title: The impact of OBRA on medical practice within nursing facilities.
abstract: Major changes in the federal oversight of nursing home care were passed by Congress and became law as the Nursing Home Reform Amendments of the Omnibus Budget Reconciliation Act of 1987 (OBRA 87). The final regulations to implement OBRA 87 were published in September, 1991. The intent of this article is to provide an overview of selected parts of the nursing home reform regulations, which have a direct impact on physician practice within nursing facilities, and to offer strategies for successful management of the changes that are required. A brief review of the origins of the legislation and the process by which law is turned into practice is provided as a context in which to understand the changes mandated by the Nursing Home Reform Amendments of OBRA 87.
authors.affiliation: Department of Health Care Sciences, George Washington University School of Medicine, Washington, DC.
authors.forename: R
authors.initials: R
authors.lastname: Elon
authors.forename: L G
authors.initials: LG
authors.lastname: Pawlson
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S. / Q000331:legislation & jurisprudence; D030881:Disclosure; D035082:Federal Government; D033161:Government Regulation; D006291:Health Policy / Q000331:legislation & jurisprudence; D006801:Humans; D007883:Legislation, Medical; D009735:Nursing Homes / Q000331:legislation & jurisprudence*; D028701:Patient Rights; D026684:Personal Autonomy; D011787:Quality of Health Care; D012149:Restraint, Physical / Q000331:legislation & jurisprudence; D014481:United States