Ohio Department of Aging
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January 2008
Twenty Years After the Nursing Home Reform Act
The quality of nursing homes has improved in 20 years, but there are still problems, concludes a new report by the Kaiser Family Foundation. The report examines the progress nursing homes have made over the past 20 years since the Omnibus Budget Reconciliation Act of 1987 (also known as the Nursing Home Reform Act).
The Nursing Home Reform Act instituted higher standards for patient care, increased staffing requirements and established resident rights, including the right to be free from abuse, mistreatment and neglect. It also established an enforcement system and merged Medicare and Medicaid standards and certification requirements.
According to the report, one of the biggest improvements since the passage of the act is the reduction in the use of physical restraints, which can decrease a resident's muscle tone and cause other health problems. In 2006, fewer than 6 percent of long-stay nursing home residents had been restrained during the last 7-day monitored period.
Although there have been improvements, the report notes, there are still serious problems. In 2006, nearly one-fifth of all certified facilities were cited for deficiencies that caused harm or immediate jeopardy to residents. Staffing levels have improved somewhat, but studies indicate that nursing homes are still significantly understaffed. Although there were improvements in the system immediately after the law's passage, improvements seem to have leveled off.
Nursing facilities are an integral component of a long-term care system that gives consumers real choice in the types of care they receive and which settings they prefer, ontinued quality improvement by the industry and policy makers is crucial. The report examines some possible future strategies for improving care, including reforming Medicaid and Medicare reimbursement, changing organizational culture and providing more information to consumers.
Ohio Department of Aging