Smith D A, Jensen S
USD School of Medicine, Yankton.
S D J Med. 1990 Jun;43(6):13-4.
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.
精神疾病在疗养院人群中相当普遍。1987年的《综合预算协调法案》（OBRA）与疗养院相关，有许多方面，包括入院前筛查、定期评估、正式的患者权利，并且给审查人员更多针对违规机构的制裁措施。OBRA废除了熟练护理和中级护理级别的指定。它规定对智障和发育障碍者的特殊需求进行评估，并期望对需要特殊治疗的居民进行重新安置。同样，它要求对疗养院中的精神病患者进行安置适宜性评估，并不鼓励接纳可能患有精神疾病的潜在疗养院居民。OBRA的这最后一个方面及其对长期护理系统、心理健康系统和南达科他州预算的潜在影响是本文的主题。
