Biomaterial Database

OBRA--its effect on the mentally ill in South Dakota nursing homes. 1990

D A Smith, and S Jensen

USD School of Medicine, Yankton.

Mental illness is quite prevalent in the nursing home population. The Omnibus Budget Reconciliation Act of 1987 (OBRA), as it relates to nursing homes, has many facets including preadmission screening, periodic assessment, formalized patient rights, and gives reviewers a broader list of sanctions for offending facilities. OBRA does away with the designation of skilled and intermediate levels of care. It provides for evaluation of special needs of the mentally retarded and developmentally disabled and expects relocation of residents in need of specialized treatments. Similarly, it requires evaluation of the mentally ill in nursing homes for appropriateness of placement and discourages admission of potential nursing home residents with mental illness. This last aspect of OBRA and its potential effect of the long term care system, the mental health system, and the budget of the state of South Dakota are the subject of this paper.

UI	MeSH Term	Description	Entries
D008605	Mental Health Services	Organized services to provide mental health care.	Mental Hygiene Services,Health Services, Mental,Services, Mental Health,Services, Mental Hygiene,Health Service, Mental,Hygiene Service, Mental,Hygiene Services, Mental,Mental Health Service,Mental Hygiene Service,Service, Mental Health,Service, Mental Hygiene
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009735	Nursing Homes	Facilities which provide nursing supervision and limited medical care to persons who do not require hospitalization.	Homes, Nursing,Nursing Home
D011569	Psychiatric Status Rating Scales	Standardized procedures utilizing rating scales or interview schedules carried out by health personnel for evaluating the degree of mental illness.	Factor Construct Rating Scales (FCRS),Katz Adjustment Scales,Lorr's Inpatient Multidimensional Psychiatric Rating Scale,Wittenborn Scales,Edinburgh Postnatal Depression Scale,Mini International Neuropsychiatric Interview
D012017	Referral and Consultation	The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide.	Consultation,Gatekeepers, Health Service,Hospital Referral,Second Opinion,Consultation and Referral,Health Service Gatekeepers,Hospital Referrals,Referral,Referral, Hospital,Referrals, Hospital,Consultations,Gatekeeper, Health Service,Health Service Gatekeeper,Opinion, Second,Opinions, Second,Referrals,Second Opinions
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly
D001523	Mental Disorders	Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function.	Mental Illness,Psychiatric Diseases,Psychiatric Disorders,Psychiatric Illness,Behavior Disorders,Diagnosis, Psychiatric,Mental Disorders, Severe,Psychiatric Diagnosis,Illness, Mental,Mental Disorder,Mental Disorder, Severe,Mental Illnesses,Psychiatric Disease,Psychiatric Disorder,Psychiatric Illnesses,Severe Mental Disorder,Severe Mental Disorders
D013023	South Dakota	State bounded on the north by North Dakota, on the east by Minnesota, on the south by Nebraska, and on the west by Montana and Wyoming.
D013223	Statistics as Topic	Works about the science and art of collecting, summarizing, and analyzing data that are subject to random variation.	Area Analysis,Estimation Technics,Estimation Techniques,Indirect Estimation Technics,Indirect Estimation Techniques,Multiple Classification Analysis,Service Statistics,Statistical Study,Statistics, Service,Tables and Charts as Topic,Analyses, Area,Analyses, Multiple Classification,Area Analyses,Classification Analyses, Multiple,Classification Analysis, Multiple,Estimation Technic, Indirect,Estimation Technics, Indirect,Estimation Technique,Estimation Technique, Indirect,Estimation Techniques, Indirect,Indirect Estimation Technic,Indirect Estimation Technique,Multiple Classification Analyses,Statistical Studies,Studies, Statistical,Study, Statistical,Technic, Indirect Estimation,Technics, Estimation,Technics, Indirect Estimation,Technique, Estimation,Technique, Indirect Estimation,Techniques, Estimation,Techniques, Indirect Estimation