Nursing Home Justice Blog

What is the Nursing Home Reform Act & How Does it Apply Today?

Written By:

Attorney Mac Hester

Date Posted:

June 15, 2023

The federal government has long since recognized the issue of nursing home abuse and mistreatment in America. It wasn’t until 1987 that official legislation was passed outlining nursing home staff members’ specific responsibilities and the duty they owe each resident. Today, these laws and regulations set the standard for the type of nursing home care residents should expect and help hold facilities accountable for their negligence.

What is the Nursing Home Reform Act of 1987

The Nursing Home Reform Act, also known as the 1987 Omnibus Budget Reconciliation Act (OBRA’ 87), helped set minimum standards of care for nursing homes in the United States. This landmark legislation aimed to improve the overall quality of nursing home care and combat abuse and neglect.

How Did the NHRA Come About?

The Nursing Home Reform Act came about due to a growing concern regarding the quality-of-care nursing home residents received. This heightened awareness was primarily due to a 1986 study by the Institute of Medicine titled Improving the Quality of Care in Nursing Homes.

This study aimed to report on the current state of nursing home care and recommend changes in policy and procedure. The researchers concluded that many nursing home residents lived in appalling conditions and staff members were grossly incompetent in providing for residents’ most basic needs.

Researchers stated, “in many other government-certified nursing homes, admitted individuals receive very inadequate–sometimes shockingly deficient–care that is likely to hasten the deterioration of their physical, mental, and emotional health.”

It was apparent that a proper regulatory system wasn’t in place to ensure that only qualified nursing home facilities remained in operation. The findings from this research helped lay the groundwork for the eventual Nursing Home Reform Act that was soon to come.

How Did OBRA ’87 Improve Nursing Home Care?

The Nursing Home Reform Act brought about many changes to current policies and procedures. Some of these new “policies” may seem standard and straightforward. However, no law protected residents’ most basic rights before this legislation.

Additionally, these new laws changed how inspectors and ombudsmen visited nursing homes. Their approach became very resident-focused, spending more time interviewing each resident and observing their living conditions rather than talking to nursing home staff. From mandatory nursing and rehabilitative services to the establishment of fundamental resident rights, the passing of the NHRA began a new era of nursing home care.

Mandatory Services

The NHRA established several mandatory services that nursing homes must provide. Some of which include:

  • Comprehensive care plans for each resident
  • Periodic assessments
  • Nursing and rehabilitative services
  • Pharmaceutical services
  • Dietician services
  • Medically-related social services
  • Physicians’ services
  • Dental services
  • A full-time social worker (if the nursing home has over 120 beds)

The NHRA also details specific requirements regarding staff member training and certification. For example, nursing aides must complete a State-approved training program before they provide resident care if they’re not licensed health professionals. Nursing aides must also receive ongoing training and regular performance reviews.

Residents’ Bill of Rights

OBRA ’87 also established the Residents’ Bill of Rights—a list of individual rights to protect residents from abuse and neglect. These include the right to:

  • Be free from abuse, neglect, and exploitation
  • Be treated with respect
  • Be free from chemical and physical restraints
  • Participate in your care planning
  • Refuse treatment
  • Privacy
  • Visitors
  • Participate in community events
  • Control your finances
  • Know about services and fees
  • Express grievances without fear of retaliation

These rights are fundamental to each resident seeking nursing home care, and if they are violated, nursing homes could be liable.

How Has the Government Continued to Improve Resident Care?

Even 30 years after the passing of the Nursing Home Reform Act, nursing home abuse and neglect remains to be an ongoing issue.

Despite the seemingly endless cycle of nursing home abuse, lawmakers still haven’t given up. They continue to create new legislation to address this issue head-on and conduct research to monitor trends.

The Biden-Harris administration has announced new steps to improve nursing home care. The comprehensive plan has several initiatives, including establishing minimum staffing requirements, cracking down on illegal debt collection, increasing accountability, and more.

While the NHRA and new legislation are huge steps toward justice, it’s up to the states to ensure that these laws and regulations get enforced. States must monitor nursing homes and hold them accountable for violating any resident rights or failing to uphold the standard of care that the NHRA established.

Have You Suffered Nursing Home Abuse? Get Justice Today

If you or your loved one are currently in a nursing home, it’s vital that you are familiar with the Nursing Home Reform Act to understand your residents’ rights.

The elder abuse lawyers will personally listen to your story and walk with you on your recovery journey. We’ll use our resources to find all liable parties and hold them accountable for their negligence. Contact us today to schedule your free consultation at (303) 775-8128.

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