Nursing Home Licensure

There were 3 types of healthcare institutions:

1)Nosocomia- care for the sick

2)Ptochia-Care for the helpless or the poor

3)Gerontochia-Care for the aged

Services were provided by the clergy and religious orders.

The ill were required to perform chores and assist in their upkeep. p1-2

The Act was to provide a supplemental retirement income for working people and their dependents.

It also provided Old Age Assistance (OAA) a form of public assistance to the needy who were 65 yr old and older that lived in the community. p2

Require states to establish a standard setting or licensing agency for nursing homes. p.2

further expands the SS program to pay for medical care for welfare recipients but also to include funds for medical care for the aged. p2

Medicare and Medicaid

This program is assigned to the DHHS. p.3

is essentially an insurance program for the elderly

CMS determines eligibility, handles funds, certifies facilities and individuals who serve as providers of services. p.3

(Clue: FEDERAL-->Obama cares )

is a program that provides health care to the medically indigent. p3

(Clue: STATE--> Aides)

When the Medicare beneficiary reaches maximum treatment benefits (their highest potential) and is no longer expected to improve, they are NOT eligible for further SNF treatment under Medicare. p4

These residents are said to be at a maintenance level (constant level) and are not expected to show significant improvement. p4

NH must be certified after it is appropriately licensed. p5

Any major renovation or new construction MUST have prior approval of the state Medicaid agency and usually the State Fire Marshal. p5

1) Conduct research and recommendations on LTC. p5-6

2)To Study and recommend professional and educational std for LTC

3)To cooperate in obtaining uniformity of the laws, rules, regulations, and procedures

4)To consider, establish, and maintain a uniform code of ethics and std of professional conduct.

1) Develop, impose, and enforce std of licensing

2) Monitor their performances

3) Issue, revoke, or suspend licenses

4) Conduct studies and investigations that will help to improve std. p7

90% of nursing homes are currently operate with dual certification p7

Medicare patients were classified into groups according to diagnosis. The hospital paid a flat rate depending on the diagnosis, without regard to length of stay. As a result hospitals reduced the length of patient stay, and the nursing homes began to admit sicker residents. p9

Hospice is the philosophy and practice of caring for the dying. p12

Their focus should be on enhancing whatever life remains rather that battling illness and warding off death.

Person has less than 6 months to live before they accept the patient.

PT/OT/Speech therapy are considered a skilled service covered by Medicare Part A and managed care replacement policies for a prescribed time. p12

managed care benefit for the frail and elderly 55 and over. p12

1) HMO (Health Maintenance Organizations)

2) PPO (Preferred Provider Organizations)

3) POS (Point-of-Service) p13

These are the Medicare Advantage Plans that a number of HMO's contract to manage Medicare benefits. p13

NOT all plans work the same way.

3 barriers for a Nursing Home:

1) Reimbursement Issues

2) a growing number of placement options

3) never-ending labor shortage p14

1) better cost-control systems in NH

2) NH diversification

3) ensure that the reimbursement rate can cover the cost of providing care.

4)..... p15

Hebrew Nation p16

1) Slowed memory retrieval

2) Increase difficulty in handling change

3) Resistance to change p16

Marked memory loss where the resident can not remember important things in their life.

This leads to confusion and loss of judgment. p17

1) Dementia

2) Delusions

3) Hallucinations

p17

Physical defects

1) loss of visual acuity

2)skin loses its elasticitu, becomes thinner

3) Declining sense of taste and smell

4) problems with balance

5) loss of muscle strength

6) some loss of hearing and more

p17

Physical defects

1)glaucoma or cataracts and age-related macular degeneration

2)shingles or hives

p17

1) Parkinson's disease

2) Dementias like Alzheimer's,

3) depression

4) strokes,

5) glaucoma and cataracts,

6) incontinence,

7) arthritis,

8) osteoporosis,

9) prostate disease,

10) hearth disorders, etc... p17

reduced resilience and the ability to relate to new stimuli. p18

Withdrawl from social contact whether in the aged or others. p18

A reason for being, one of the greatest needs in the American culture. p18

continue throughout everyone's life at all ages, although not always at the same intensity.

Nursing facilities MUST provide privacy to married couples who reside in the facility. p18

The family

p19