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Flashcards in Comm Health CH. 37 Deck (37):
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Home health care

Service enable individuals of all ages to remain in the comforts and security of their homes while receiving health care

1

Services of home health care include:

Skilled nursing
Physical therapy
Psychiatric therapy
Pain education and management
Speech language therapy
Occupational therapy
Social services
Intravenous therapy
Nutritional support
Respiratory therapy
Acquisition of medical supplies and equipment
Home health aid
Homemaker and companion care

2

OFFICIAL home care perspective

Individuals and their facilities receive services in their place of residence for the purpose of promoting, maintaining, or restoring health, or of minimizing the effects of illness and disability

3

PATIENT home care perspective

Skilled and compassionate care provided on a one to one basis in the comforting and familiar surrounding of the home

4

FAMILY home care perspective

To keep the family of ether as a functioning integrated unit

5

PROVIDER Home care perspective

Challenges all disciplines involved to provide excellent care in often less than excellent conditions and surrounding

6

What was home care formerly defined as?

Providing physical care to the sick in their homes

7

The first home health care program in the U.S. was organized WHEN? And as WHAT?

1796

The Boston dispensary

8

The first visiting nurse service in the U.S. Was formed where and when??

1886
Philadelphia

9

Lilan wald and Mary Brewster developed a visiting nurse service for the poor in WHAT CITY and WHEN at WHERE?

NY city
1893
Nurses' settlement house on Henry street

10

When was the visiting association formalized, and public health departments became widespread?

1800's and early 1900's

11

Types of home care agencies

The a fence typically has to comply with the federal, state, and local laws and regulations via the following :

Licensure by the state
Certification by state certifying body that the federal government designated
Certificate of need
Accreditation

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Licensure

Gives legal permission to operate within the state only

13

Certification

Federal government set of rules governing certification (a process in which the government evaluates and recognizes an individual, institution, or educational program as meeting certain standards)

Only certified agencies are permitted to receive Medicare payment

14

Accreditation

A process whereby a professional association or nongovernmental agency grants recognition to a school or institution for demonstrating ability in a special are of practice or training) from the national league of nursing community health accreditation program, joint commission, commission on accreditation or rehabilitation facilities (CARF)

15

Changes in home health care

Medicare is reimbursing psychiatric nurse clinicians for home visits

Social workers are taking a more active role in home health care

Most agencies are obtaining a separate Medicare certification to provide hospice care

Pet care programs

Electronic home visits

Infusion therapy is one of the most rapidly growing segments in home health care

16

Skilled nursing

Provided and directed by RN

LPN/LVN is permitted to provide basic nursing services under the supervision of the RN

17

Service goals of a skilled nursing services

Restorative: return to previous level of functioning

Improvement: achieving better health

Maintenance: maintain current level of health

Promotion: teach healthy lifestyle

18

Role of the LVN/LPN

Independent practice NOT allowed, but self- direction
Motivation
Creativity
Clinical proficiency
flexibility
Compassion
Empathy
And patience are essential

19

Physical therapy

Goal of treatment must be restorative for Medicare reimbursement but may be maintenance or preventive for other payer sources

20

Speech- language therapy

Therapy goals include minimizing:
Communication disorders
Physical, emotional, and social impact

Independent functioning and maximum rehabilitation of speech and language abilities are primary treatment goals

21

Occupational therapy

Deal with life's practical tasks
Assist to restore functional level
Services include:
Techniques to increase independence
Design, fabrication, and fitting orthotic or self-help devices
Assessment for vocational training

22

Medical social service

Services are provided by social workers prepared at the master's level
Focus is on EMOTIONAL AND SOCIAL aspects of illness
The care plan includes education, counseling, payment source identification, and referrals

23

Homemaker- home health aide

Provides the basic support services that can enable an elderly individual, disabled adult, or dependent child to remain at home.

3 categories:
Personal care
Physical assistance
Household chores

24

Referral

Entry point into the home health care system

Done by:
Patient
Family
Social service agency
Hospital
Physician,
Other agency

25

Admission

-Physicians order must be obtained
-The INITIAL evaluation and admission visits are made by an RN 24-48 hours of referral

26

Evaluation of admission process (10)

-complete patient evaluation
- environmental assessment
- identification of primary functional impairments
- assessment of support system
Determine knowledge and adherence to treatments and medication
-determine desire of care and services
- involvement of the patient and family in the development of the plan of care and goals
Notification to the patient of rights as a patient, along with costs, payment sources, and billing
- explanation of the patients right to self- determination
- provision of initial nursing interventions

27

Care plan

-Planning the patients health care
-Physician is contacted for specific orders before delivery of care
- plan describes:
Current physical status of the patient
Medication
Treatments
Frequency and duration of services
Outcome

28

Documentation

- concise and complete documentation is essential
- it may be hand written, dictated, or entered into a computer

29

Discharge planning

-Planning begins with admission
- when patient goals or other specific criteria are met, the discharge occurs

30

Medicare

Base on old age
- this federal program requires agencies to be certified
- 65 years or older, disabled, or have end- stage renal disease
- must be under the care of a licensed physician, homebound, and in need of skilled nursing therapy

31

Medicaid

Based on low income
- this pays for home care services to indigent and low- income people of all ages
- services vary from state to state

32

Third party

Limited home care services are paid for

Converge, requirements, and payment rates vary

Reimbursement is often tied to post hospitalization recoveries

33

Private party

Pay directly for home health services

34

Health maintenance organization (HMOs)

Preferred provider organizations (PPOs)

Prepaid health plans operated independently or through employer groups

35

LVN scope of practice in home care

-check patient on regular basis
- give medications
- assist with ADL's
- wound care
- document
- work together with the rest of the health team helping the patient

36

Diagnosis- related groups (DRGs)

Pats a set rate for hospitalized patients care rather than the cost or charges)