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27 Cards in this Set
- Front
- Back
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What is the difference between long-term care and chronic care?
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The is no difference; can be used interchangeably.
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Definition of long-term care
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extended type of care that is required for long periods of time, with temporary, short-term breaks, but which goes on for most cases, for the remainder of the individuals life.
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What caused LTC to develop?
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It started as almshouses, poor farms, for those whose family members were no longer willing or able to take care of them. The following are how LTC came about:
-growing role of government in financing -increasing regulations -results of past successes -effort to reduce healthcare costs |
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Formal caregiver
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are staff members of healthcare organizations
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Informal caregiver
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do so as a matter of personal or familial obligation, friendship, or simply the desire to help someone less fortunate
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What is the spread of years for the baby boomers?
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1946-1964
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Weaknesses of LTC
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-A reimbursement driven system
-Inequitably distributed services -a fragmented and uncoordinated system -a mix of health and social services -multiple points of entry into the system -overshadowed by acute care -poor public image -inadequate support for informal caregivers -a confusing and "user-unfriendly" system |
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Define subacute care.
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is a relatively new and rapidly growing medical care service in America. It focuses upon care after a serious illness in a hospital; provides high-tech hospital-like medical care to seriously ill patients of all ages. Generally, the individual's condition is such that the care does not depend heavily on high-technology monitoring or complex diagnostic procedures.
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Difference in categories of subacute care.
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rehab
physical and occp therapy respiratory therapy cardiac rehab speech therapy postsurgical care chemo total parental nutrition dialysis pain management complex medical care wound management ventilation care |
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When does a care plan begin?
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the care plan begins with a detailed assessment of each patient on admission to a facility.
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What is case management primarily concerned with?
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while case management is concerned with the type and quality of care received, case management's primary goal is the cost-effectiveness of the care given
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Reimbursement for subacute care
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Most reimbursement comes from Medicare, Medicaid, and managed care orgs with a small amount from other insurance groups
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Medical model of care
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simply means that the care given is determined by physicians and is aimed at repairing clinical conditions or diseases or overcoming the results of accidents or other "medical misadventures"
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Social model of care
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on the other hand...this deals with people who have a variety of conditions--medical, social, financial. The focus is on care not cure.
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How did adult day care start?
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ADC developed from the concept of respite: providing a short reprieve from the responsibilities of caregiving for those who have a family member living with them who needs constant care and supervision.
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What is OASIS?
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Outcome and Assessment Info Set: a method of collecting and monitoring data to improve outcome measures in home health care.
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What is the largest caregiver in home health?
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Nurses. RN and LPN
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How did home health agencies begin?
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They started as visiting nurse services that often supplemented the work of physicians when they use to make house calls. They eventually became free-standing and become more independent when 3rd party reimbursement became more available.
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What does Medicare cover for Home Health?
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Medicare pays for 37% of home health expenditures. With PPS, Medicare pays HH providers for each 60-day "episode of care." The amount paid for that 60-day period is a set amount based on a standard rate and adjusted for the type and intensity of care provided, in what is known as a case-mix formula. There are 153-category case-mix.
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What doesnt Medicare cover for Home Health?
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It does not cover 24-hour care, prescription drugs, meals delivered to the home, homemaker services, and personal care if that is the only care needed.
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What does Medicare require from Home health>
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Medicare requires them to comply with state and local regulations. Medicare reimbursement must be certified by them and must comply with certain conditions of participation.
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Is adult day care covered by Medicare?
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No
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What are acuity levels in nursing homes?
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finding the most cost-effective, high quality care.
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Are nursing homes more men or women?
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Women make up 3/4 of residents.
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What is one of the factors in the growth of subacute care?
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Managed care
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What is the average age of assisted living residents?
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Average age of 85, with 76% women
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What was OBRA?
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Omnibus Reconciliation Act: set much more rigid national standards to which state Medicaid programs and the providers they oversee must adjust.
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