ABSTRACT
Non-institutional long-term care is a broad, poorly defined, rapidly developing field. The need for it, the technologic ability to provide it, and the amount of money spent on it are all growing. Reconciling the public's reluctance to support social programs with the inevitable overlap of social and medical needs in the care of the frail elderly presents a serious challenge in formulating policy. Medical directors of programs in non-institutional long-term care will have to face governmental constraints and will be responsible for developing and implementing new policy in the future.
Subject(s)
Home Care Services/organization & administration , Long-Term Care/organization & administration , Physician Executives/organization & administration , Physician's Role , Aged , Frail Elderly , Health Policy , Health Services Needs and Demand , Hospice Care/organization & administration , Humans , Job Description , Medicare Part A , Reimbursement Mechanisms , United StatesABSTRACT
The nursing home reform amendments passed by Congress in 1987 (known as OBRA 87) have several sections that are relevant to medical practice and medical direction in the nursing home. The regulations and interpretive guides specify the medical director's role, physician services, resident assessments, resident rights, and restrictions on the use of chemical and physical restraints. This article provides the nursing home attending physician and medical director with basic information to help bring medical services into regulatory compliance.
