Health Care Org, Week 10 notes
Health Care Org, Week 10 notes HCA 340 -002
Popular in HEALTH CARE ORG/MGT
Popular in Nursing and Health Sciences
HCA 340 -002
verified elite notetaker
This 6 page Class Notes was uploaded by Loretta Hellmann on Monday April 11, 2016. The Class Notes belongs to HCA 340 -002 at Western Kentucky University taught by Steven W. Maddox in Spring 2016. Since its upload, it has received 26 views. For similar materials see HEALTH CARE ORG/MGT in Nursing and Health Sciences at Western Kentucky University.
Reviews for Health Care Org, Week 10 notes
Report this Material
What is Karma?
Karma is the currency of StudySoup.
You can buy or earn more Karma at anytime and redeem it for class notes, study guides, flashcards, and more!
Date Created: 04/11/16
Week 10 Tuesday, April 05, 2016 9:37 AM Chapter 9 Long-term care Tuesday Introduction Care needs of a lifespan may vary in intensity and duration Level of support required for optimal functioning may vary over time on a continuum Service locations vary with type and intensity of needs… home to institution Services ranges from intense medical to social support, many combinations Formal long term care (LTC) institutionally- based or operated Inform LTC- family, friends 72M 65+ by 2030; 6.6 M 85+ 2020 Long-term care need increase due to medical advanced that increase longevity; changes in social structures that preclude home/informal care Development of Long-Term Care Services Colonial era: almshouses started by charitable colonists who purchased private homes for communal residences 19ths-early 20th century: city, county-operated homes and infirmaries for impoverished older adults; professional home care began as response to living conditions of immigrants (e.g. Visiting Nurse Association) and expanded to education about hygiene, nutrition Great Depression (1929): private citizens boarded older adults for financial benefit; many quality of care issues Social Security (1935): enabled older adults and those with certain disabilities to avoid reliance on charity 1950s: government loans aided not-for-profit nursing home development 1965: Medicare and Medicaid passage had profound effects on the LTC industry Medicare and Medicaid Stimulated home industry development as a profitable businesses Required minimum standards of care for reimbursement Attracted scrupulous and unscrupulous operators Abuses 1970s public exposes': Congressional hearings on inhumane treatment, by Ralph Nader, others e.g. Untrained, inadequate staff Hazardous, unsanitary conditions Over, under-medication Discrimination against minorities Thefts of belongings Reforms Medicare and Medicaid certification State nursing home and home care licensing Appropriate staff credentialing Laws for elder abuse reporting Regulations on restraints Nursing home residents' "Bill of rights" (discrimination, respect, abuse, neglect, ect) Ombudsman programs Modes of Long-term care Service Delivery Institutions such as nursing homes and skilled nursing facilities (SNFS): custodial, chronic care management Community-based: adult day health care, residential group homes, in-home care Skilled nursing care Assisted living facilities Home care Hospice Respite Adult day care Innovations Skilled Nursing Care Skilled nursing facility: (Medicare/Medicaid certified): "a facility or distinct part of one, primarily engaged in providing skilled nursing care and related services for people requiring medical or nursing care, or rehabilitation services" 3.3M reside in 15,884 facilities. 86% are 65+ years Costs Annual national; expenditures: $138.4 B; double cost of home care Medicare, Medicaid pay- 62%; 38% private, out-of-pocket, long-term care insurance Private room= $90,520 a year. Semi-private room 81,030 a year Occupancy declining: more assisted living, community support options, staying healthy longer Staffing Administrator Medical director Registered nurses and licensed practical nurses Certified nurse assistants Social workers Nutrition and dietary staff Rehabilitation (PT, OT, ST) Recreational/ activities Housekeeping/ plant and facilities 1987 OBRA increased government regulations re: periodic functional assessments of residents, aide training, restraints, bill of rights, medical director oversight States licensure administrators Analyses indicate quality variations between for-profit and not-for-profit entities ACA: certified SNFs must publicly disclose ownership information, expenditures, quality indicators on the web Assisted Living Facilities Appropriate for people not require skilled nursing whose needs lie in the custodial and supportive realm: "a program that provides and/or arranged for daily meals, personal and other supportive services, health care and 24 hour oversight to persons residing in a group residential facility who need assistance with the activities of daily living" Includes residential group homes of developmentally disabled, physically challenged Single home to multi-unity apartments 6,315 communities with 472,000 apartments housing 1 million+; growth projected to 2M+ by 2030 Primarily personal payment; varying costs; average monthly cost- $3,326 State regulations vary; quality is function of ownership policies coupled with regulation Home Care Community-based care provided in private residences; long-term or chronically ill; short-term for rehabilitation after illness or hospitalization Formal system: agency-employed professionals or self- employed who contract privately with clients Agency rapid growth following Medicare reimbursement in 1965; by 1987 5,900+ dominated by public health agencies; 1990s growth again: Olmstead decision (right to care in community), MC and MA changes, evolving demographic and technology advances expanded care in homes 3.4 M Medicare receipts among 11,900 agencies, 70% are for profit, $74.3 B annual costs; MC and MA covered 81.4% total expenditures Medicare reimbursement initial criteria: professional nursing; allied health services; home confinement; physician order; agency certification; ACA include added patient assessment requirements to guard against fraud Additional ACA provisions support home and community based care: "Medicaid follows the person" for home and community services for individuals transitioning from institutional to home care "Community First Choice Options in Medicaid", "State Balancing Incentive Program", "Federal Coordinated Health Care Office." all these to encourage community based over institutional care Medicare and Medicaid certification require agency state licensing; accreditation by private organizations, e.g. the Joint Commission is voluntary Extensive research 2000-2010 from multiple sources documents cost-effectiveness of home care compared with institutional care for conditions requiring IV antibiotic therapies, diabetes, chronic obstructive pulmonary disease and congestive heart failure
Are you sure you want to buy this material for
You're already Subscribed!
Looks like you've already subscribed to StudySoup, you won't need to purchase another subscription to get this material. To access this material simply click 'View Full Document'