Omnibus Budget Reconciliation Act of 1987
On December 22, 1987, President Ronald Reagan signed the Omnibus Budget Reconciliation Act of 1987 (OBRA-87) also known as the Federal Nursing Home Reform Act. While not all components have to do with drugs and pharmacology, there are a few points all pharmacy technicians should be aware of. OBRA-87 was enacted to protect the rights of patients in long-term care facilities such as nursing homes, skilled nursing facilities, and assisted living homes.
It sets forth regulations for Medicare and Medicaid Conditions of Participation in long-term care facilities. It states that residents should not be given unnecessary medications, and that antipsychotic drugs can only be given to patients who have a condition that necessitates them. These patients must have documentation stating that they have a condition requiring antipsychotic drugs. For those who do receive it, doses must be gradually tapered off, and behavior modification and “drug holidays” (a drug-free period) can be used to see if the medication can be stopped completely.
In addition, long-term care residents should not have any significant medication errors, and all necessary drugs, both routine and emergency, must be given as required. The facility itself is required to have a consultant pharmacist, and medications must be labeled and stored according to federal and state laws.