The following information is based on federal regulations that apply to all nursing homes receiving Medicare or Medicaid funding. This is for informational purposes only and should not be taken as legal advice. If you feel your rights or the rights of your loved one in long-term care have been violated seek professional legal advice on how to proceed.

While federal regulations are public domain, this comprehensive interpretation, organization, and family-friendly presentation is © 2025 NursingHomeFamilyCouncil.com. All rights reserved. Distribution and linking permitted with attribution intact.

Your Loved One’s Rights in Long-Term Care

Diagnostic Services & Testing

Laboratory Services & Testing Standards

Essential Laboratory Testing Rights

Your loved one has the right to proper laboratory testing services that accurately diagnose and monitor their health conditions.

Laboratory Service Requirements:

All laboratory services must meet federal quality standards
Tests must be performed by qualified, certified personnel
Results must be accurate, timely, and properly reported
Laboratory must be licensed and regularly inspected
Quality control procedures must be followed consistently

Types of Laboratory Tests Available:

Blood chemistry panels (glucose, cholesterol, kidney function)
Complete blood counts and blood clotting studies
Urinalysis and urine cultures
Infection testing (bacterial cultures, virus detection)
Medication level monitoring
Cardiac markers and thyroid function tests

When Laboratory Tests Should Be Ordered:

Initial health assessment upon admission
Regular monitoring of chronic conditions
When symptoms suggest possible health problems
Before starting new medications that require monitoring
Annual wellness examinations

Quality Assurance in Laboratory Testing:

Proper specimen collection and handling procedures
Accurate labeling and chain of custody
Timely processing and result reporting
Regular equipment calibration and maintenance
Staff training and competency verification

🚨 Warning Signs of Poor Laboratory Services:

Test results taking unusually long to receive
Repeated need to redraw blood due to “lab errors”
Conflicting results that don’t match clinical symptoms
No follow-up on abnormal test results
Staff unable to explain why tests are being ordered

Connect with other families about laboratory testing experiences: Join our community for support and information sharing.

Federal Authority: 42 CFR §483.50 – Laboratory, Radiology, and Other Diagnostic Services
→ Violation Remedies if laboratory service requirements are being violated
eCFR Reference: View complete regulations

Radiology & Imaging Services

Medical Imaging Rights and Standards

Your loved one has the right to necessary diagnostic imaging services performed by qualified professionals using properly maintained equipment.

Types of Imaging Services:

X-rays for bone fractures, pneumonia, and chest conditions
Ultrasound for internal organ evaluation
CT scans for detailed internal imaging
MRI for soft tissue and neurological evaluation
Bone density scans for osteoporosis screening
Cardiac imaging for heart function assessment

Radiology Service Requirements:

All imaging equipment must be properly licensed and maintained
Technologists must be certified and qualified
Radiologists must interpret and report results promptly
Safety protocols must protect patients from excessive radiation
Emergency imaging must be available when medically necessary

When Imaging Studies May Be Needed:

After falls or suspected injuries
To diagnose unexplained symptoms
Monitoring progression of chronic diseases
Pre-operative planning and evaluation
Regular screening for certain conditions

Your Rights Regarding Imaging:

Clear explanation of why imaging is recommended
Information about any risks or preparation needed
Prompt communication of results
Right to request copies of images and reports
Second opinion if results are unclear or concerning

Safety Considerations:

Radiation exposure kept to minimum necessary levels
Pregnancy screening before certain procedures
Allergy assessment before contrast materials
Proper positioning and comfort during procedures
Clear communication about what to expect

🚨 Red Flags for Imaging Services:

Delays in obtaining necessary emergency imaging
Results not communicated to doctor or family promptly
Poor image quality requiring repeated procedures
Equipment that appears old or poorly maintained
Technologists who seem unfamiliar with procedures

Federal Authority: 42 CFR §483.50 – Laboratory, Radiology, and Other Diagnostic Services
→ Violation Remedies if radiology service requirements are being violated
eCFR Reference: View complete regulations

Diagnostic Testing Procedures

Specialized Diagnostic Services

Your loved one has the right to comprehensive diagnostic testing that helps identify and monitor health conditions effectively.

Types of Diagnostic Procedures:

Cardiac testing (EKG, echocardiogram, stress tests)
Pulmonary function tests for breathing problems
Neurological testing (EEG, nerve conduction studies)
Endoscopic procedures (colonoscopy, upper endoscopy)
Sleep studies for sleep disorders
Specialized blood tests and genetic testing

Procedure Standards and Requirements:

All procedures must be medically necessary and physician-ordered
Informed consent must be obtained before invasive procedures
Proper preparation and instructions must be provided
Qualified specialists must perform complex procedures
Results must be communicated promptly to the care team

Pre-Procedure Preparation:

Clear instructions about eating, drinking, and medications
Information about what to expect during the procedure
Transportation arrangements for off-site procedures
Family notification and involvement as appropriate
Coordination with facility nursing staff

Post-Procedure Care:

Appropriate monitoring after procedures
Pain management and comfort measures
Clear instructions for recovery and follow-up
Documentation of procedure results in medical record
Communication with family about outcomes

Your Role in Diagnostic Testing:

Ask questions about why tests are being recommended
Understand the risks and benefits of procedures
Ensure your loved one is properly prepared
Request updates on results and follow-up plans
Advocate for necessary testing that may be overlooked

🚨 Concerns About Diagnostic Procedures:

Procedures ordered without clear medical justification
Inadequate preparation or explanation provided
Results not communicated to care team or family
Follow-up care not provided after procedures
Complications not properly managed

Federal Authority: 42 CFR §483.50 – Laboratory, Radiology, and Other Diagnostic Services
→ Violation Remedies if diagnostic procedure requirements are being violated
eCFR Reference: View complete regulations

Results Communication & Access

Your Right to Know Test Results

Your loved one has the right to receive clear, timely communication about all diagnostic test results and their implications for care.

Communication Requirements:

Results must be communicated promptly to the attending physician
Abnormal or critical results require immediate attention
Results must be explained in understandable language
Family members should be informed when appropriate
Written copies of results should be available upon request

What You Should Receive:

Clear explanation of what tests were performed and why
Results presented in terms you can understand
Information about what results mean for ongoing care
Next steps or follow-up recommendations
Copies of lab reports and imaging studies if requested

Timing of Result Communication:

Routine results: Within 24-48 hours of completion
Abnormal results: Communicated same day when possible
Critical results: Immediate communication to physician
Family notification: As soon as practical after physician review
Written documentation: Available within reasonable timeframe

Your Rights Regarding Test Results:

Right to request explanation of any test results
Right to obtain copies of all test reports
Right to have results shared with other healthcare providers
Right to seek second opinions on concerning results
Right to understand how results affect the care plan

Understanding Different Types of Results:

Normal results: Values within expected healthy ranges
Abnormal results: May indicate health problems needing attention
Critical results: Require immediate medical intervention
Inconclusive results: May require additional testing
Trending results: Changes over time that show patterns

🚨 Red Flags for Result Communication:

Test results not communicated for several days
Abnormal results not followed up with appropriate care changes
Family not informed of concerning test results
Results explained in confusing medical jargon
Difficulty obtaining copies of test reports
No discussion of what results mean for care planning

Federal Authority: 42 CFR §483.50 – Laboratory, Radiology, and Other Diagnostic Services
→ Violation Remedies if result communication requirements are being violated
eCFR Reference: View complete regulations

Outside Testing & Specialist Referrals

Access to External Healthcare Services

Your loved one has the right to access specialized testing and consultant services outside the facility when medically necessary.

When Outside Services May Be Needed:

Advanced imaging not available at the facility (MRI, specialized CT)
Specialist consultations (cardiology, neurology, oncology)
Complex diagnostic procedures requiring hospital setting
Emergency testing that exceeds facility capabilities
Second opinions for serious diagnoses

Facility Responsibilities for Outside Services:

Arrange necessary transportation to appointments
Coordinate scheduling with external providers
Provide complete medical records and test results
Send qualified staff member if patient requires assistance
Follow up on recommendations from specialists

Specialist Referral Process:

Physician must determine medical necessity for referral
Insurance authorization obtained when required
Appointment scheduled within reasonable timeframe
Medical history and current medications provided to specialist
Family informed of appointment details and purpose

Transportation and Assistance:

Facility must arrange appropriate transportation
Staff escort provided when medical condition requires
Medical equipment transported if needed (oxygen, wheelchair)
Insurance and identification documents provided
Emergency contact information available

Follow-Up Care Coordination:

Specialist recommendations incorporated into care plan
New medications or treatments properly implemented
Follow-up appointments scheduled as recommended
Family informed of specialist findings and recommendations
Changes in care documented in medical record

Insurance and Payment Considerations:

Medicare/Medicaid coverage verified before services
Prior authorization obtained when required
Family informed of any potential out-of-pocket costs
Payment arrangements made before non-emergency services
Billing coordination between facility and external providers

🚨 Warning Signs for Outside Services:

Needed specialist referrals being delayed or denied
Transportation not arranged for scheduled appointments
Medical records not provided to external providers
Specialist recommendations not implemented
Family not informed about outside appointments
Follow-up care not coordinated properly

Federal Authority: 42 CFR §483.50 – Laboratory, Radiology, and Other Diagnostic Services
→ Violation Remedies if outside service coordination requirements are being violated
eCFR Reference: View complete regulations

Red Flags: When to Take Action

Critical Warning Signs for Diagnostic Services

If you notice these problems with diagnostic testing and services, take immediate action to protect your loved one’s healthcare:

🚨 Immediate Safety Concerns:

Delayed Emergency Testing: Critical tests not performed promptly when medically urgent
Missing Follow-Up: Abnormal results not addressed with appropriate medical intervention
Poor Quality Testing: Repeated test failures, contaminated samples, or unreliable results
Communication Failures: Critical results not communicated to medical team or family
Denied Services: Medically necessary testing refused without valid justification

System-Wide Diagnostic Problems:

Frequent laboratory errors requiring repeated blood draws
Imaging equipment that frequently malfunctions
Long delays in obtaining routine test results
Staff unfamiliar with proper testing procedures
No access to emergency diagnostic services
Poor coordination with outside specialists and testing facilities

Escalation Steps for Diagnostic Issues:

Immediate Documentation: Record specific incidents, dates, and staff involved
Speak with Attending Physician: Discuss concerns about delayed or inadequate testing
Contact Facility Administrator: Address systemic problems with diagnostic services
File Formal Complaints: Report to state health department if problems persist
Seek External Help: Contact ombudsman or regulatory agencies for serious violations

When to Seek Outside Testing:

Facility cannot provide necessary diagnostic services
Repeated testing errors or quality concerns
Physician recommends specialized testing not available on-site
Family has concerns about accuracy of facility testing
Emergency situations requiring immediate advanced diagnostics

Protecting Your Loved One’s Diagnostic Care:

Ask questions about all tests being ordered
Request copies of all test results for your records
Ensure abnormal results are being followed up appropriately
Advocate for necessary testing that may be overlooked
Monitor timing of test results and follow-up care

Resources for Diagnostic Service Concerns:

Attending Physician: Primary advocate for necessary diagnostic testing
Medical Director: Facility oversight of medical service quality
State Health Department: Regulatory oversight of facility diagnostic services
Medicare/Medicaid: Coverage and quality concerns for beneficiaries
Outside Specialists: Second opinions and advanced diagnostic capabilities

Remember: Accurate, timely diagnostic testing is essential for proper medical care. Your loved one’s health depends on reliable diagnostic services, and you have the right to advocate for quality testing and prompt communication of results.

Connect with other families navigating diagnostic service challenges: Join our community for support and advocacy strategies.

Federal Authority: 42 CFR §483.50 – Laboratory, Radiology, and Other Diagnostic Services
→ Violation Remedies for comprehensive guidance on diagnostic service violations
eCFR Reference: View complete regulations