Jump to navigation Jump to content

Understanding the Nursing Home Reform Act

The federal Nursing Homes Reform Act (NHRA) was passed under the Reagan administration in 1987 in an effort to improve the quality of care in nursing home facilities and reduce incidents of nursing home abuse. The NHRA applies to any facility that participates in the federal Medicare and Medicaid programs. Under the legislation, nursing home care facilities are subject to unannounced inspections that must occur at least once in a fifteen-month period. Nursing homes that repeatedly fall below the standard of care outlined in the NHRA may risk losing their certification to participate in Medicaid and Medicare programs.

While the NHRA does not establish a private cause of action for nursing home residents or the administrators of their estates, it does create a heightened standard of care that must be met by all facilities, including those located in Virginia, who participate in federal health care programs. A private cause of action is a law or statute that can be used as the basis for a lawsuit. A standard of care is the minimum level of care, attention, and treatment that a nursing home facility must maintain in order to be in compliance with the law.

Several of the main provisions that make up the standard of care that must be achieved by nursing home facilities include the following:
• Providing a “skilled nursing facility” that is capable of administering medical care and rehabilitation services for residents who are medically ill, injured or disabled;
• Providing an environment that will enhance the quality of life for each resident;
• Maintaining a “quality assessment and assurance committee” that will meet to identify necessary assessments and activities, as well as areas where the facility is falling below the required standard of care;
• Assessing each individual resident and creating a care plan that describes the resident’s medical and psychological needs as well as their ability to perform daily life functions.

In the case of Brogdon ex rel. Cline v. National Healthcare Corporation, numerous residents of a nursing home facility brought a lawsuit in federal court alleging that the facility did not meet the minimum standard of care under the Nursing Homes Reform Act. They claimed that the facility employed poorly trained nurses that were not capable of providing adequate medial care, that the nursing staff failed to respond to the resident’s complaints in a timely manner, and that the staff failed to meet the social, emotional and dietary needs of the residents.

The residents sought to enforce the standard of care provisions outlined in the federal law. However, since neither the Medicare or Medicaid programs provide remedies for private plaintiffs, the court was unable to force the facility to comply with the federal law. The residents should have alerted the state government agency that was in charge of ensuring that the nursing home facility was in compliance with the federal law since they are vested with the power to issue sanctions and fines against the facility. Each of the residents may have had a private cause of action under state law, which may have allowed them to recover monetary damages from the facility. However, that issue was not discussed in this case.

If you or a loved one is currently residing in a nursing home care facility that is not meeting the standards of care that are described above, you should contact a caring and experienced attorney who will be able to evaluate your situation to determine whether you may have a private claim for negligence under Virginia law against your nursing home or care facility.




Michael S. Weisberg, P.C.
112 College Place
Norfolk, VA 23510
Phone: (757) 622-7740
Fax: (757) 533-9223
Toll Free: (800) 690-0235
Email: info@weislaw.com
www.weislaw.com