Heath Care Fraud & Abuse: Nursing Homes

Nursing homes and long-term care facilities that receive federal funds must comply with certain federal regulations and laws. These regulations and laws set out in detail the type and quality of care that residents in these facilities must receive. Due to the many reports of nursing home abuse and neglect that surfaced in the 1980's, in 1987 Congress passed legislation in an effort to reform nursing home practices and procedures and to set standards for the care rendered to residents. These laws were incorporated into the Omnibus Budget Reconciliation Act of 1987 (OBRA 1987) and is also known as the Nursing Home Reform Act. New Jersey also requires nursing homes to meet state standards on the type and quality of care required for residents of these facilities.

Reports from various state agencies note that some of the reported causes of death of nursing home residents are chronic urinary tract infections, pressure ulcers and respiratory infections. Many of these deaths may be preventable. An extensive report on nursing home care problems in California generated a congressional hearing and an extensive report to the Special Committee on Aging of the United States Senate.

While a number of the federal regulations are listed here: Nursing Home Regulations, a basic tenet of the Act is that a nursing home or long term care facility must provide services and care to attain or maintain the highest practicable physical, mental and psychosocial well-being of each resident and this care must be given based on written documentation for each resident, known as an individualized plan of care.

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