38 Notes on Long-Term Care

Long-Term Care Overview

Settings of Long-Term Care Services

• Types of Settings: Home, hospice, community resources (adult day care/mental health centers/senior centers), residential care (assisted living/retirement communities).

Patients of Long-Term Care Services

• Individuals needing assistance with personal care due to chronic conditions, disabilities, or post-acute care requirements.

Regulations Related to Long-Term Care

• Federal and State Regulations: Governed by OBRA (interdisciplinary care planning), OSHA (safe environment), and HCFA (reimbursement mechanisms for Medicare and Medicaid).

Sources of Reimbursement

• Medicare: National health insurance for individuals over 65, adhering to HCFA guidelines.
• Medicaid: State-operated medical assistance for low-income individuals, significant revenue source for long-term care facilities.

Care Types Defined

• Acute Care: Short-term, intensive treatment.
• Chronic Care: Long-term support for ongoing health issues.
• Subacute Care: Transitional care focusing on rehabilitation, between acute and long-term care.

Goals of Long-Term Care

• Patient-centered and individualized approaches to care.

Nursing Care Process

1. Assessment
2. Identify Patient Problem
3. Expected Outcomes and Planning
4. Implementation
5. Evaluation

Interdisciplinary Teamwork

• Collaboration of healthcare professionals to address resident needs, overseen by an administrator and a director of nursing.

Safety Goals (Joint Commission)

• Identify residents correctly.
• Safely manage medications.
• Prevent infections.
• Prevent falls and pressure injuries.