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Omnibus Budget Reconciliation Act (OBRA) – Nursing Home Regulations

The Omnibus Budget Reconciliation Act (OBRA) was first enacted in 1987. It’s sometimes referred to informally as the Nursing Home Reform Act but more commonly just OBRA.

OBRA’s purpose was to improve the quality of care in nursing homes for the health and safety of nursing home residents. OBRA is quite extensive setting forth a long list of duties and requirements for nursing homes, staff, nurses and physicians. OBRA sets the ground rules for nursing home care.

OBRA Codified

OBRA has been codified through the U.S. Code of Federal Regulations at 42 CFR Part 483. Each state is also required to implement its own regulations for the implementation of OBRA at the state level.

New Mexico’s regulations regarding nursing homes are found in the New Mexico Health Code at N.M. Admin. Code 7.9.2. The NMAC §7.9.2 is also fairly exensive and will play a role in a New Mexico based nursing home lawsuit. However, OBRA is the starting point.

Violations of Omnibus Budget Reconciliation Act (OBRA)

Violations of OBRA mandates have significant regulatory consequences such as fines, penalties and even the loss of the facility’s license to operate. They also play a significant role in any medical malpractice, nursing home neglect and/or wrongful death lawsuits.

For any medical malpractice in New Mexico, including nursing home lawsuits, it must be shown that the medical providers (the nursing home company, nursing home facility, nurses, doctors/physicians, staff and consultants) breached the standard of care.

OBRA is the standard of care for nursing home lawsuits. This is point A in the evaluation of a nursing home case.

Resident Rights Under OBRA

As stated, OBRA is extensive in both duties upon the nursing home and the rights of nursing home residents. The entirety of rights and duties under OBRA is too extensive to fully lay out here. On the other hand, there are some simple guides for residents and their families.

In short, residents have the right to:

1. Respect and dignity
2. Participation in decisions regarding care
3. Freedom from abuse and neglect
4. Professional and competent care
5. Care best suited to their medical needs, physical and emotional

Using OBRA to Protect Your Loved One

Again, OBRA is the standard of care for nursing homes both nationally and in New Mexico. It is extensive and will take some time to review. The time spent to understand your loved one’s rights is well worth it.

To fully protect your loved one’s rights, you must understand those rights. You must also be vocal in asserting those rights. You should document carefully each issue, what you or your loved one did to address it, and the response of the facility. You should make sure that everything is memorialized in writing in case a lawsuit is necessary.

If the facility fails to respond appropriately and your loved one’s health and safety have been seriously harmed, you should then seek the assistance of an attorney. Unfortunately, this is often the only way to get the full attention of the nursing home and its doctors.

The 1987 Nursing Home Reform Act | AARP

The 1987 Nursing Home Reform Act In a 1986 study, conducted at the request of Congress, the Institute of Medicine found that residents of nursing homes were being abused, neglected, and given inadequate care. The Institute of Medicine proposed sweeping reforms, most of which became law in 1987 with the passage of the Nursing Home Reform Act, part of the Omnibus Budget Reconciliation Act of 1987.

Key Issues in Long-Term Services and Supports Quality | The Henry J. Kaiser Family Foundation

Key Issues in Long-Term Services and Supports Quality | The Henry J. Kaiser Family Foundation 2017 marks the 30th anniversary of the passage of the Nursing Home Reform Act as part of the Omnibus Budget Reconciliation Act of 1987, the federal legislation that substantially strengthened federal standards, inspections and enforcement of nursing home quality. The Act also merged Medicare and Medicaid standards, required comprehensive assessments of residents, set minimal requirements for licensed nursing staff, and required inspections to focus on outcomes of care…  Recurring concerns include staffing levels, abuse and neglect, unmet resident needs, quality problems, worker training and competency, and lack of integration with medical care.