HA 150 Exam 2 Review Questions
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46 Terms
Does age increase need for LTC
Yes, age increases need for LTC
What determines the need for LTC?
Functional disabilities such as ADL’s and IADL’s
Name the 5 ADL’s
Bathing
Dressing
Toileting
Transferring
Eating
Which ADL’s do nursing home residents need the home help with
Most assistance is needed with transferring, bathing, and toileting
Which ADL’s do assisted living residents need the home help with
Bathing, dressing and possibly transferring. Often have more independence
What are the strengths of todays LTC system
Responds to changing pops
Dedication to caregivers
Development of innovative types of care
Increasing focus on customer service
What are the weaknesses of todays LTC system
Reimbursement driven system
Inequitable distribution of services
Fragmented system
Poor public image
Overshadowed by acute care system
What is post-acute care
A type of care where people who just got out of the hospital are assisted back into ADL’s
Where does post-acute care take place
In either a Inpatient Rehabilitation Facility (IRF) 20% or a Skilled Nursing Facility (SNF) 80%
What is the major payment source of post-acute care
Medicare through DRG bundling
What is an assisted living facility
It's a type of residential community designed for seniors who need help with ADL’s, but don't need the intensive medical care of a nursing home
Where do assisted living facility residents come from and where are they discharged to
Independent living, 1/3 die, 1/3 nursing home care
What is the major payment source for assisted living?
Residents or resident family
What is hospice?
A philosophy and program of care that addresses the needs of end stages of terminal illness. Emphasis on quality of life, pain management (not to cure)
How is hospice paid
Medicare, Medicaid, Donations
What types of diseases are handled in hospice?
Terminal diseases
Is the number of hospices in the U.S. increasing, decreasing or staying the same?
Increasing
Why isn’t hospice used as much as it could be?
Doctors are afraid to tell people they are going to die, Societal resistance to discuss/ deal with death
What is a nursing home?
A place where people with disabilities, chronic conditions and usually stay till death
Who pays for nursing home care
Medicaid
What is a diagnose related group (DRG)
The hospital is paid a flat rate for the entire stay, regardless of actual length or cost of care. This incentivizes efficient care
What is a patient-driven payment mode (PDPM)
A Medicare payment model that pays SNFs based on the clinical characteristics and needs of the patient, not therapy minutes
What is a patient-driven grouping model (PDGM)
A Medicare payment model for home health care that focuses on patient needs and characteristics rather than the volume of therapy visits
What is home health care (HHC)?
Medical care is provided at home for individuals who are ill, injured, or recovering from a hospital stay
How is home health care paid for
Medicare
60 day episode of care
PDGM- patient driven grouping model
Prospective payment
Home health care (HHC) vs Home care (HC)
HHC is medical care provided by licensed workers while HC is not. HHC requires a doctors order and is covered by insurance while HC is not.
Why should there be more government funding available to consumers to utilize home care?
The government should fund it because it is cost-effective, the aging population and better quality of life
How does more funding towards HHC impact the Iron Triangle?
It improves all factors
What is the minimum data set (MDS)
Filled out at every SNF, helps with reimbursement and quality of care (PDPM)
What is the outcome assessment and information set (OASIS)
Self-assessment document filled out by Home health caregivers (PDGM)
What piece of legislation enacted the MDS?
Omnibus Budget Reconciliation Act of 1987
What is an RNAC and why do nursing homes hire them?
Complete and coordinate the MDS assessments accurately and on time and use MDS data to create individualized care plans
What are adult day services? Is the demand growing?
Community-based group programs designed to meet the needs of impaired adults through plan of care, is growing to due aging population and cost effectiveness
What’s the difference between social and medical ADS?
Social ADS = community + structure
Medical ADS = health care + supervision
What is PACE/LIFE?
PACE = all-inclusive care for frail elders to stay at home (Program of All-Inclusive Care for the Elderly)
LIFE = Living Independence for the Elderly (PACE’s name in some states like Pennsylvania)
Why doesn’t every state have a PACE program?
Cost, complexity, and policy choices
What is “direct care work” in LTC?
Direct care workers are the frontline caregivers who assist people with daily tasks and basic health needs. They form the backbone of long-term care
How much training do you need to work as a DCW at a NH
75hrs of training
12hr per year in service training
How much training do you need to work as a DCW at a ALF
None
What are DCWs called in nursing homes?
CNA certified nurse assistan
What are DCWs called in ALF’s?
PCA personal care aid
What are DCWs called in HHC?
HHA home health aid
What is the “crisis” in LTC regarding the workforce?
Chronic staffing shortages in nursing homes, assisted living, and home care
What is “spend down”?
In a SNF, Medicare pays up to 100 days total of care, once they go past 100 day threshold the patient starts paying for everything, they then run out of money and qualify for Medicaid
What is a CCRC?
It's a type of senior living community that offers multiple levels of care on one campus (IL, ALF, SNF)
What entities regulate CCRCs?
A mix of state and federal entities