medicare & Medicaid Services) survey protocol in response to terminated facilities’ chain’s  challenge that the protocol was not promulgated in accordance with the Administrative Procedure Act.
      • As part of the settlement of a federal health care program investigation arising under a variety of civil false claims statutes, a provider or entity agrees to certain obligations in a Corporate Integrity Agreement (CIA), and in exchange, OIG agrees not to seek their exclusion from participation in Medicare, Medicaid, or other federal health care programs. A CIA typically lasts 5 years and includes requirements that the provider/entity: hire a compliance officer/appoint a compliance committee; develop written standards and policies; implement a comprehensive employee training program; retain an independent review organization to conduct annual reviews; establish a confidential disclosure program; restrict employment of ineligible persons; report overpayments, reportable events, and ongoing investigations/legal proceedings; and provide an implementation report and annual reports to the OIG on the status of compliance activities. CIAs include breach and default provisions that allow the OIG to impose certain monetary penalties (referred to as Stipulated Penalties) for the failure to comply with certain obligations set forth in the CIA. 

    Federal False Claims Act

    New York State Agencies

    Residents Rights

    Community-Based Housing & Services

    Home & Community Based Services Final Regulation
    The only federal regulations related to assisted living, promulgated about five years ago, relate to the community characteristics necessary to qualify as a home and community based setting (HCBS) for purpose of receiving federal funding for long-term services and supports in HCBS settings.

    U.S. Dept. of Health & Human Services promulgated regulations in 2014 establishing the characteristics necessary to qualify as a home and community based setting (HCBS) for purpose of receiving federal Medicaid funding for long-term services and supports in HCBS settings under several Medicaid authorities.

    Money Follows the Person
    Money Follows the Person (MFP) is a federal Medicaid demonstration project that supports state efforts to transition people from nursing homes and intermediate care facilities to the community with long-term services and supports.

    Open Doors Transition Program / New York Department of Health MFP Site
    Open Doors is New York’s Money Follows the Person (MFP) program.  The program is operated through the New York Association on Independent Living (NYAIL), with transition staff located statewide in New York’s independent living centers. Open Doors Transition Center is assists people living in nursing homes and intermediate care facilities to transition to the community where they can receive individualized home and community-based services.

    Olmstead Housing Subsidies
    A statewide rental subsidy and transitional housing support service program for high-need Medicaid members.

    Rapid Transition Housing
    Rental subsidy and supportive housing for Medicaid beneficiaries living with chronic physical disabilities and conditions.  This program is available on Long Island and in Syracuse, New York City and Rochester.

    • Managed Long Term Care
    • Health Home Care Coordination

    Empire State Supportive Housing Initiative
    The anticipated development of supported housing across the state.

    NYS DOH - Consumer Guide to Community-Based Long Term Care

    Consumer-Directed Personal Assistance Program

    HCBS Waiver Program Basics

    Medicaid Home-and-Community-Based Waiver Programs in New York State

    Certified Home Health Care Agencies
    List of CHHCAs registered in NYS as of April 5, 2021. All CHHAs are certified and regulated by the New York State Department of Health and are also certified by the Federal government to receive Medicare and Medicaid payments. 

    Licensed Home Care Services Agencies
    List of LHCSAs registered in NYS as of March 19, 2021. LHCSAs are not certified to receive direct payments from Medicare and Medicaid but they may contract to provide services for Medicare/Medicaid beneficiaries. 

    Expanded In-home Services for the Elderly
    EIHSEs serve elderly people who need home care but are not financially eligible for Medicaid

    New York Continuing Care Retirement Communities
    Includes list of the 14 CCRCs in NYS 

    New York Housing Options for Older Adults

    Capital Region Villages Collaborative
    Villages that are self-governing, grassroots membership, nonprofit organizations run by volunteers, and sometimes paid staff, that coordinate access to a variety of services and activities for seniors wanting to maintain independence in their own home.

    Medicaid Topics

    Guardianship, Supported Decision-Making, & Advance Directives


    Medical Orders for Life Sustaining Treatment

    The Medical Order for Life Sustaining Treatment (MOLST) form is one way of documenting a patient's treatment preferences concerning life-sustaining treatment. The MOLST form is the only authorized form in New York State for documenting both nonhospital DNR and DNI orders. 

    New York State Attorney General's Advance Directives Guide

    Federal Statutes

    Public Readiness and Emergency Response Act (PREP Act), 2005, and Declarations

    The PREP Act was enacted on December 30, 2005, as Public Law 109– 148, Division C, section 2. It amended the Public Health Service (PHS) Act, adding section 319F–3, which addresses liability immunity, and section 319F–4, which creates a compensation program. These sections are codified at 42 U.S.C. 247d–6d and 42 U.S.C. 247d–6e, respectively. Section 319F–3 of the PHS Act was amended by the Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA), Public Law 113–5, enacted on March 13, 2013 and the Coronavirus Aid, Relief, and Economic Security (CARES) Act, Public Law 116–136, enacted on March 27, 2020, to expand Countermeasures under the PREP Act.

    COVID-19 PREP Act Declaration and Amendments

    Selected PREP Act Cases - Federal Courts

    Third Circuit

    Estate of Maglioli v. Alliance HC Holdings, LLC, No. 20-2833 (3d Cir. 2021)

    New York

    Dupervil v. All. Health Operations, LCC
    (E.D.N.Y. Feb. 2, 2021), appeal dismissed and remand order vacated (2nd Cir. 2022)


    Lyons v. Cucumber Holdings, LLC
    (C.D. Cal. Feb. 3, 2021)


    Est. of Smith by and through Smith v. Bristol at Tampa Rehab. and Nursing Ctr., LLC
    (M.D. Fla. Jan. 12, 2021)


    There are 13 cases against Big Blue Healthcare, Inc. 

    Eaton v. Big Blue Health Care, Inc. - Represents the decisions of all 13 cases, which were ultimately remanded to the state court because the federal court lacked subject matter jurisdiction.

    Eaton v. Big Blue Healthcare, Inc.
    (D. Kan. Aug. 19, 2020)

    Additional cases:

    Anson v. HCP Prairie Village KS OPCO LLC
    (D. Kan. Jan. 29, 2021)

    Grohmann v. HCP Prairie Village KS OPCO LLC
    (D. Kan. Jan. 29, 2021)

    Goldblatt v. HCP Prairie Village KS OPCO LLC
    (D. Kan. Jan. 29, 2021)

    New Jersey

    Estate of Maglioli v. Andover Rehab Center
    (D. N.J. Aug. 12, 2020), 478 F. Supp. 3d  518


    Sherod v. Comprehensive Healthcare Mgt. Services, LLC
    (W.D. Pa. Oct. 16, 2020)


    Est. of Jones v. St. Jude Operating Co., LLC
    (D. Or. Oct. 14, 2020)

    Parker through Parker v. St. Jude Operating Co., LLC
    (D. Or. Dec. 28, 2020)

    Agency Guidance & Actions

    Centers for Medicare and Medicare Services

    Centers for Disease Control and Prevention (CDC)

    U.S. Department of Health and Human Services

    Select Caselaw on Federal Actions


    Characteristics and Quality of United States Nursing Home Reporting Cases of Coronavirus Disease 2019 (COVID-19)
    Paula Chatterjee, MD et al.
    JAMA Network, July 29, 2020

    Community-Based Long-Term Care Has Lower COVID-19 Rates and Improved Outcomes Compared to Residential Settings
    Julie Robison, PhD et al
    JAMDA, Dec. 7, 2020

    Staffing Levels and COVID-19 Cases and Outbreaks in United States Nursing Homes
    Rebecca J. Gorges, PhD and R. Tamara Konetzka
    JAGS, NOV. 2020-VOL. 68, NO. 11

    Characteristics of United States Nursing Homes with COVID-19 Cases
    Hannah R. Abrams, MD et al.
    JAGS, Aug. 2020-VOL. 68, NO. 8

    Rates of COVID-19 Among Residents and Staff Members in Nursing Homes--United States May 25-Nov. 22, 2020
    Suparna Bagchi, DrPH et al.
    Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, Jan. 15, 2021

    Is the End of the Long-Term Care Crisis Within Sight?: New COVID-19 Cases and Deaths in Long-Term Care Facilities Are Dropping
    Priya Chidambaram
    Kaiser Family Foundation, Feb. 24, 2021

    Association of Nursing Home Ratings on Health Inspections, Quality of Care and Nurse Staffing with COVID-19 Cases
    Jose F. Figueroa, MD, MPH et al.
    JAMA, Sept. 15, 2020 Volume 324, Number 11

    A Study of the COVID-19 Outbreak and Response in Connecticut Long-Term Care Facilities
    Patricia Rowan, M.P.P., PMP
    Mathematica, Inc, Sept. 30, 2020


    New York State Statutes

    Emergency Powers Provision:  N.Y Executive Law §29-a
    as amended by L. 2020, c. 23
    (Paragraph a of subdivision 2 of section 20 of the executive law) to include the term “disease outbreak,” and allowing the governor to suspend “statute, local law, ordinance, or orders, rules or regulations, or parts thereof, of any agency during a state disaster emergency,  . . . if necessary to assist or aid in coping with such disaster.”

    Immunity Provision: N.Y. Public Health Law, Art. 30-d

    Repeal of Immunity Provision N.Y. Public Health Law, Article 30-d​​​​​

    Agency Guidance & Data

    Implementation of Pharmacy Partnership for Long-Term Care Program - Approximately 600 nursing homes across the state that are participating in the program 

    Department of Health - COVID data tracker

    COVID-19 Nursing Home and Adult Care Guidance Review Version 1.0

    Attorney General - Nursing Home Response to COVID-19 Pandemic

    Office of People With Developmental Disabilities


    Governor’s Executive Order 202.10 - limited immunity for health care providers related to Covid-19

    Crisis Standards of Care and State Liability Shields
    Valerie Gutmann Koch
    57 San Diego L. Rev. 973 (2020)

    Nursing Homes Need Increased Staffing, Not Legal Immunity
    Nina A. Kohn and Jessica L. Roberts
    The Hill (May 23, 2020)

    Reports & Research

    New York State Comptroller's Office:  New York State Department of Health's Use, Collection and Reporting Infection Control Data
    Issued March 15, 2022, this audit found that the Department failed to provide accurate and reliable information during a public health emergency, and instead understated the number of COVID-related deaths at nursing homes by as much as 50%; at times, the Department deliberately misled the public.  Moreover, the Department failed to routinely analyze data at its disposal to detect interfacility outbreaks, geographic trends, and emerging infectious diseases or to shape its infection control practices and policies and its oversight of facilities.

    COVID-19 outcomes among people with intellectual and developmental disability living in residential group homes in New York State
    Disability and Health Journal, June 19, 2020

    Examining How Crisis Standards of Care May Lead to Intersectional Medical Discrimination Against Covid-19 Patients
    The Bazelon Center for Mental Health, The ARC of the United States, Lawyers Committee for Civil Rights, Justice in Aging, ASAN, CUNY School of Law, DREDF, National Disability Rights, CPR, with Professors Natalie Chin and Jasmine Harris  Feb. 2021

    Factors Associated with Nursing Home Infections and Fatalities in New York State During the COVID-19 Global Health Crisis
    February 11, 2021

    New York State Bar Association Health Law Section COVID-19 Report
    May 14, 2020, revised September 20, 2020

    Nursing Home Response to COVID-19 Pandemic
    N.Y. Attorney General, January 30, 2021

    DOH Response - New York State Bar Association Report, Task Force on Nursing Homes and Long Term Care

    Vaccination Guidance - Your Legal Questions Answered: COVID-19 Vaccine


    Executive Budget Amendments re Nursing Home Reform, New York State
    S. 2507, A. 3007, 2021-2022
    The following measures were passed and signed into law in the wake of the first COVID waves, to improve nursing home quality of care and accountability.

    Publication of Nursing Home Ratings - Chapter 441, Laws of 2021
    Requires that the most recent Center for Medicare and Medicaid Services (CMS) rating of every nursing home be prominently displayed on the home page of the Department of Health's website and at each nursing home facility's website and displayed at the facility for view by the general public.

    Allowing Compassionate Care-Giving Visitors - Chapter 69, laws of 2021
    Creates a standardized program to allow personal care and compassionate care visitors at nursing homes.

    Requirements for Transfer, Discharge and Voluntary Discharge - Chapter 80, Laws of 2021
    Sponsored by Senator Gustavo Rivera, creates requirements for the transfer, discharge and voluntary discharge of residents from residential healthcare facilities. 

    Standards for Ownership of Nursing Homes - Chapter 102, Laws of 2021
    Requires more review of ownership of nursing homes through the certificate of need process - including consideration of past violations at other facilities by owners - and requires more notice to the public during the CON process. 
    Transparency of Violations - Chapter 344, Laws of 2021
    Requires residential health care facilities to disclose in writing to potential residents and their family members the website where a list of violations and other actions taken against the facility can be found.

    Joint Virtual Legislative Hearing on Nursing Homes, Assisted Living, Home Health Care and COVID-19: August 3, and August 10, 2020

    Selected Cases

    Empire Center for Public Policy v. New York State Department of Health
    Albany County State Supreme Court decision holding that New York State Department of Health collects and maintains COVID-19 nursing home and assisted living center data requested by petitioner and violated New York’s Freedom of Information Law by subjecting petitioner to unreasonable delays in providing the requested information.


    Opinion - Proposals threaten nursing homes
    Michael Balboni, Albany Times-Union March 22,2021

    How Vaccine Hesitancy Is Driving Breakthrough Infections in Nursing Homes  
    Masha Gessen, The New Yorker, April 27, 2021

    Maggots, Rape and Yet Five Stars: How U.S. Ratings of Nursing Homes Mislead the Public
     Jessica Silver Greenberg & Robert Gebeloff, , N.Y. Times, March 13, 2021

    Tragedy Must Lead to Reforms
    Michael Brevda, Albany Times Union, March 12, 2021

    High Staff Turnover at U.S. Nursing Homes Poses Risks for Residents’ Care  
    Reed Abelson, N.Y. Times, March 1, 2021

    Early COVID-19 First Dose Vaccination Coverage Among Residents and Staff Members of Skilled Nursing Facilities Participating in the Pharmacy Partnership for Long-Term Care Program--United States, December 2020-January 2021
    Radhika Gharpure et al.
    Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, February 1, 2021

    Can Long-Term Care Employers Require Staff Members to Be Vaccinated?
    Radhika Gharpure et al,  N.Y. Times, March 5, 2021, updated March 8, 2021

    Long Term Care Residents’ Advocacy Organizations

    Albany Guardian Society 
    Its mission is to engage in a wide range of activities including education, research, information, and community engagement that will improve the quality of life for seniors, their families, and caregivers in the Capital Region.

    American Bar Association Commission on Law and Aging 
    The Commission secures and strengthens the legal rights, dignity, autonomy, quality of life and quality of care of older adults  through research, policy development, advocacy, education, training and through assistance to lawyers, bar associations and others working on aging issues.  

    Capital Region Villages Collaborative
    Villages are self-governing, grassroots, membership, nonprofit organizations run by volunteers, and sometimes paid staff, that coordinate access to a variety of services and activities for seniors wanting to maintain independence in their own home.

    Center for Elder Law and Justice
    Provides free civil legal services to seniors, people with disabilities and low-income populations in Western New York. Their goal is to protect the essentials of life such as housing, income, access to healthcare and protection from abuse. Some of their services include: health care advocacy, elder abuse prevention, housing and consumer protection. 

    Center for Medicare Advocacy
    The Center for Medicare Advocacy is a national, non-profit, law organization that works to advance access to comprehensive Medicare coverage, health equity, and quality health care for older people and people with disabilities.  Its work includes legal assistance, advocacy, education, analysis, policy initiatives, and litigation of importance to Medicare beneficiaries nationwide. 

    Coalition of Institutionalized Aged & Disabled
    The Coalition of Institutionalized Aged and Disabled (CIAD) is a non-profit, grassroots organization run by and for adult home and nursing home residents and resident councils, dedicated to protecting the rights of residents and improving the quality of their life and care. It is governed by a Board of Directions, largely composed of residents in the NYC area.

    Consumer Voice
    The Consumer Voice is the leading national voice representing consumers in issues related to long-term care  and a primary source of information and tools for consumers, families, caregivers, advocates and ombudsmen to help ensure quality care for the individual.

    Disability Rights New York
    DRNY is a Protection and Advocacy System and Client Assistance Program for persons with disabilities. DRNY advocates for the civil and legal rights for New Yorkers with disabilities. DRNY provides free legal and advocacy services to individuals with disabilities and works to protect and advance the rights of children and adults with disabilities. 

    Family Service League in Suffolk County
    Family Service League (FSL) helps individuals, children, and families on Long Island to mobilize their strengths and improve the quality of their lives at home, in the workplace, and in the community. FSL assists with seniors seeking companionship, homeless seeking shelter, and provides assistance to those suffering from addiction and mental illness.

    Independent Consumer Action Network (ICAN)
    Independent Consumer Action Network (ICAN) provides information about Medicare and Medicaid programs for people receiving long-term care, such as home care or nursing home care.

    Justice in Aging
    Justice in Aging focuses on advocacy, training, and litigation  on health care and economic security with the goal of having an impact on the lives of low-income seniors.

    Long Term Care Community Coalition 
    LTCCC is a nonprofit organization which works to improve the quality of care, quality of life and dignity for elderly and disabled people in nursing homes, assisted living, and other residential settings. LTCCC focuses on systemic advocacy by researching national and state policies, laws and regulations to identify relevant issues and develop recommendations to improve quality, efficiency, and accountability. LTCCC then uses this research and recommendations to educate policymakers, consumers, and the general public. 

    Long Term Care Ombudsman Program
    New York’s LTCOP is  a resource for older adults and people with disabilities who live in nursing homes, assisted living, and other licensed adult care homes. The program provides information and consultation to residents, families, facility staff, and community about issues in long term care and specific issues they are experiencing in facilities, advocates on behalf of residents to assure rights are not violated, identifying, and investigating and working towards resolution of resident complaints.

    Mental Hygiene Legal Services
    The Mental Hygiene Legal Service (MHLS) is a New York State agency responsible for representing, advocating and litigating on behalf of individuals receiving services for a mental disability under the care or jurisdiction of State-operated or licensed facilities. It also provides protective legal services and assistance in proceedings under the Mental Hygiene Law (MHL) Article 81 Guardianship and most of the MHL Assisted Outpatient Treatment.

    Mobilization for Justice
    Offers free legal assistance to low-income New Yorkers throughout New York City. Some of their legal areas include: housing; foreclosure; civil, disability, and aging rights; bankruptcy, tax, consumer, employment, government benefits; immigration; and kinship care. Their goals include: prevent homelessness, help seniors and people with disabilities live independently, stabilize families, maintain and increase income, and address racial disparities.

    Nassau-Suffolk Law Services 
    Nassau-Suffolk Law Services provides free legal services for civil matters to people with low incomes or disabilities on Long Island. Some services include applications for Medicaid, SNAP, SSI, and temporary shelter. It also provides extensive community education and outreach.

    New York Association for Independent Living 
    New York Association for Independent Living (NYAIL) is a not for-profit, non-government membership organization composed of, Independent Living Centers (ILCs) throughout New York State. NYAIL advances the independence of New Yorkers with disabilities through advocacy, education, resources, referral and the exchange of information.

    Other Resources & Self-Help Information

    American Bar Association Commission on Law and Aging, Health Care Advance Planning Packet
    This tool kit contains a variety of self-help worksheets, suggestions, and resources which provide guidance for advance health care decision-making.

    Care Compare
    A searchable federal nursing home website. 

    Caregiver Resources & Long-Term Care
    This resource offered by the U.S. Department of Health and Human Services includes links for national caregiver support program; eldercare locator; alternatives to nursing homes; health information counseling and more.

    Elder Care Locator
    This resource, a public service of the federal Administration on Aging,  includes links for national caregiver support program; eldercare locator; alternatives to nursing homes; health information counseling and more.

    Mobilization for Justice Nursing Home Resident Guides
    Also see MFJ’s useful guides on Medicaid, Adult Home Residents’ rights, and other topics in this self-help list.

    National Partnership – Dementia Care Resources
    The National Partnership to Improve Dementia Care in Nursing Homes (the National Partnership) provides resources to assess the quality of care for individuals with dementia, living in nursing homes. It provides a list of dementia care resources by category

    New York State Bar Association Webinars
    Webinar programs on a variety of issues relating to long term care.

    New York State Office for the Aging
    The New York State Office for the Aging identifies and connects individuals with programs and services relating to caregivers, housing, health, employment, transportation, elder abuse, food and meals, and veterans.

    NY Connects - Find Local Offices
    NY Connects provides one stop access to free, objective, comprehensive information and assistance on long term services and supports for people of all ages or with any type of disability. NY Connects programs are located across the state. A listing of each local program can be found  through the website.

    ProPublica’s Nursing Home Inspect
    A searchable website to compare nursing homes based on the deficiencies cited by regulators and the penalties imposed in the past three years, as well as trends and patterns.

    U.S. Department of Veterans Affairs; Geriatric and Extended Care
    Older veterans may be eligible for a wide-variety of benefits available to all U.S. military Veterans, including disability compensation, pension, education and training, health care, home loans, insurance, Veteran Readiness and Employment, and burial.