fundamentals 2nd test.txt


To qualify for coverage by medicare, a health maintenance organization (HMO), or various types of insurance, it is necessary for the patient to be?


?home-bound? meaning unable to leave the home or requiring a great deal of effort to travel for appointment to see the health care provider.


What are the four different perspectives for home health care?


Perspectives: Official, patient, family, and providerPerspectives for what?


What are the reasons for home health care?


Reasons: Longer life span, more disease/conditions requiring care, shorter hospital stays, women working outside the home, unserved/underservedWhat are these reasons for?


When and who organized the earliest organized systems for home care?


1617 by st. Vincent de Paul. Named: sisterhood of the Dames de ChariteWhat is this?


Sisterhood of the Dames de Charite


Earliest organized system for homecare developed in 1617 by St. Vincent de PaulName?


What, when and where was the first home care program in the US?


1796 as the Boston DispensaryWhat?


when was medicare and medicaid started?


both insurances's were started in 1965which insurance's were started then?


Medicare's title is?


title XVIIIknown as?


medicaid's title is?


title XIXknown as?


Metropolitan Life insuranc ecompany started in?


it started in 1909what started then?


Home health care


Services enable individuals of all ages to remain in the comfort and security of their homes while receiving health care.


DRG;s


Diagnosis-related groupsAbbrev?


CDC


centers for disease control and preventionabbrev?


what degree does a speech language therapist need?


they need a masters degree like medical social serviceswho does?


what degree does medical social services need?


they need a masters degree like speech language therapistwho does?


what degree does occupational therapist need?


they need a bachelors degreewho does?


what are the two programs medicare has developed tat promise to allow older adults with health care needs to continue living at home while receiving services?


programs called :prgram of all-inclusive care for the elderly (PACE) ans social managed care planwho started these programs and why?


PACE


program of all-inclusive care for the elderlyabbrev?


Diagnosis-related groups


Pays a set rate (according to diagnosis) for the hospitalized patient?s care rather than the ?cost,? or charges an institution traditionally bills according to its own schedule of fees. This also leads to sending patients home earlierWhat does?


Licensure


States gives permission for agency to operate with thisWhat is this?


Certification


A process in which the government evaluates and recognizes an individual, institution, or educational program as meeting certain predetermined standards


Accreditation


A process whereby a professional association or nongovernmental agency grants recognition to a school or institution for demonstrated ability in a special area of practice or training


Medicare model of services include:


Skilled nursing, PT, ST, OT, medical social services, and homemaker-home health aide


What are the major goals of skilled nursing?


Restorative, improvement, maintenance, promotion


Restorative


Return to a previous level of functioning as appropriate and realisticTerm?


Improvement


Achieving better health and a higher level of functioning than at admissionTerm?


Maintenance


Preserving functional capacities and independence by maintaining current level of healthTerm?


Promotion


Teaching healthy life styles that keep the effect of illness or disability to a minimum and prevent the recurrence of illnessTerm?


What is the typical home health process?


Referral, admission, care plan, visits, documentation, and discharge planningWhat is this?


What does referral entail in the home health process?


It entails entry point, from pt/family or social worker, hospital, physician or another agencyWhat entails this?


HHA?


Home health aide ? referred as this by MedicareAbbr?


Home health aide


Integral part of the home health care team. Provide the basic support services that sometimes enable an elderly individual, disabled adults, or dependent child to remain at home.


When does discharge planning occur?


This begins on admission


Why is documentation important?


It is important because if you do not document it, it means that you have not performed that task


How long would it take a pt to be admitted with a referral for a home health admission?


RN makes initial evaluation and admission is within 24-48 hoursAdmission to where?


Nursing process


Assessment, nursing diagnosis, expected outcomes and planning, implementation, evaluation


First step of Nursing process


Assessment - Consider the patient and the family members.


Nursing diagnosis


Part of nursing process ? focus on the family?s ability to cope with the illness of the family member


Third step in nursing process


Plan ? teaching (pt centered) goals: self care/independent functioning. Work with the family in setting goals


Fifth step in nursing process


Be prepared to revise plan as needed (revising interventions)


Medicare


Federal program that requires agencies to be certified as meeting the federal condition of participation, which set forth specific requirements for organization, staffing, training, types of services covered and agency evaluation


Medicaid


Program pays for home care services to indigent and low income people of all ages


Medicaid is also known as?


MedicalIs also known as?


Long term care


Defined by the American nurses association as the provision of physical, psychological, spiritual, social and economic services to help people attain, maintain, and regain their optimum level of functioning.Term?


Quality of life


Measure of the optimum energy or force that endows a person with the power to cope successful with the full range of challenges he or she encounters in the real worldTerm?


What settings are considered long term care settings?


Home, hospice, palliative care, adult day care, residential care settings, assisted living, institutional settings, continuing care retirement communitiesAre all considered?


ADL?s


Activities of daily livingAbbrev?


Hospice


Agencies provide services to patients and families as the end of life approaches. For any age groupTerm?


Palliative care


Extends the principles of hospice care to a broader population that has the possibility to benefit from the comfort care earlier in their illness or disease process.Term?


Adult daycare


Community-based programs designed to meet the needs of functionally or cognitively impaired adults through supervised health care and social and recreational activitiesTerm?


What are the typical services offered by adult daycare centers?


Offer: transportation, social services, meals, nursing interventions, personal care, counseling, therapeutic activities, rehabilitation therapies.Who offers all this?


Residential care


Settings serve primarily an older adult population, offering a wide variety of servicesTerm?


Assisted living


A type of residential care setting in which the adult pt. rents a small one bedroom or studio type apartment and has the option of receiving several personals care services such as bathing dressing and taking meds. Term?


Instrumental activities of daily living


Complex daily tasks such as shopping and using the phoneTerm?


IADL?s


Instrumental activities of daily livingAbbrev?


CCRC


Continuing care retirement communityAbbrev?


Continuing care retirement community


Complete range of housing and health care accommodations from independent living to 24 hour skilled nursing care. This is a lifetime commitmentTerm?


What are key features of assisted living?


Features: Services and supervision available all the time. Services to meet scheduled and unscheduled needs, promote independence, emphasis on resident?s dignity, autonomy, and choice, privacy and a home like environment.Features of what?


Subacute unit


Type of institutional setting that has become extremely popular since the late 1980s when the advantage became clear of providing less expensive alternative to acute care when pts have higher needs for nurses. Stronger rehab focus, short length of stay and nearly same level of care as in the hospital


Resident


not a patient. One who stays in nursing home or extended care facility, Usually admitted for cardiovascular disorder, cognitive impairment, incontinence, inability to perform ADL?s, single/widowed.Term?


Restorative nursing care


Basic concepts of physical therapy for maintenance of functional mobility and physical activity Term?


What is the goal of long term care?


Plan of care that accurately reflect the resident?s needs and goals and as much as possible, retains life as it was at home


OBRA


Omnibus Budget Reconciliation Act of 1987Abbrev?


Which is the Act of 1987?


OBRA ? omnibus budget reconciliation actWhat year is this act from?


Omnibus Budget Reconciliation Act


Defines requirements for the quality of care given to residents and covers many aspects of institutional life, including nutrition, staffing, qualifications required of personnel, and many others. This was very beneficial to residents


OSHA


Occupational Safety and Health AdministrationAbbrev?


Occupational safety and health administration


Federal organization that provides guidelines to help reduce safety hazards in the workplace. Long-term care facilities, like all other health care providers, come under the regulation of this. This also significantly increases the cost of care in this setting but ensures a safe environment for the personnel.


Ethical issues related to long-term care


Ethical issues: Adherence to a patient?s bill of rights, advance directives, DNR orders, power of attorney, guardianship and responsible party designationIssues to what?


Resident assessment instrument


An instrument OBRA prescribed the method of resident assessment and care plan development Name of instrument ?


RAI


Resident assessment instrumentAbbrev?


What are the parts of RAI?


Parts: Minimum data set (MDS), resident assessment protocols (RAPs) and the utilization guidelinesParts to what?


RAPs


Resident assessment protocolsAbbrev?


MDS


Minimum data setsAbbrev?


RAPs


Assessment guides that address common clinical problems, such as delirium, falls, and urinary incontinenceWhat?


What is the purpose of RAI?


Purpose: lead to improved care planning and provision of care for long-term care facility residentsPurpose of what?


Assessment for long term care resident?


Similar as regular assessment with the addition of having 30 day summary and 90 day reassessment


MNA


Metropolitan nursing associationAbbrev?


What and when was the first organized nursing service?


Started in 1859 and named Metropolitan nursing associationWhat is this?


What are Lillian Wald and Mary Brewster known for?


In 1893 they did visiting nurse service for the poor in NYWho is they?


Metropolitan life insurance company


It started in 1909, began offering nursing services to policy holdersWhat started?


Social security act


Started in 1935, 1st provided governmental rather than charitable funding for selected servicesWhat did?


Case management


RN/social worker who determines/ arranges for mix home care, therapy services, counseling, supplies, equipment for patient and allows earlier dischargesWhat is this process called?


Different types of home care agencies


Voluntary, official, combination, hospital, proprietary, private not for profit, and otherWhat are all of these?


What are the steps to break through cultural barriers to communication?


Step 1. Assess your attitudes about ppl from other cultures. Step2 assess comm. Variables from a cultural perspective. 3 modify comm. to meet cultural needs 4. Respect the pts and his or her communicated needs. 5. Communicated in a nonthreatening manner. 6. Use interpreters to improve comm.Steps to what?


HCFA


health care financing administrationabbrev?