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20th anniversary of nursing home reforms reevaluated

Twenty years ago, Congress passed the Omnibus Budget Reconciliation Act (OBRA) and it is now time to review its successes and failures in order to improve the quality of nursing home care. OBRA regulates inadequate nursing homes by either shutting them down or allowing well-performing nursing home care providers to take over substandard facilities. However, the system in place requires that those who take over failing homes must be responsible for the liabilities that the previous management had incurred, including fines, penalties and deadlines to correct certain problems, including issues regarding nursing home abuse and neglect. Because the new management must take on these liabilities there are less resources to dedicate to improvement of the quality of care. The American Association of Homes and Services for the Aging (AAHSA) has strongly urged congress to pass legislation regarding “the counterproductive nurse aide training lock-out, the need for joint training of nursing home and surveyor staff, allowing states to demonstrate alternative quality assurance systems, facilitating new ownership for chronic problem homes, and using civil money funds to improve nursing home quality.”

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