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May 12, 1993

After Long Delay, Federal Regulations for Enforcing Nursing Home Standards May Be Issued This Year

JAMA. 1993;269(18):2348-2353. doi:10.1001/jama.1993.03500180036016

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MORE THAN 5 years after nursing home reform legislation was signed into law, nursing home residents and their families are still waiting for the adoption of federal rules to enforce the new standards.

Advocates for nursing home residents are blaming massive lobbying efforts by the nursing home industry for the long delay and for ongoing attempts to seriously weaken the congressionally mandated reform. Industry representatives, however, argue that the proposed enforcement regulations are flawed.

The nursing home reform provisions of the Ominbus Budget Reconciliation Act of 1987 (OBRA 87), which became effective October 1,1990, called for comprehensive revision of federal requirements for long-term care facilities that participate in Medicare and Medicaid programs. While most of the standards mandated by the law were established by the US Department of Health and Human Services (HHS) when it published its final rules (Federal Register, September 26,1991), regulations for surveying and enforcing the standards