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Nursing Home Reform Act

An aging population and other social factors have led to the need for an extended care system. Nursing homes and other elder care facilities were largely unregulated, and congressional investigations in the 1980s revealed that nursing home residents were often neglected or abused. The Nursing Home Reform Act (NHRA) was passed in an attempt to enact sweeping reforms that would protect the rights of nursing home residents and create a set of uniform standards for elder care.

Nursing Home Reform Act Coverage

The NHRA is a federal law. But while the fed can't compel states to enact the NHRA, compliance with the Act is mandatory for facilities seeking funding for Medicare and Medicaid service. The state is responsible for certifying that the facilities receiving Medicare and Medicaid funding are substantially compliant with the Act's standards.

Some states have also incorporated some or all of the NHRA's requirements into their local laws regulating long term care facilities. Washington and Michigan are two such states. Where state law has incorporated NHRA's provisions its coverage will extend to all nursing homes in the state (not just those seeking Medicare or Medicaid funds.)

Nursing Home Residents Bill of Rights

One of the most important protections of the Nursing Home Reform Act was the creation of a nursing home resident bill of rights, establishing basic rights for those living in covered facilities, including:

  • The right to be treated with dignity and respect;
  • The right to be informed in writing about services and fees prior to admission;
  • The right to manage one's own finances or designate someone of their choice to do so;
  • The right to privacy, personal belongings, and property, to the extent this does not interfere with the rights, health, or safety of others;
  • The right to be informed of one's medical conditions and to consult a doctor of their choice;
  • The right to refuse medications and treatments;
  • The right to a choice as to schedule and activities; and
  • The right to an environment that provides the maximum comfort and independence possible.

The bill of rights contains other important protections, including the right to complain and the right to be free of abuse and neglect. How these rights are meant to be protected is indicated by the Nursing Home Reform Act's requirements relating to standards of care.

Standards of Care

In addition to establishing the rights of residents, the NHRA also provides guidelines for providing a standard of care intended to protect resident rights. NHRA standards of care include requirements that nursing homes:

  • Maintain adequate staffing;
  • Determine each resident's functional capacity;
  • Develop comprehensive care plans for all residents;
  • Protect resident's ability to care for themselves and provide services necessary to complete basic functions relating to hygiene and nutrition;
  • Ensure access to proper medical treatment;
  • Monitor medication and provide pharmaceutical services; and
  • Maintain accurate and complete clinical records.

Violating resident rights or failing to comply with nursing home standards of care may incur penalties, including the reimbursement of fees, fines, changes in the facility management, or the denial of Medicare and Medicaid funding eligibility.

Free Legal Review of Your Nursing Home Reform Act Claim

Claims against nursing homes may involve a complicated analysis of the protections offered by the Nursing Home Reform Act, state laws, and the facility involved. State protections may, in some cases, even exceed the Act's, or provide additional causes of action. If you have a possible claim, you can get started today with a free legal evaluation of your matter.

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