Nursing homes are regulated by the federal government under the Omnibus Reconciliation Act of 1987 (OBRA), 42 U.S.C. § 1395 – 1396 (1999). State governments are also involved in the regulation of nursing homes. Under OBRA, state governments are responsible for licensing and certifying nursing homes in their respective states. In order for nursing homes to receive Medicare or Medicaid, facilities must comply with OBRA provisions.

• Although OBRA seeks to protect residents in nursing homes, OBRA does not allow nursing home residents to file a lawsuit in order to enforce OBRA regulations. State and federal agencies, however, are able to impose penalties or seek legal action for OBRA violations.
• The primary goal of OBRA is to establish uniform standards for nursing homes and ensure the protection and safety of patients. OBRA requires that nursing homes must be inspected annually. Nursing homes are also required to create individualized care plans, reduce the use of chemical and physical restraints, and ensure that staff members are properly trained for special needs situations.

State Legislation

• Because states are responsible for licensing and certification of nursing homes, most states have adopted similar provisions found in OBRA. One provision that states have widely adopted is a “Resident Bill of Rights.” A resident bill of rights requires a nursing home to provide certain rights to residents. The rights generally grant residents in nursing homes a right to a dignified existence, self-determination, and access to other persons and services inside and outside the facility. Residents also have a right to be free from coercion, discrimination, interference, and reprisal from the facility. If a nursing home fails to meet these rights, it may be penalized or have its license revoked.
• Some states also have statutes that provide patients various remedies for nursing home malpractice. In Florida, persons who violate a resident’s rights may be liable for damages.Fla. Stat. § 400.023.