Few pieces of American legislation evoke as many raised eyebrows and quizzical looks in non-Americans as does the Omnibus Budget Reconciliation Act of 1987 (OBRA-87). Incorporated into this legislation is the Nursing Home Reform Act, which contains guidelines for establishing a better environment and better care for nursing home residents. Certainly, some of the provisions focusing on nutrition, improved staff education, and the collection and evaluation of data have resulted in improved care, but the provision that regulates the prescription of psychotropic medications has received mixed reviews.