About Family-Run Councils ("Family Councils")


The federal government understood the importance of having independent Family Councils in the institutional setting of a nursing home which can be bureaucratic and intimidating. Consequently, the 1987 Omnibus Budget Reconciliation Act (“OBRA ‘87”) included legislation to support the formation of Family Councils. These regulations gave families the freedom to meet, discuss, and recommend improvements to the quality of life for not only their loved ones, but for all residents in a nursing home.


Several states have adopted additional rights for Family Councils to strengthen federal regulations. In July, 2004, MA became the third state in the country to enact state Family Council legislation. MANHR is proud to have authored this legislation. Other states which have comprehensive Family Council laws include California, Maryland, New York, and Texas.


See Council Laws for the full text of the federal and MA Family Council laws.



Family Councils are not only made up of family, but also friends and others who have or have had a loved one in a long-term care facility. Family Councils develop for a variety of reasons, such as:



Each family council is different, according to the needs and interests of its members. A group may have as few as 2 members or many more. The size is not important, but commitment is. In general, the Council chooses a Chairperson and other officers as needed, maintains minutes, and submits all questions/concerns to Administration in writing. The group should focus on issues that are of interest to ALL residents in the facility. Specific resident care issues should be handled through the Care Plan process.


Staff Involvement

Improving the quality of life for residents takes a true “team effort”, and Family Councils can be a productive, non-threatening way for staff and family members to work together to accomplish the best quality of life for the residents. Long-term care facilities should educate their staff about what a Family Council can accomplish. Every department should be aware of the issues that are raised by the Council, since the entire team should be called upon to work on solutions.


 Often the Administrator, the Director of Nursing and the Social Worker are the key staff who work closely with Councils, but any staff member may be invited to Family Council Meetings. However, the majority of the meeting should be set aside for Family Council members to discuss their issues without staff present. This ensures confidentiality and alleviates retaliation concerns that some members may feel.


How Family-Run Councils differ from Facility-Run Councils

Sometimes, nursing homes organize Facility-Run Family Councils which may be chaired by the social worker or other staff member. Although nursing home-sponsored Family Councils can be helpful, they frequently do not provide members with a venue for sharing serious concerns in private or advocating for change. Only a true Family-Run council provides members with confidentiality and the avenue for advocacy intended by federal and state laws.


Facilities also may run a quarterly or semi-annual event to update the families/friends of residents on various educational topics and nursing home news. These gatherings would more appropriately be called a Family “Forum”, not a Family “Council”.


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