Nursing home and skilled nursing facility marketing: the federal rules

A nursing home markets itself under federal rules written for long term care facilities. Facilities that take Medicare or Medicaid follow the requirements for long term care facilities in 42 CFR Part 483, and several of those requirements reach what you say before a resident ever arrives: what you may ask of a family at admission, what you must tell them about services and charges, and how residents may be photographed. CMS also publishes star ratings for every certified facility, and families find them when they search for you.

This guide is for nursing home and skilled nursing facility operators and the people who write their websites, listings and tour scripts. It covers resident rights as they touch marketing, admission promises, Care Compare star ratings, Medicare coverage wording, hospital discharge planners, gifts to residents and families, and resident photos. Fair housing wording for residential communities is covered in our guide to assisted living marketing, and end of life care is covered in our guide to hospice marketing. We do not repeat them here. Communities that sell entrance fee contracts should read continuing care retirement community marketing.

Resident rights start before admission

42 CFR 483.10 sets out resident rights. Paragraph (a) opens with the right to “a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility,” and (a)(2) requires the facility to “provide equal access to quality care regardless of diagnosis, severity of condition, or payment source.” Marketing that implies better care, better rooms or faster attention for people who pay privately runs against that sentence. Describe your services once, for everyone, and describe any private pay extras as items and charges, not as a better level of care.

Three other parts of 483.10 shape what your website and tour team say:

• Choice of physician. Under 483.10(d), “The resident has the right to choose his or her attending physician.” You can name the physicians and practitioners who round at your facility. Do not say or imply that residents must use them.
• Services and charges. Under 483.10(g)(18), the facility must inform each resident before or at admission, and periodically during the stay, of services available and their charges, including charges for services not covered under Medicare or Medicaid or by the daily rate. Under (g)(17), Medicaid eligible residents must be told in writing which items and services are included in nursing facility services under the State plan and which others may be charged, with the amounts.
• Information on benefits. Under 483.10(g)(13), the facility must give residents and applicants for admission oral and written information about how to apply for and use Medicare and Medicaid benefits.

Your website does not have to carry the full admission notice, but it should not contradict it. If your pricing page, brochure and tour answers describe what is included in the daily rate, keep them word for word consistent with the admission agreement your attorney approved.

Admission promises you cannot make

42 CFR 483.15(a) is the section to read before you write an admissions page or a tour script. It says the facility must not:

• Request or require residents or potential residents to waive their rights, including their rights to Medicare or Medicaid (483.15(a)(2)(i)).
• Request or require oral or written assurance that residents or potential residents are not eligible for, or will not apply for, Medicare or Medicaid benefits (483.15(a)(2)(ii)).
• Request or require a third party guarantee of payment as a condition of admission, expedited admission or continued stay (483.15(a)(3)).
• For a person eligible for Medicaid, charge, solicit, accept or receive any gift, money, donation or other consideration, beyond what the State plan requires, as a precondition of admission, expedited admission or continued stay (483.15(a)(4)).

Read those against your marketing. A line such as “private pay residents are admitted first” or “a family member signs as guarantor” on a website or in a call script is the kind of wording to take to counsel before it is published. Offers of a faster admission in exchange for a donation fall under (a)(4). Charitable gifts from people unrelated to a Medicaid eligible resident are addressed separately in (a)(4)(ii), only to the extent they are not a condition of admission or stay.

483.15(a)(6) adds a disclosure duty that helps marketing rather than limiting it: a nursing facility must disclose and provide to a resident or potential resident, before admission, notice of “special characteristics or service limitations of the facility.” If you do not provide a service, such as a ventilator unit or a secured dementia unit, say so on the website as well. It saves families a wasted tour and keeps your marketing in line with the notice you must give anyway.

Care Compare star ratings: use them as CMS describes them

CMS says it created the Five-Star Quality Rating System “to help consumers, their families, and caregivers compare nursing homes more easily and to help identify areas about which you may want to ask questions.” Nursing Home Care Compare gives each nursing home a rating between 1 and 5 stars. CMS says there is one overall rating for each nursing home, and separate ratings for health inspections, staffing and quality measures. Nursing homes with 5 stars “are considered to have much above average quality,” and those with 1 star “are considered to have quality much below average.”

CMS adds a caution that belongs next to any star rating you quote: “No rating system can address all of the important considerations that go into a decision about which nursing home may be best for a particular person.” CMS tells consumers to use the site together with other sources, including a visit and local organizations such as the State Ombudsman program.

If you mention your rating in marketing, these habits keep it accurate:

• Name the rating and the date. Say which rating it is (overall, health inspections, staffing or quality measures) and the date you saw it on Care Compare. CMS updates the data behind the ratings, so an undated rating can go stale.
• Link to your listing. Let families see the full Care Compare page, including the other ratings and inspection results.
• Do not cherry pick without context. Quoting a high staffing rating while the overall rating is lower, without saying so, may leave a false impression. Section 5 of the FTC Act, 15 U.S.C. 45, makes unfair or deceptive acts or practices unlawful.
• Do not invent ratings or awards. Never describe the facility as five star, top rated or best in the area unless the claim matches a named, dated, current source you can show.
• Update or remove. Put a review date on every page that quotes a rating and check it after each Care Compare update.

CMS publishes a Technical Users’ Guide that explains how the ratings are calculated. If a rating looks wrong, raise it with CMS or your state survey agency through the channels CMS provides. Do not argue with it in your advertising.

Describing Medicare coverage accurately

Skilled nursing care and long term care are different things under Medicare, and your website should keep them apart. Medicare.gov says Part A covers skilled nursing facility care “for a limited time (on a short-term basis)” when the person meets all of the listed conditions. Those include a qualifying inpatient hospital stay, which Medicare.gov describes as “a prior medically necessary inpatient hospital stay of at least 3 days in a row,” not counting the day of discharge. Medicare.gov adds that time under observation or in the emergency room before admission does not count toward those 3 days, and that Part A limits coverage to 100 days in each benefit period. It also says some Medicare Advantage plans and some Accountable Care Organizations may waive the 3 day requirement.

Medicare.gov’s Long-term care page says “Medicare doesn’t pay for long-term care” when that care is custodial, meaning help with personal tasks such as dressing and bathing, and that people may be eligible for it through Medicaid if they meet eligibility requirements in their state.

Write your coverage page in those terms and link to both Medicare.gov pages. The daily amounts a resident pays change each year, so link to Medicare.gov for current figures instead of copying them. Avoid phrases such as “Medicare covers your stay” with no conditions, or “no cost to you,” unless you explain exactly when that is true.

Hospital discharge planners and referral sources

Hospital discharge planners are a referral source for skilled nursing care, and the hospital rule at 42 CFR 482.43(d) shapes that relationship. When a patient is transferred to a SNF for post-hospital extended care, the hospital must include in the discharge plan a list of available SNFs that participate in Medicare, and it must inform the patient or their representative “of their freedom to choose among participating Medicare providers and suppliers of post-discharge services.” The rule also says the hospital “must not specify or otherwise limit the qualified providers or suppliers that are available to the patient.”

That means your outreach to a hospital should give discharge planners accurate information they can pass on: services, admission hours, insurance accepted, service limitations and how to reach intake. It should never ask them to steer patients to you. Anything of value tied to referrals raises the federal anti-kickback statute, 42 U.S.C. 1320a-7b(b), which reaches anyone who knowingly and willfully offers or pays remuneration to induce referrals of items or services payable by a federal health care program. Our guide to patient and physician referrals covers that statute and its safe harbors in detail.

Inpatient rehabilitation facilities draw on the same hospital discharge planners, under different Medicare admission criteria. Our inpatient rehab facility marketing guide covers those criteria, acute rehab versus skilled nursing comparison claims and IRF quality data.

No inducements to residents and families

42 U.S.C. 1320a-7a(a)(5) provides civil monetary penalties for offering or transferring remuneration to a person eligible for Medicare or a State health care program that the offeror “knows or should know is likely to influence” them to order or receive items or services from a particular provider. OIG’s 2016 policy statement explains how it reads the nominal value limit for gifts to beneficiaries, and says cash and cash equivalents are never nominal. In nursing home marketing, that rules out gift cards for choosing your facility, waived charges offered as a move in incentive, and similar offers. Describing the services you provide to every resident is different from offering something extra to win a particular one. Have counsel review any incentive before you advertise it.

Our guide to marketing to Medicare patients covers the beneficiary inducement rules for practices in more detail.

Resident photos, stories and reviews

Under 483.10(h), the resident “has a right to personal privacy and confidentiality of his or her personal and medical records,” and personal privacy includes accommodations, medical treatment, personal care, visits and meetings of family and resident groups. CMS memo S&C 16-33-NH, dated August 5, 2016, says that “Taking photographs or recordings of a resident and/or his/her private space without the resident’s, or designated representative’s, written consent, is a violation of the resident’s right to privacy and confidentiality.” Its examples include a photograph of a resident’s room, a resident eating in the dining room and a resident taking part in an activity in a common area.

For marketing, that sets a simple standard: no resident appears in a photo or video, and no resident’s room is shown, without written consent from the resident or their designated representative. If the facility is a HIPAA covered entity, using protected health information for marketing also generally needs a written authorization; our guide to patient photo consent for marketing covers that form. Photos of the building, empty rooms, the dining room before service and staff who have agreed to be photographed tell families a great deal without those risks.

Family stories and reviews follow the FTC rules. Under 16 CFR 255.2(b), an ad that presents one family’s experience on a central point is likely to be read as typical, and if it is not, the ad should clearly disclose the generally expected results. 16 CFR 465.4 prohibits incentives conditioned on reviews expressing a particular sentiment. When you reply to a review, do not confirm that the writer or their relative is or was a resident; our guide to replying to negative reviews shows wording that works.

Illustration: rewriting an admissions page

Illustration only, not a real facility. A nursing home’s admissions page reads: “Five star rated. Medicare covers your stay. Private pay residents enjoy priority admission and our premium care package. A family member signs as financial guarantor.” A rewrite in line with the sources above would say:

• “Overall rating on Nursing Home Care Compare as of [date]: [rating]. See our full Care Compare listing, including health inspections, staffing and quality measures.”
• “Medicare Part A can cover skilled nursing care for a limited time when you meet Medicare’s conditions, including a qualifying inpatient hospital stay. See Medicare.gov for the conditions and current costs.”
• “We accept Medicare, Medicaid and private pay. Every resident receives the same care. Optional items and services, and their charges, are listed in our admission information.”
• “Services we do not provide: [list].”

The guarantor sentence is removed and referred to counsel under 483.15(a)(3).

Checklist

• Describe one standard of care for every resident, whatever the payment source.
• Name visiting physicians without implying residents must use them.
• Keep website, brochure and tour wording consistent with the admission agreement.
• Remove any guarantor, Medicaid waiver or donation for priority wording and ask counsel.
• List service limitations on the website as well as in the admission notice.
• Quote star ratings by type and date, link to Care Compare and recheck after updates.
• Explain Medicare skilled nursing coverage in Medicare.gov’s terms and link to it.
• Give discharge planners information, never anything of value tied to referrals.
• Offer no gifts or waived charges to win residents.
• Get written consent before any resident, or resident’s room, appears in marketing.
• Ask every family for honest reviews, with nothing tied to a positive one.

How we help

We build websites, local search and Google Ads for independent health care businesses, and we check claims, ratings and photos against the rules above before anything goes live. See our medical website design work. Our AI front desk is built with HIPAA in mind and answers questions about hours, tours, services and insurance accepted from a list you approve. We confirm in writing what a BAA covers before any patient information flows through a tool, and if it is not covered, we do not route patient information through it. We do not sell lead lists, do not pay for referrals and do not work on pay per admission arrangements. For the wider set of rules we follow, see our healthcare marketing rules hub.

Sources

• 42 CFR 483.10: Resident rights
• 42 CFR 483.15: Admission, transfer, and discharge rights (paragraph (a))
• CMS: Five-Star Quality Rating System (last modified October 27, 2026)
• Medicare.gov: Nursing Home Care Compare
• Medicare.gov: Skilled nursing facility care
• Medicare.gov: Long-term care
• 42 CFR 482.43: Discharge planning (paragraph (d))
• 42 U.S.C. 1320a-7a: Civil monetary penalties (subsection (a)(5))
• 42 U.S.C. 1320a-7b: Criminal penalties for acts involving Federal health care programs (subsection (b))
• HHS OIG: Policy Statement Regarding Gifts of Nominal Value to Medicare and Medicaid Beneficiaries (December 7, 2016)
• 15 U.S.C. 45: Unfair methods of competition unlawful; prevention by Commission
• 16 CFR 255.2: Consumer endorsements
• 16 CFR Part 465: Use of consumer reviews and testimonials
• CMS: S&C 16-33-NH, Protecting Resident Privacy and Prohibiting Mental Abuse Related to Photographs and Audio/Video Recordings by Nursing Home Staff (August 5, 2016)

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