Trends in Medicaid nursing home reimbursement: 1978-89.

Medicaid nursing home reimbursement is of concern because of implications for nursing home expenditures. This article presents data on State Medicaid nursing home reimbursement methods, ratesetting methods, and average per diem rates, refining earlier data and updating through 1989. A trend in the early 1980s toward adopting prospective systems played out by the end of the decade.

Transient ST elevation associated with tension pneumothorax.

In a 52-year-old man, a spontaneous right tension pneumothorax was associated with transient bradycardia, hypotension and electrocardiogram (ECG) changes consisting of precordial ST elevation suggestive of acute myocardial injury. Immediately after chest tube placement, the ECG reverted to near normal. Serial cardiac enzymes and isoenzymes showed no evidence of myocardial infarction.