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R Elon

Publications and source records attributed to R Elon.

4 recordsLinked to original sources
PubMed1993

The nursing home medical director role in transition.

OBJECTIVE: To compare the self-reported role of nursing home medical directors in 1989 (prior to the implementation of the nursing home reform amendments of OBRA 87 in 1990) with the role outlined in the Joint Commission on Accreditation of Healthcare Organizations Long Term Care Standards Manual. DESIGN: Survey. MEASUREMENTS: Using a telephone interview survey, physicians were questioned about their role as nursing home medical director. Responses were compared with the definition of the medical director's role in the Long Term Care Standards Manual. Information about time spent per month and reimbursement received for medical direction was also obtained. PARTICIPANTS: Physicians serving as nursing home medical directors in 1989 in Houston/Harris County, Texas. RESULTS: Of 50 nursing home medical director positions in Houston/Harris County in 1989, interviews were completed for 36 (72%). The majority of the medical directors met the criteria for having a signed agreement with the facility, assuring continuous medical coverage, developing emergency procedures, and participating in quality assurance activities. Twenty-eight percent of the medical directors received no monetary compensation for their work. Of those who were paid, the mean monthly earnings for nursing home medical direction were $345. CONCLUSION: Although all nursing facilities are now required by regulation to have medical directors, a wide variation in medical directors' level of involvement and commitment was documented.

Data Collection↗
PubMed1992

The impact of OBRA on medical practice within nursing facilities.

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.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1990

Ethics in cardiovascular medicine. Task Force II: The relation of cardiovascular specialists to patients, other physicians and physician-owned organizations.

1. The American College of Cardiology acknowledges the continuum of changing societal, medical and economic perspectives affecting traditional medical ethics. Primacy of patient responsibility remains paramount to the cardiovascular specialist who at the same time should participate in the development of broader societal programs. 2. Medical decisions should be freely and jointly formulated by the patient and the cardiovascular specialist with appropriate sensitivity to such matters as mental competence, pertinent medical information and standards of care, sufficient time for contemplation, informed consent, patient right of refusal, physician right to refuse to provide inappropriate care and the right of patient, physician or third party payer to seek consultation or additional opinions. 3. The cardiovascular specialist should make a special effort to clarify and document patient preferences regarding end-of-life treatment through some form of advance directive. 4. The cardiovascular specialist bears a moral obligation to provide medical care to any patient who is HIV positive or has AIDS. 5. A conflict of interest occurs when a cardiovascular specialist places personal or financial interest ahead of the welfare and health of a patient. Professional accountability should be established through local or regional peer review. 6. The American College of Cardiology encourages and supports a renewed dedication to the principles of medical ethics, particularly in the field of cardiovascular disease. Cardiovascular specialists are encouraged to participate in the promulgation of medical ethics by teaching and by example, individually and with others.

Acquired Immunodeficiency Syndrome↗