Lessons in U.S. Policymaking from the Nursing Home Reform Act of 1987 and Near-Repeal in 1995


What lessons in U.S. policymaking can be learned from the passage of the Nursing Home Reform Act of 1987 and near-repeal in 1995?   List 2 examples.

List one benefit which resulted from the implementation of OBRA -87 (the Act which contains the Nursing Home Reform Act). Please support your answer.

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Lessons in U.S. Policymaking from the Nursing Home Reform Act of 1987 and Near-Repeal in 1995

Importance of Stakeholder Engagement

The passage of the Nursing Home Reform Act of 1987 and its subsequent near-repeal in 1995 highlight the significance of stakeholder engagement in policymaking. In the case of the Nursing Home Reform Act, strong advocacy from consumer groups, families, and healthcare professionals played a crucial role in bringing attention to the issues within nursing homes and pushing for reform. This demonstrates the power of collective action and the need to involve relevant stakeholders in shaping healthcare policies.

Example 1: Grassroots Advocacy and Legislative Support

During the passage of the Nursing Home Reform Act, various advocacy groups, such as AARP and the National Citizens’ Coalition for Nursing Home Reform, actively campaigned for improved care standards and resident rights. They engaged in public awareness campaigns, lobbied policymakers, and provided testimony to highlight the shortcomings of nursing home care. Their efforts resulted in increased public support and bipartisan legislative backing, leading to the successful passage of the Act.

Example 2: Impact of Industry Influence

The near-repeal of the Nursing Home Reform Act in 1995 reveals the influence of industry interests and the potential for policy regression. Due to pressure from nursing home industry lobbyists, certain provisions of the Act were targeted for rollback, including regulations related to staffing ratios, training requirements, and resident rights. This serves as a reminder that policymaking processes can be influenced by powerful stakeholders with vested interests, necessitating continuous vigilance to protect and maintain beneficial policies.

Benefit from the Implementation of OBRA-87

One significant benefit that resulted from the implementation of OBRA-87, which contains the Nursing Home Reform Act, was the improvement of resident rights and quality of care in nursing homes.

Example: Enhanced Resident Rights and Protection

OBRA-87 introduced comprehensive regulations to protect the rights and well-being of nursing home residents. It mandated individualized care plans, regular assessments, and the right to participate in decisions about their care. This empowered residents and their families to actively engage in their healthcare and raised the standard of care within nursing homes. Additionally, the Act established a Resident Bill of Rights, ensuring dignity, privacy, and freedom from abuse or neglect. These provisions significantly improved the quality of life for nursing home residents and provided them with legal recourse if their rights were violated.

Supporting Evidence

Research studies have shown that the implementation of OBRA-87 resulted in positive outcomes for nursing home residents. A study published in the Journal of the American Geriatrics Society in 2011 found that the Act led to improvements in various areas, including reduced use of physical restraints, increased staffing levels, and improved compliance with quality standards. These improvements translated into better resident outcomes, such as decreased pressure ulcers, fewer urinary tract infections, and lower rates of functional decline.


Lessons in U.S. policymaking can be drawn from the passage and near-repeal of the Nursing Home Reform Act of 1987. Engaging stakeholders, particularly through grassroots advocacy and legislative support, is vital for successful policymaking. The Nursing Home Reform Act, embedded within OBRA-87, resulted in significant benefits, such as enhanced resident rights and improved quality of care. These lessons highlight the importance of ongoing vigilance, stakeholder engagement, and evidence-based policymaking to address healthcare challenges and promote positive change.

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