Using OBRA Regulations in a Nursing Home Negligence Case

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Nursing Home Negligence Is Different from Medical Malpractice

While medical malpractice cases and nursing home negligence cases share a number of similarities - both are often subject to a 1-year statute of limitations, or 2 years in the event of wrongful death, both often require expert medical testimony, and both seek to hold medical practitioners responsible for professional misconduct - there are significant differences between a medical malpractice case and a nursing home negligence case.

Medical malpractice cases typically deal with a single negligent act, such as a a botched surgery or a missed diagnosis. Nursing home negligence cases, by contrast, often involve a pattern of substandard care and neglect. A nursing home resident does not develop decubitus ulcers, or become malnourished or dehydrated in a single day. Even falls in nursing homes are often caused by poor planning, insufficient staffing, of improper supervision of the resident.

In some ways, the pattern of neglect can make a nursing home negligence case more difficult than a medical malpractice case. Rather than a single act involving one person, a nursing home case requires proving systemic substandard care by a number of individuals and corporate entities, including the nursing home medical director, the resident’s treating physician, the nursing home administrator, the individual nurses, the CNAs, STNAs, physical and occupational therapists, wound care doctors, dieticians, and others. While a medical malpractice case focuses on one, or maybe more than one, negligent doctors, a nursing home negligence case focuses on the entire care apparatus at a nursing home or assisted living facility, including the nursing home management company and its policies, practices, and business decisions that related to patient care.

State and Federal Regulations Define the Standard of Care in a Nursing Home Negligence Case

Unlike medical malpractice, where the standard of care is defined by individual professional standards, nursing home standards are set forth in state and federal statutes.

Ohio’s nursing home standards are set forth in Ohio Revised Code §3721, and Ohio Administrative Code §3701-17.

Ohio nursing homes must also comply with federal home regulations which are set out in 42 CFR §483. These standards are collectively referred to as OBRA standards. OBRA stands for the Omnibus Budget Reconciliation Act of 1987 which was the legislation that implemented the federal nursing home standards.

The federal OBRA standards and Ohio’s nursing home statutes establish the minimum standard of care for nursing home residents and recognizes that nursing home and assisted living facility residents are often vulnerable, confused, and must rely almost entirely upon the care of the nursing home and its staff. The state and federal regulations recognize that nursing home and assisted living facility residents are elderly, frail, and may have multiple medical diagnoses. These factors require a high level of care. Even temporary lapses in judgment can have disastrous consequences.

Nursing homes and assisted living facilities are regularly inspected for compliance with the state and federal standards, and failure to comply can result in hefty fines, citations, or even the suspension of a license.

Within the OBRA guidelines are massive guidelines, referred to as F-tags, that spell out how a facility must comply with the standards and are intended to provide the highest level of care for this vulnerable population.

A Skilled Nursing Home Negligence Will Use State and Federal Standards to Prove Nursing Home Negligence

A skilled nursing home negligence attorney knows how to use the state and federal standards to show that a nursing home or assisted living facility resident was injured because of a systemic failure within the facility.

Many of the most common nursing home complaints - such as catastrophic injury, malnutrition, bedsores, or fractures - also mean that there has been a violation of both OBRA and the state statutes. In other words, negligence in a nursing home cannot exist without an accompanying violation of both state and federal statutes.

A skilled nursing home negligence attorney, assisted by experts, uses these statutes to prove his client’s case. The combination of OBRA standards, state statutes, and F-tags that provide interpretive guidance on how the standards are to be implemented address the precise interpretation and implementation of the state and federal statute.

Robenalt Law Seeks Justice for Victims of Nursing Home Negligence

If someone you care about was catastrophically injured in a nursing home, contact an experienced nursing home negligence home attorney at Robenalt Law today to schedule a free initial consultation to discuss your case. We have the experience, expertise, and resources to go toe-to-toe with large nursing home companies, and we pride ourselves on zealously advocating for our clients. Contact Robenalt Law today by calling 216-223-7573, complete our online form, or email

Tom Robenalt started his litigation career representing nursing homes at a large firm in Cleveland. For the past 25 years, he has used that experience to help victims and the families of those injured by negligent health care providers.

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