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  1. Boroughs, Deborah S. MSN, RN, NHA


The challenge of delivering care in the long-term care setting has been sharpened in recent years by the increasing diversity of the U.S. population, the increase of the oldest elderly, and the percentage of Medicare patients with disabilities and dementia. The result is a heightened need for more gerontologic nurses. However, as nurses enter the long-term care arena to meet the demand, they experience confusion and frustration with the newly mandated Prospective Payment System (PPS) contained in the Balanced Budget Act of 1997. Under the PPS, accurate assessment and documentation is linked directly to the amount of reimbursement. Reimbursement, in turn, influences the quality of care for geriatric patients and the salaries for nurses. The author discusses the long-term care setting and the history and importance of the PPS documentation and offers a guide for PPS implementation in the long-term care setting.