: In 1987, Congress passed the Omnibus Budget Reconciliation Act (OBRA87) with the goal of improving the quality of care in nursing homes. OBRA87 mandated minimum-staffing standards and required a reduction in the use of unnecessary drugs, unnecessary physical restraints, and any significant medication errors. Since the implementation of OBRA87 in 1990, serious questions have been raised about whether the federal regulations brought about a positive change in nursing homes. However, research findings in this field are limited and inconclusive. The main objective of this study is to examine the nursing homes in the United States with data before and after the implementation of OBRA87 in order to answer the following questions: (1) What is the influence of OBRA87 regulations on nursing home staffing levels? and (2) What is the influence of OBRA87 regulations on the quality of care in nursing homes? The specific aims are to: (a) build a data set containing a panel sample of nursing homes before and after the implementation of OBRA87; and (2) develop and estimate models to determine the effects of OBRA87 on staffing levels and on quality of care in nursing homes. Data sets from the Medicare/Medicaid Automated Certification System (MMACS); Online Survey, Certification and Reporting (OSCAR) system; and Area Resource File (ARF) will be merged and analyzed through a series of Ordinary Least Square (OLS) multiple regression analyses to determine whether the implementation of OBRA87 improved nursing home staffing levels and, furthermore, improved the quality of care in nursing homes. This study will provide information about the OBRA87's influence on staffing levels and quality of care in nursing homes. The information will have important policy implications and will provide deep insights into factors important in nursing home markets. ? ?
