Federal Nursing Home Care Reform Act

Federal Nursing Home Care Reform Act

A 1986 study by the Institute of Medicine concluded that many nursing home residents were abused. This study fueled reform efforts that became law in 1987. The Nursing Home Reform Act was passed as part of the Omnibus Budget Reconciliation Act of 1987.

The aim of the reforms was to ensure that patients receive the best practical care to promote their mental, physical and psychosocial well-being. The act created a Bill of Rights for residents and specified the services to be provided. Medicare and Medicaid payments will be suspended if the facility does not comply with the reforms. As nursing homes rely on the majority of their costs to be funded from these sources, facilities are forced to ensure that their care meets standards.

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

The Residents Bill of Rights gives patients the following:

-Right to freedom from abuse, maltreatment and neglect;

-Right to freedom from physical restraints;

– Right to privacy;

– Right to accommodate medical, physical, psychological and social needs;

– Right to participate in resident and family groups;

-The right to be treated with dignity;

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

-Right to express grievances without discrimination or repression

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

If a nursing home is found in violation, it may have an opportunity to correct the deficiencies before discipline is imposed. However, the following sanctions are imposed on facilities that fail: targeted in-service training for staff, targeted plan of remediation, state monitoring, civil monetary penalties, denial of payment for all new Medicare or Medicaid admissions, denial of payment for all Medicaid or Medicare patients, interim management and termination of provider agreement.

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