Federal Nursing Home Care Reform Act

A 1986 study conducted by the Institute of Medicine concluded many residents of nursing homes were being subject to ill treatment. This study fueled the efforts for reforms which became law in 1987. The Nursing Home Reform Act was passed as a portion of the Omnibus Budget Reconciliation Act of 1987.

The objective of the reforms was to ensure patients received the highest practical care to foster their mental, physical, and psychosocial well-being. The act established a Resident’s Bill of Rights and specifies services which should be given. Medicare and Medicaid payments will be halted if the facility does not comply with the reforms. As nursing homes rely on the majority of their expenses to be funded from these sources, the facilities are forced to make sure their care is up to standards.

Required resident services include: comprehensive care plans for each individual resident, periodic assessments by professional, nursing services, rehabilitation services, social services, pharmaceutical services, dietary services, and if the facility houses more than 120 patients, it must employ a social worker full time.

The Residents’ Bill of Rights gives patients the following:

-The right to freedom from abuse, mistreatment, and neglect;

-The right to freedom from physical restraints;

-The right to privacy;

-The right to accommodation of medical, physical, psychological, and social needs;

-The right to participate in resident and family groups;

-The right to be treated with dignity;

-The right to participate in the review of one’s care plan, and to be fully informed in advance about any changes in care, treatment, or change of status in the facility; and

-The right to voice grievances without discrimination or reprisal

To asses whether nursing homes meet the criteria as designated by the Nursing Home Reform Act, the law established a certification process. It requires the state to conduct unannounced surveys and resident interviews at random times. However, the government did not issue regulations for the process until 1995. If there are specific complaints filed against a nursing home, the residents will often be surveyed accordingly so if a problem exists it can be detected.

If a nursing home is found in violation, it might have the opportunity to correct deficiencies before discipline is imposed. However, the following sanctions have been imposed for facilities which do not pass: directed in-service training of staff, directed plan of correction, state monitoring, civil monetary penalties, denial of payment for all new Medicare or Medicaid admissions, Denial of payment for all Medicaid or Medicare patients, temporary management, and termination of the provider agreement.