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What Are OBRA Guidelines for Indiana Nursing Homes?

June 4, 2018
Elders and a nurse talking outside in the nursing home.

The Omnibus Budget Reconciliation Act of 1987 forever changed the way our country views the rights of nursing home residents. It also changed our expectations about the quality of care that nursing homes must provide to them. Today, thanks to OBRA, we now have federal regulations that apply to the majority of nursing homes in our country.

If your loved currently lives in a nursing home in Fort Wayne or elsewhere in Northeastern Indiana, you should familiarize yourself with OBRA and the regulations that this landmark piece of legislation created. You may have grounds for a nursing home abuse lawsuit if your loved one suffers harm due to a nursing home’s violation of his or her rights and fails to meet the basic standard of care that federal regulations have established.

What Is OBRA?

As AARP describes, the Institute of Medicine released a study in 1986 that exposed widespread abuse and neglect of nursing home residents throughout the country. The study’s findings spurred Congress to put the Federal Nursing Home Reform Act and several other bills into what became the Omnibus Budget Reconciliation Act of 1987, or OBRA.

The legislation led to the enactment of federal regulations that are aimed at ensuring that nursing home residents receive “the necessary care and services to attain or maintain the highest practicable physical, mental and psychosocial well-being, consistent with the resident’s comprehensive assessment and plan of care.” The regulations apply to all nursing homes in the U.S. which receive Medicare and Medicaid funding, which means the majority of nursing homes. You can find the regulations at 42 CFR Part 483.

State agencies such as the Indiana Department of Health are responsible for the enforcement of these regulations. At least once every 15 months, the agency must conduct an unannounced survey of a nursing home and check on whether the facility is providing residents with the quality of care that they are legally entitled to receive. The surveys include interviews with residents. Additionally, the agency must respond to complaints about nursing homes.

If the agency conducts a survey or investigation and finds that a nursing home is out of compliance, the agency can impose sanctions. Those potential sanctions include ordering nursing home to follow a “plan of correction,” imposing fines and – in the worse cases – forcing the facility to close. A nursing home’s violation of federal regulations may also serve as strong evidence in a personal injury or wrongful death claim against a nursing home.

Rights of Nursing Home Residents

As stated above, OBRA recognized that nursing home residents have certain rights. Facilities must respect those rights and provide an environment that allows residents to exercise them. They include the right to:

  • Enjoy living in a safe, clean, comfortable and homelike environment
  • Freedom from abuse, mistreatment and neglect (including corporal punishment or involuntary seclusion)
  • Freedom from misappropriation of their property or financial exploitation
  • Freedom from physical (and chemical) restraints
  • Privacy (including confidentiality of their medical records)
  • Accommodation of their medical, physical, psychological and social needs
  • Participate in resident and family groups
  • Be treated with dignity and respect
  • Exercise self-determination
  • Communicate freely
  • Choose their attending physician
  • Participate in the review of their written care plan and to be notified in advance about any changes in care, treatment or change of status in the facility.
  • Voice grievances without discrimination or reprisal (and without being put in fear of such retaliatory action).

Additionally, federal regulations require that nursing homes inform residents of their rights upon their admission to a facility.

Duties of Nursing Homes

In addition to spelling out the rights of nursing home residents, the federal regulations set out specific requirements that nursing homes must follow. Those requirements include:

  • Developing a comprehensive “person-centered” care plan for each resident. The facility generally must prepare this plan within 14 days after the resident’s admission and review it on a quarterly basis. Additionally, the facility must keep accurate and thorough records that document the resident’s care and treatment.
  • Preventing pressure ulcers. If a resident develops a pressure ulcer, or “bed sore,” the staff must provide treatment that promotes healing, avoids infection and stops new sores from developing.
  • Preventing accidents. The facility must ensure that the living environment “remains as free of accident hazards as is possible.” The staff must also provide adequate supervision and assistive devices to residents in order to prevent accidents such as falls.
  • Providing adequate nutrition and hydration. In particular, the facility must offer a “therapeutic diet” if a resident suffers from a nutritional problem, and a health care provider orders the diet.
  • Maintaining an infection prevention and control program. The facility must provide a safe and sanitary environment that prevents the development and spread of infections and communicable diseases.
  • Providing competent medication services. The facility must have procedures in place that ensure patients receive the right type and dosage of prescribed medications.
  • Maintaining sufficient staffing levels. The facility must have a sufficient number of nurses on staff to meet residents’ needs, and the nurses must have “appropriate competencies and skills sets.”

What Can You Do If a Nursing Home Violates Federal Regulations?

If you suspect that a nursing home has violated federal regulations and harmed your loved one, you should take steps that include:

  • Notifying the nursing home in writing. The nursing home may investigate the matter and take corrective action. However, if the facility ignores you or fails to take action that satisfies you, then you should take further action.
  • Contact your local ombudsman. The Indiana Long-Term Care Ombudsman Program has local representatives who will review and investigation your complaint.
  • Report the suspected abuse or neglect. Call your local law enforcement agency or Indiana Adult Protect Services at (800) 992-6978.

Our Fort Wayne Nursing Home Abuse Lawyers Can Help You

If you believe that your loved one has suffered abuse or neglect in a nursing home, contact Truitt Law Offices for a free consultation. For nearly four decades, we have protected the rights of nursing home residents in Fort Wayne, Huntington and throughout Northeastern Indiana. We will take immediate steps to protect your loved one’s safety and pursue the compensation that you and your loved one deserve.

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