NCLEX RN GUIDE                                                                                   the best of NCLEX

OMNIBUS Budget Reconciliation Act (OBRA)

The OMNIBUS Budget Reconciliation Act (OBRA) of 1990 requires that states provide advanced directives as options for clients.

Advanced directives:

  • document that allows clients to make legal decisions about how they wish to receive future medical treatment.

  • may indicate who the client wishes to make medical decisions in situations in which the client is unable to do so.

  • needs to be signed and witnessed and copies kept on file in the physician's office and the hospital.

  • witness to this document should not be a hospital employee who gives direct care, relative or heir to the clients estate - medical social workers are acceptable as witnesses in many states.

  • vary among states.

  • a living will is a type of advanced directive.