Quality Commission, the health and social care regulator for England, describes national minimum standards under the Care Standards Act 2000'' for services in care homes, including dignity and privacy rights, dietary and pecuniary rights, and the right to complain if one is unhappy with the care provided. United States Residents' rights in the US are protected at both the federal and state level. However, the legal rights of nursing home residents are currently controversial, as delegation clauses used in many nursing home contracts have been blamed for effectively permitting the rape of residents. Federal law In 1980 the Civil Rights of Institutionalized Persons Act was passed to protect the civil rights of, amongst others, residents of nursing homes and similar facilities. In 1987, amendments known collectively as the Federal Nursing Home Reform Act, including a robust section on nursing home residents' rights, were attached to an Omnibus Budget Reconciliation Act of 1987 (OBRA '87) which was then enacted into law and codified at section 483 of Volume 42 of the Code of Federal Regulations and related United States Code sections. These required nursing homes to provide facilities to ensure that residents had a high quality of life, good physical and mental activities, and were able to participate in the administration of the home. Appeals to an ombudsman in case of dispute were to be facilitated. However, the act's protections may or may not apply to some nursing home residents whose nursing homes receive only state funds, and do not participate in Medicare or Medicaid. Some rights provided by federal law as of 2010 include rights to dignity, privacy, freedom from discrimination, freedom from restraint, to be informed of medical care and treatment, pecuniary rights, visitation, rights of complaint and protection against transfer and unfair discharge. Specific rights include: choice of physician and involvement in treatment options; a right to be admitted without a third-party guarantee as a condition of admission; freedom from improper physical or chemical restraints; freedom from abuse; right to be treated with dignity; right to reasonable accommodation; right to participate in planning care and treatment and any changes in care and treatment; right to informed consent in language patient can understand; right to refuse treatment; right of family and Ombudsman to immediately access resident and have reasonable access to facility; right to privacy, confidentiality, and visitors; a right to not be transferred unless necessary to meet residents'