Ask the care expert: Where can I learn more about OBRA 87?

Share this article:
Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
Q: I hear a lot about OBRA 87. Is there a document that I could read to learn more about the thoughts behind it?

A: Having been a director of nursing before, during and after OBRA, I can tell you, “We have come a long way, baby.” The best document I have found is from the Henry J. Kaiser Family Foundation. It's an entire booklet titled “Nursing Home Quality Care Twenty Years After the Omnibus Reconciliation Act of 1987,” printed in 2007, prepared by Joshua Wiener, Ph.D. It's available at www.kff.org.

At the booklet's conclusion, Wiener writes, “In the 20 years since the passage of OBRA 87, real progress has been made in providing improved quality care to nursing home residents, yet significant problems remain ...

“The 20th anniversary of the nursing home reform amendments provides an important opportunity to consider lessons learned, assess options for the future, and strategies for caring for an aging population in a variety of long-term care settings.”

The Kaiser booklet puts “everything OBRA” into one concise booklet. It goes over the rules, the changes in regulations and inspections, and how regulations were initiated. It reviews the reimbursement and prospective versus retrospective payment.

OBRA changed long-term care as it forced us to look at the needs of the “individual” resident. For instance, we would produce a policy, say, on whirlpool baths and everyone was forced to have their bath on our time schedule, when the CNA or charge nurse would create the WP schedule, with no consideration to the fact that the resident might be in pain and an evening bath may be less painful for him or her.

Before OBRA, we felt as though we allowed those residents to live in OUR facilities. Facilities today are much more homelike and friendlier places.
Share this article:

More in News

Also in the news for Oct. 23, 2014 . . .

ManorCare facility reaches $41,000 settlement over excluded nursing assistant ... Gait linked to Parkinson's-related dementia ... Automated tracking helps mandatory healthcare worker flu vaccination

CMS expands therapy payment research

The government is expanding its research into alternative therapy payments, to consider more holistic changes to the way Medicare reimburses skilled nursing facilities, the Centers for Medicare & Medicaid Services announced Tuesday.

CDC tightens Ebola guidelines for healthcare workers

The Centers for Disease Control and Prevention has issued more stringent guidelines for how healthcare workers should interact with Ebola patients, following an outcry from nurses and other professionals.