The Nursing Home Reform Act (NHRA): Quality of Life

The Nursing Home Reform Act (or NHRA) was put into place to make sure that residents of nursing homes could receive the highest practical mental, physical, and psychological well-being. The act serves to reinforce the quality of care and the provision for certain services to those residents. Also, it created a Bill of Rights for the residents themselves.

The Nursing Home Reform Act was made as a guideline for those facilities that want to receive funding from the state for Medicare and Medicaid services. Those facilities that get funding are required to meet certain criteria put into place by the Nursing Home Reform Act, and the state is then responsible for seeing that those nursing home facilities who substantially comply with the criteria are certified.

Now, let’s look at some of the residents’ rights as laid out by the Nursing Home Reform Act. Residents have the right to:

  • Privacy
  • Accommodation of physical, mental, and psychosocial needs
  • Communicate freely
  • Be free of mistreatment, abuse, and neglect
  • Exercise self-determination
  • Voice grievances without facing reprisal or discrimination
  • Be free of physical restraints
  • Participate in family and resident groups
  • Participate in their own care plan, including advance notice of changes in treatment, care, or facility status

Required Services for Residents

Nursing homes are required under the Nursing Home Reform Act to provide certain services to their residents. It also puts a set of standards into place for these services. Required services include the following:

  • Access to nursing, social, and rehabilitation services
  • Access to dietary and pharmaceutical services
  • Periodic assessment of each resident
  • A comprehensive care plan developed for each individual resident
  • Access to a full-time social worker if the facility has more than 120 beds

Nursing Home Regulations

The NHRA also has some strict guidelines to certify facilities and regulation while getting funding. States are required to conduct unannounced surveys that include interviews with residents, and these have to be conducted at irregular intervals that happen no more than 15 months apart. Required surveys will always have a general focus on evaluating quality of care, residents’ rights, and services that the facility provides for its residents. If and when complaints are filed against the facility, surveyors have to conduct targeted surveys in order to investigate them.

The NHR also has an enforcement process that starts when a survey reveals any non-compliance of a nursing home. The nature of the deficiency, or violation, then determines the actions that the state takes to rectify the issue. In some scenarios, the nursing home could be provided with an opportunity to correct the violation before any further action is taken.

The state has several criteria which it uses to evaluate violations, including:

  • Whether or not the deficiency at once jeopardizes a resident
  • Whether or not it is an isolated happening or part of an ongoing pattern, or widespread within the facility.

If facilities violate any of the guidelines within the NHRA, the state can impose remedies like monitoring, temporary management, Medicare or Medicaid payment denial, civil monetary penalties, and termination of the agreement.