Role of the CNA
Payers in Healthcare
Definition of Payers: Individuals or organizations responsible for paying for healthcare services. Examples include:
Insurance Companies
Government Agencies: Such as Medicare and Medicaid
Individuals
Health Maintenance Organizations (HMOs)
Preferred Provider Organizations (PPOs)
Long-Term Care (LTC)
Definition: Facilities providing long-term skilled care.
Previous Terminology: Formerly known as Nursing Homes.
Current Terms:
Skilled nursing facilities
Rehabilitation centers
Extended care facilities
Assisted Living
Definition: Residences for individuals requiring some help with daily care but do not need 24-hour skilled care.
Acute Care
Definition: Medical care provided in hospitals and ambulatory settings for illnesses or injuries.
Outpatient Care
Definition: Care that does not require an overnight stay in a medical facility.
Rehabilitation
Definition: Services including physical, occupational, and speech therapy.
Policies and Procedures
Policy: A defined course of action to be followed in specific situations (e.g., handling confidentiality).
Procedure: A method or guideline for how to perform certain tasks (e.g., filling out a form, submission procedures).
Medicare Information
Definition: A federal government insurance plan for individuals aged 65 or older or those with certain disabilities or illnesses.
Parts of Medicare:
Part A: Covers hospital care, skilled nursing facilities, home health care, and hospice care.
Part B: Provides coverage for doctor services and other necessary medical equipment and services.
Part D: Assists with the costs of prescription medications.
Funding: Primarily funded by the federal government with contributions from each state.
Eligibility and Coverage: Varies based on income and specific circumstances; requires individuals to qualify for Medicaid.
Providers in Healthcare Systems
Definition of Providers: Individuals or organizations that deliver healthcare.
Examples of Providers:
Facilities: Locations where care is administered (e.g., hospitals, clinics).
Home Health Care: In-home care often for elderly or chronically ill patients wishing to stay at home.
Adult Day Services: Out-of-home services that provide respite care.
Acute vs. Chronic Conditions: Distinction between short-term and long-term medical issues.
Hospice Care: Specialized care for patients with terminal illnesses.
Policies and Procedures Practice
Examples: Determining if statements are policies or procedures:
Nursing assistants will not perform tasks outside their job description. (Policy)
Nursing assistants must arrive on time in approved uniforms. (Policy)
Incident forms post-fall to be completed quickly and placed in the supervisor’s office. (Procedure)
Nursing staff must clock in using the designated time clock. (Procedure)
Definitions of Healthcare Roles
Roles and Responsibilities:
Nursing Assistant (CNA): Viewed as the "eyes and ears" of the healthcare team, providing essential care and supervision.
Registered Nurse (RN): Coordinates, manages, and provides skilled nursing care.
Licensed Practical Nurse (LPN/LVN): Administers medications and treatments.
Physical Therapist: Focuses on increasing movement and mobility.
Speech Therapist: Provides care for communication and swallowing disorders.
Registered Dietitian: Assesses nutritional needs and treatment plans.
Medical Social Worker: Assists patients in accessing support services like counseling and financial aid.
Activities Director: Plans social and recreational activities for residents.
CNA Certification and Training
CNA Definition: Certified Nurse Aide proficiently certified by the Department of Aging and Disability Services (DADS) in Texas.
Certification Requirements:
Completion of a training course.
Passing a written examination.
Successfully demonstrating skills.
Employment Settings: CNAs can work in hospitals or long-term care facilities.
Duties and Responsibilities of a CNA
Providing a Safe Environment:
Ensuring physical safety of residents.
Addressing psychosocial needs of residents.
Fulfilling Responsibilities:
Meeting residents' individual needs.
Reporting any issues to supervisors promptly.
Maintaining cleanliness and confidentiality in all practices.
Actively participating in educational programs.
Person-Centered Care:
Recognizing that individuals have unique values and rights to dignity and respect.
Actively listening to residents' needs and preferences and integrating these into care plans.