The Omnibus Budget Reconciliation Act of 1987 entitles residents of nursing homes to receive the "highest practicable physical, mental, and psychosocial well-being." This act also included various other provisions to clearly indicate the proper care residents should receive. Any nursing home that receives Medicaid or Medicare funds must abide by these rules. Violators are subject to sanctions.
One provision outlaws clinically avoidable pressure sores or contractures, which occur when a patient does not move around and lays stagnant during the course of the day. Another rule defines nutritional standards, which maintain a resident's proper body weight and hydration at healthy levels. Finally, the doctrine establishes that facilities have a proper number of staff to maintain these provisions.
These provisions and rules seem to force nursing homes to maintain a high standard of care for patients. However, for various reasons, many nursing homes are not keeping up to this standard. Many homes are currently understaffed and many patients are experiencing both nursing home abuse and injuries in the home.
The obvious reaction involves people wondering how these homes are avoiding sanctions and repercussions from the government or costly lawsuits from residents. One answer involves the massive legal team many of the conglomerate corporations employ. Corporate defense attorneys are very well trained and have developed many strategies to defeat these lawsuits or force private settlements.