Federal Nursing Home Law
The earliest federal legislation dealing with nursing home regulation came in 1965, when Medicare and Medicaid were introduced. Nursing homes that were chosen to receive this government funding had to abide by government regulations laid out the Department of Health and Human Services. Although efforts were made in the late 1960’s, the need for universal government regulation of nursing home care was not really addressed until the 1980’s, a decade in which America was made aware of how widespread nursing home abuse and neglect had become. In 1987, the Nursing Home Reform Act was passed as apart of the Omnibus Budget Reconciliation Act (OBRA). OBRA, for the first time, had made the responsibility of nursing home care a matter of federal legislation. The Nursing Home Reform Act created a federally standardized bill of rights for nursing home residents, and created laws to protect and honor those rights. The Nursing Home Reform Act also provides different consequence and solution methods to problems and violations that are discovered.
The Nursing Home Reform Act
The Nursing Home Reform Act established standards that nursing homes had to meet when providing service and care for their residents.
These federal standards require:
- that nursing homes maintain updated periodic assessments for each of their residents.
- that each resident is provided with a comprehensive care plan designed specifically around their care needs.
- that nursing homes meet a standardized quality of nursing.
- that nursing homes meet the federal standards of quality when providing or dealing with social services.
- that nursing homes meet the federal standards of quality when providing rehabilitation services.
- that nursing homes meet the federal standards of quality when providing pharmaceutical services
- that nursing homes meet the federal standards of quality when providing dietary services.
- that nursing homes consisting of 120 beds or more enlist the services of a full-time social worker.
The Nursing Home Resident's Bill of Rights
The Nursing Home Reform Act established the following rights for nursing home residents:
- The right to live in a positive and caring environment that is free from abuse and neglect.
- The right to live without the fear of facing physical resistance or restraint from the nursing home staff.
- The right to live in an environment that respects the privacy of each of its patients.
- The right to receive care that is consistent with their mental, physical, medical, emotional, and social needs.
- The right to a social life that consists of social contact with fellow residents and family members.
- The right to live life with dignity and with the expectation of that dignity being respected.
- The right to continue to exercise self-determination while under the care of the nursing home facility.
- The right to exercise their freedom of speech, the right to communicate and if need be, the right to voice complaints and concerns they might find with the nursing home facility.
- The right to be an active member in the creation of their own care plan.
- The right to be made aware of any necessary changes to be made in their care plan.
Federal Surveys and Sanctions
To ensure that these standards are being put into effect, the federal government reserves the right to conduct unannounced surveying of nursing home facilities. This allows the government to monitor nursing homes and make sure that the rights of the patients are being respected. These surveys can include a range of in depth probing into the facility, such as interviewing residents. These surveys are usually just broad examinations of the quality of care provided in the nursing home and whether or not the rights of each resident are being respected. However, if the survey uncovers a violation of rights, then the Nursing Home Reform Act then requires enforcement procedures. During this enforcement process the government decides, based on the severity of the violation, how to best remedy the situation. In response to some lesser violations, the federal government might only require the facility to assess and correct the problem. But, if a violation is found that directly infringes upon a resident’s rights or safety, then the government is required to impose corrective and punitive sanctions.
The following is a list of possible corrective and punitive sanctions approved by the Nursing Home Reform Act:
- Government dictated staff training sessions
- A demand for a directed plan of correction
- An increased continuance of monitoring by the state government
- Fines and other forms of civil monetary penalties
- A discontinuance of Medicare and Medicaid funding
- Government takeover of the facility
- Rejection of certification/licenses/ and all other agreements.
The Nursing Home Reform Act, enacted in 1987 was the U.S. government’s response to the disturbing nation-wide revelations of nursing home abuse and neglect. After decades of inaction, the federal government created a law that dealt with standardizing the quality in America’s nursing homes. The federal government established standards for all federally funded nursing home facilities to abide by, therefore making a violation of these standards a violation of federal law. The Nursing Home Reform Act states clear and nationally standardized rights that all nursing home residents are to be granted. The 1987 Nursing Home Reform Act makes the health and well-being of nursing home residents a matter of federal law.