Abstract

The Omnibus Budget Reconciliation Act of 1987 transformed the quality assurance system for nursing homes through mandatory resident assessment, new inspection processes, quality measurement and public reporting. Despite these changes, quality remains problematic in many facilities, which consumer advocates blame on inadequate enforcement. At the same time, states and the private sector have greatly expanded home and community-based services, including assisted living facilities, with relatively little quality oversight or regulation.

The expansion of these noninstitutional services are premised on their better quality, but little systematic data are available to support these claims.

Audio   Slides