Federal Regulations Title 42

  The Omnibus Budget Reconciliation Act (OBRA), also known as the Nursing Home Reform Act of 1987, dramatically improved the quality of care in the nursing home over the last thirty years by setting forth federal standards of how care should be provided to residents.

  This Act is interpreted with the U.S. Code of Federal Regulations (42 CFR Part 483).

  Such improvements include less use of anti-psychotic drugs, a reduction in chemical and physical restraint use, and a reduction in inappropriate use of indwelling urinary catheters.


  The quality of care mandates contained within OBRA, and the regulations, require that a nursing home must provide services and activities to attain or maintain the highest practicable physical, mental, and psycho-social well-being of each resident in accordance with a written plan of care. In order to participate in Medicare and Medicaid programs, nursing homes must be in compliance with the federal requirements for nursing homes.

  The mandates of OBRA are regarded in the nursing home setting to represent minimum accepted standards of care. The failure of a nursing home to comply with the OBRA quality of care mandates in caring for a resident represents a failure to exercise the degree of reasonable care and skill that should be expected.

  OBRA brought about the Residents Rights §483.10 Resident rights.

(a) Residents rights. The resident has a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility, including those specified in this section.

    (1) A facility must treat each resident with respect and dignity and care for each resident in a manner and in an environment that promotes maintenance or enhancement of his or her quality of life, recognizing each resident's individuality. The facility must protect and promote the rights of the resident.

    (2) The facility must provide equal access to quality care regardless of diagnosis, severity of condition, or payment source. A facility must establish and maintain identical policies and practices regarding transfer, discharge, and the provision of services under the State plan for all residents regardless of payment source.


      Revised OBRA practice test As the newly refreshed and revised OBRA practice test and Flash Cards are still being edited, here is a free copy of the regulations here. You can also visit the GPO for yourself.

      Keep checking back as we will soon have the refreshed California Title 22 and other states as well.

Click here to download your copy of Title 42 for Long Term Care Facilities.