OBRA (Omnibus Budget Reconciliation Act of 1987)

Landmark legislation, sometimes called “The Nursing Home Reform Bill” that increased emphasis on care and codified many provisions for the first time. The law requires that each resident be evaluated upon admission, receive an individualized care plan and be informed about treatment decisions.

Occupancy rate

A measure of inpatient use, determined by dividing available bed days by patient days. It measures the average percentage of a hospital's beds occupied and may be institution-wide or specific for one department or service.

Occupational health services

Health services concerned with the physical, mental and social well being of an individual in relation to his or her working environment and with the adjustment of individuals to their work. The term applies to more than the safety of the workplace and includes health and job satisfaction.

Occupational therapist

Occupational therapists evaluate, treat and consult with individuals whose abilities to cope with the tasks of everyday living are threatened or impaired by physical illness or injury, psychosocial disability or developmental deficits. Occupational therapists work in long-term-care facilities, hospitals, rehabilitation agencies and other healthcare organizations.

Occupational therapy (OT)

Designed to help patients improve their independence with activities of daily living through rehabilitation, exercises and the use of assistive devices. May be covered in part by Medicare.

Older Americans Act (OAA)

Federal legislation that specifically addresses the needs of older adults in the United States. Provides some funding for aging services (such as home-delivered meals, congregate meals, senior centers and employment programs). Creates the structure of federal, state, and local agencies that oversee aging services programs.


A representative of a public agency or a private nonprofit organization who investigates and resolves complaints made by or on behalf of older individuals who are residents of long-term care facilities.

Omnibus Budget Reconciliation Act of 1987

Omnibus Budget Reconciliation Act of 1987 -- see OBRA

Omnibus Budget Reconciliation Act of 1993

Federal legislation that limits the amount of compensation that can be paid to employees covered by long-term disability plans funded through voluntary employees' beneficiary association trusts. Any such plan with participants earning more than $150,000 could lose its tax-exempt status.

OMRA (Other Medicare required assessment)

An MDS used to alter the resource utilization classification to a non-rehab group from a rehab group. This is filled out 8 to 10 days after the final therapy session if a resident is going to remain under Medicare Part A coverage.

OPPS (Outpatient prospective payment system)

Covers Medicare reimbursement levels for hospital outpatient services, some Part B services for inpatients with no Part A coverage and partial hospitalization services provided by community mental health centers.

OSCAR (Online survey, certification and reporting)

A Centers for Medicare & Medicaid Services database that holds survey and certification information of providers certified by either Medicare, Medicaid or both. Different types of information are required from different providers.


Occupational Safety and Health Administration - An agency within the U.S. Department of Labor, it is charged with distributing and enforcing rules that protect employees from workplace hazards and injuries. In rare instances, states rely on their own occupational safety and health agencies for guidance to protect workers.


Patients whose length of stay or treatment cost differ notably from most others’ stays or treatment.


A patient who is receiving ambulatory care at a hospital or other facility without being admitted to the facility. Usually, it does not mean people receiving services from a physician's office or other program that also does not provide inpatient care.