P.L. 114-10 (H.R. 2), the Medicare Access and CHIP Reauthorization Act signed April 16 by President Obama, contains “standard of care” provisions that the ABA maintains would make it more difficult to establish a case of negligence in a lawsuit by arguing that there was a violation of federal requirements, including those under the Nursing Home Reform Act of 1987 (NHRA). In a March 25 letter to House Speaker John Boehner (R-Ohio) and House Minority Leader Nancy Pelosi (D-Calif.) urging that the provisions be removed during House consideration of the legislation, ABA Governmental Affairs Director Thomas M. Susman explained that the NHRA and its regulations recognize a minimum level of care that each resident should receive for a nursing home to participate in the Medicare and Medicaid programs and for each resident to attain or maintain the highest level of well-being. “The safety of more than one million nursing home residents relies on the act’s critical minimum requirements for nursing homes,” Susman wrote. He added that governmental studies have repeatedly shown that state inspection agencies fail to cite or penalize facilities for harming residents even when they find serious injuries, and many violations are never discovered by state regulatory authorities. “Often the courts are the only recourse for consumers trying to hold nursing homes responsible for their actions,” Susman wrote, “Less accountability inevitably leads to poorer quality care and greater abuse and neglect.”