CNA ch.1

providers

people or organizations that provide health care, including doctors, nurses, clinics, and agencies

facilities

places where health care is delivered or administered, including hospitals, long term care facilities, and treatment centers

payers

people or organizations paying for healthcare services

long term care (LTC)

care given in long term facilities for people who need 24 hour skilled care

skilled care

medically necessary care given by a skilled nurse or therapist

length of stay

the number of days a person stays in a healthcare facility

terminal illness

a disease or condition that will eventually cause death

chronic illness

a disease or condition that is long term or long lasting and requires management of symptoms

home health care

care that is provided in a person’s home

diagnoses

medical conditions determined by a doctor

assisted living

residences for people who do not need 24 hour skilled care, but do require some help with daily care

dementia

general term referring to a serious, progressive loss of mental abilities such as thinking, remembering, reasoning, and communicating

adult day services

care for people who need some assistance or supervision during certain hours, but who do not live in the facility where care is given

acute care

24 hour skilled care given in hospitals and ambulatory surgical centers for people who require short term, immediate care for illnesses and injuries

subacute care

care given in a hospital or in a long term care facility for people who need less care than for an acute illness, but more care than for a chronic illness

outpatient care

care given to people who have had treatments, procedures, or surgeries and need short term skilled care

rehabilitation

care given by specialists to help restore or improve function after an illness or injury

hospice care

holistic, compassionate care given to people who have approximately six months or less to live

managed care

a system or strategy of managing health care in a way that controls costs

health maintenance organizations (HMOs)

a form of health insurance in which the cost of care is covered only when a person uses a particulare doctor or group of doctors except in case of emergency; seeing specialists generaly requires referrals from the primary doctor 

preferred provider organizations (PPOs)

a form of health insurance in which patients are encouraged to recieve care from a network of approved providers, but can see other providers at an additional cost; patients cant usually choose their providers, including specialists, without being referred by another doctor

what is inked in red in this diagram

providers, facilities, payers

what is blocked in red in this diagram

doctors, nurses, clinics, agencies 

what is blocked in red in this diagram

hospitals, long term care facilities, treatment centers

what is blocked in red in this diagram

medicare, medicaid, insurance compancies, individuals, employers

what is blocked

overall high costs

what is blocked in red

HMOs, PPOs, managed care

what is blocked in red

hospital high costs

what is blocked in red

long term care facilities, home health care

what are the major changes that have a serious impact on how health care is provided

• increased use of expensive tech

• rising costs of healthcare

• new ways to control costs of care

activities of daily living (ADLs)

daily personal care tasks: bathing, skin, nails, hair care, mouth care, walking, eating, drinking, dressing, transferring, and elimination

catheter

a think tube inserted in the body to drain fluids or inject fluids

what percentage of residents in LTC facilities are over the age of 65

83.5%

what percentage of residents in LTC facilities are female

68%

what percentage of residents in LTC facilities are white and non hispanic

75%

what statistic of residents in LTC facilities are from a private residence

1/3

what percentage of residents in LTC facilities come from a hospital or other facility

50%

what percentage of residents in LTC facilities have dementia

48%

residents with a length stay of six months or more make up how many of total residents

2/3

residents with a length stay of six months require what type of care

24 hour care

residents with a length stay of six months have what reason for staying

did not have caregivers able to give enough care at home

residents with a length stay of six months or more have what type of disability

developmental disabilities

the group with the ____ average stay is made up of people who are developmentally disabled

longest

residents with a stay of less than six months may be admitted for what type of care

terminal care (will die in facility)

residents with a stay of less than six months may be admitted for what type of reason

rehabilitation or temporary illness (will recover and return to community)

many residents lack ___ support. This means it is very important to care for the ____ person - addressing ____ and ____ needs as well as ___ needs

outside, whole, social, emotional, physical

policy

a course of action that should be taken every time certain situation occurs

procedure

a method or a way of doing something

according to common policies and procedures in long-term care facilities: what type of information is confidential

all resident info

according to common policies and procedures in long-term care facilities: what care plan must be followed

resident’s care plan

according to common policies and procedures in long-term care facilities: what type of tasks can be performed

tasks in job descriptions

according to common policies and procedures in long-term care facilities: who do NA’s report to

a nurse

according to common policies and procedures in long-term care facilities: what types of problems can NAs discuss with residents or families

no discussion of personal problems

according to common policies and procedures in long-term care facilities: what can NAs not accept from residents or families

money or gifts

according to common policies and procedures in long-term care facilities: what is expected of NAs when attending work

must be on time and dependable

what steps should be taken if an NA is unsure about policies or procedures

ask questions or review procedure manual

cite

in a long term care facility, to find a problem through a survey

joint commission

an independent, not for profit organization that evaluates and accredits healthcare organizations

what are surveys

regular inspections performed in facilities to make sure they are following state and federal regulations at least every three years

surveys conducted to the join commission are not affiliated with ___ inspections. facilities participate in joint commission surveys are on a ___ basis

state, voluntary

surveyors use these methods to study residents’ care and determine how their needs are being met:

• interview residents and their families

• observe staff interactions with residents and care given

• review residents’ charts

• observe residents’ meals

centers for medicare and medicaid services (CMS)

a federal agency within the US department of health and human services that is responsible for medicare and medicaid, among many other responsibilties

medicare

federal health insurance program for people who are 65 and older, have certain disabilities or permanent kidney failure, or are ill and cannot work

medicaid

a medical assistance program for people who have low income, as well as for people with disabilities

medicare part a - hospial insurance

helps pay for care in a hospital or skilled nursing facility or for care from a home health agency or hospice

medicare part b - medical insurance

helps pay for doctor services and other medical services and equipment

medicare part c - medicare advantage plan

allows for private health insurance companies to provide medicare benefits

part d - prescription drug coverage

helps pay for medications prescribed for treatment

what is an important factor that is set in place for medicare coverage

will only pay for care that it determines to be medically necessary

who funds medicaid

federal government and each state

medicare and medicaid work with long-term care facilities in these ways:

• LTC facilities receive a fixed amount for services provided

• services are based on the resident’s needs upon admission and throughout the facility stay

culture change

a term given to the process of transforming services for elders so that they are based on values and practices of the person receiving care

what are the core values of culture change

• choice

• dignity

• respect

• self-dtermination

• purposeful living

person-centered care

a type of care that places the emphasis on the person needing care and his or her individuality and capabilities

description of person-centered care:

• emphasized individuality of person who needs care

• each person’s background, culture, language, beliefs, and traditions are respected

• improving each resident’s quality of life is an important goal

trauma-informed care

an approach to patient care that recognizes that people may have experienced trauma in their lives so trauma, experiences, and preferences should be considered while providing care

what are the four Rs in the TIA approach

• realization: understand how trauma can affect the individual

• recognize: people in the organization recognizes signs of trauma

• responds: the organization or care team responds by applying the principles of TIA approach to all areas of providing care

• resist Re-traumatization: seek to resist exposing the individual to re-traumatization