A 1986 study by the Institute of Medicine found that many nursing home residents were being abused. This study prompted 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 goal of the reforms was to ensure that patients received maximum practical care to promote their mental, physical, and psychosocial well-being. The law established a Resident Bill of Rights and specifies the services that must be provided. Medicare and Medicaid payments will stop if the facility does not comply with the reforms. As nursing homes depend on the majority of their expenses to be financed 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 evaluations by a professional, nursing services, rehabilitation services, social services, pharmaceutical services, dietary services, and if the facility houses more than 120 patients, you must employ a full-time social worker.
The Resident Bill of Rights grants patients the following:
-The right to be free from abuse, mistreatment and neglect;
-The right to be free from physical restrictions;
-The right to privacy;
-The right to the accommodation of medical, physical, psychological and social needs;
-The right to participate in groups of residents and relatives;
-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 of any change in care, treatment, or change in status at the facility; and
-The right to express their complaints without discrimination or retaliation.
To assess whether nursing homes meet the criteria designated by the Nursing Home Reform Act, the law established a certification process. Requires the state to conduct unannounced surveys and interviews of residents at random times. However, the government did not issue regulations for the process until 1995. If specific complaints are 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 to be in violation of the rules, it may have an opportunity to correct the deficiencies before discipline is imposed. However, the following penalties have been imposed for facilities that do not pass: Targeted in-service staff training, Targeted remediation plan, 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 administration and termination of the provider contract.