Numerous federal and state laws have been adopted and implemented to improve the quality of care that residents receive in nursing homes across the United States throughout the history of this policy arena. The impact of these laws has lead to improved patient care to some extent, yet many serious problems persist that have caused residents to suffer or die. For instance, in 1987 Congress enacted a series of nursing home reform laws in the Omnibus Budget Reconciliation Act (OBRA 87) which expanded the focus of inspections to include assessing resident outcomes, reduced facility usage of physical and chemical restraints on residents, and expanded the range of sanctions that could be imposed on nursing homes not complying with the laws. State inspection agencies implemented the OBRA 87 laws and the results showed a reduction in the usage of physical and chemical restraints. Yet, the results also indicated that significant problems persist that have resulted in poor or fatal resident outcomes and few sanctions being imposed on facilities not complying with the laws.
This study will help to identify and explain which political and facility structural factors systematically influence the number of deficiencies (proxy measure for sanctions) inspectors cite that determine the type of sanction imposed on nursing homes not complying with the OBRA 87 laws across the United States. Regression analyses and diagnostic tests were performed on state-level data covering the period 1991 through 1997. The results of this study show that political and facility structural factors influence nursing home inspections nationally.
Learning Objectives: At the conclusion of this poster presentation, the participants will be able to: 1. List the political and facility structural factors that influence nursing home inspectors acorss the United States. 2. Analyze how political and facility structural factors influence nursing home inspectors across the United States. 3. Develop recommendations that can improve inspection of nursing homes across the United States
Keywords: Aging, Regulations
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.