Family and Resident Councils

Family Councils
Click image for Fact Sheet.

The Nursing Home Reform Act of 1987, the basis for all Federal protections for nursing home residents, recognized the importance of Family and Resident Councils, as an important, independent voice to advocate for all residents in a nursing home.  Councils have the right to meet in private to discuss and make recommendations on any aspect of resident care and life.  This is the Federal Council Law.

Facilities must consider Council recommendations and attempt to accommodate them, to the extent practicable.  This may include developing or changing policies affecting resident care and life.  Facility staff must document its response, and rationale, to the Council.

Even though these regulations do not require residents or their families to organize a Council, if they choose to do so, it must be without interference from the facility.

The right of family members/others to participate in a Family Council is subordinate to residents’ rights.  For example, there may be situations when a resident may not want a family member, such as an estranged spouse, to join the Family Council, and the resident can block that person from joining.  Residents also have the right to participate in a Family Council.

More information on Family and Resident Councils follows.

Family Councils


Please use this handbook, developed by MANHR, to help you start and run a Family Council: Independent Family Councils In Nursing Homes.  And feel free to your local Long-Term Care Ombudsman for assistance!


Do you have a desire to help make positive change in a nursing home, and would like to talk to others who want to do the same? Do you want to meet in the nursing home to talk to other people about the experience of having a loved one in a nursing home?  If so, you should join or form a Family Council at your loved one’s nursing home.

Family Councils, which are protected by both Federal and Massachusetts law, are one of the best ways for family members to be involved with their loved one’s care. They are a great way to help support your loved one and other nursing home residents, and are a powerful way to seek improvements within the nursing home.

Councils give families, friends and resident representatives a confidential place to:

  • Advocate for all residents in the nursing home — raise issues and offer recommendations for the quality of care and life for all residents.
  • Support each other in the long-term care experience.
  • Supplement or enhance the nursing home’s activity programs.
  • Learn about your loved one’s specific facility and long-term care in general.
  • Run staff recognition events.

In 2004, Massachusetts, due to efforts by MANHR, was the third state in the country to mandate additional protections for Family Councils, including:

  • A nursing home cannot prohibit the formation or maintenance of a Family Council, nor can a nursing home discriminate against any member of a Family Council.
  • The nursing home, if a Family Council exists, must inform new residents and their representatives of its existence and contact information for the person or persons running it.
  • The nursing home must respond, in writing, within 5 working days, with the resolution or progress update to written requests or concerns of the Family Council.
  • Nursing homes must provide adequate space on a prominent bulletin board or other posting area so that Family Councils can post Family Council notices/information (per Massachusetts Department of Public Health Circular Letter noted below).

Here are links to the Massachusetts law, including a MA Department of Public Health Circular Letter that provides implementation protocols of the law to nursing homes:

Resident Councils

Resident Councils also exist so residents can talk in private to each other about their experiences, and/or changes they would like to make in the nursing home. Resident Councils are one of the best, and easiest ways for your loved one to get involved in their own care. They also are protected by the same Federal law that protects Family Councils.

Resident Councils provide a place for nursing home residents to:

  • Voice concerns about life in the nursing home.
  • Suggest and request improvements and changes within the nursing home.
  • Support new nursing home residents.

As with Family Councils, nursing homes must allow a Resident Council to exist, provide a meeting place for the Council, and respond to any complaints issued by the Council. Resident Council meetings are confidential, and anyone who is not a resident, can only attend if he/she is invited by the Council or members thereof.

→ Next: Two MA Budget Issues Protecting MassHealth Residents