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Flashcards in Lecture 2 Deck (35):
1

What model is the basic expectation from medical care that it will make a difference. Why geriatric care can be frustrating because their conditions may not get better.

Therapeutic model

2

What model is usually associated with social services. Plan of care developed to address identified deficits and allows patient to enjoy as normal a lifestyle as possible.

The Alternative Model

3

What are 2 things that a good geriatric care requires?

Communication
Rely on other healthcare professionals

4

Insurance-type program
People are entitled to after contributing a certain amount

Medicare

5

A welfare program
Eligibility based on need/poverty
To become eligible
Must prove illness
Exhaust personal resources
Big payer of nursing home care

Medicaid

6

what public program is associated with nursing homes

medicaid

7

is medicare all inclusive?

No, out-of pocket expenses still >20% income

8

If you don't enroll in Medicare when you are 65 what will happen?

10% fee for each 12-month period that you could have had medicare Part B but didn't take it

9

What is medicare- part A?

Hospital insurance
Covers most medically necessary hospital, skilled nursing facility (100 days worth), home health and hospice care

10

when can you get on medicare part A?

free if you have worked and paid Social Security taxes for at least 40 calendar quarters (10 years)

11

if there coverage for medications for medicare part A?

No

12

Medicare part A covers 20 days of skilled nursing then facility after a hospitalization of at least 3 days 100% for the first 20 days and __% for the last 80 days

80

13

do you have to pay for medicare part B?

Yes, monthly premium

14

Is there pharmacy coverage with medicare part B?

No

15

what medicare cover prescription drug coverage. Provided only through private insurance companies that have contracts with the government- it is never provided directly by the government

Medicare D

16

Allows private health insurance companies to provide Medicare benefits
Must offer at least the same benefits as Original Medicare

Medicare C "Medicare Advantage Plans"

17

what is the major public payer for long-term care?

Medicaid

18

In order to get medicaid what must you have?

Nothing

19

Medicare gives the same amount of compensation per admissions based on the ____________

admitting diagnosis- Diagnosis-related group (DRG)

20

Does medicare cover readmissions within 30 days?

No

21

Medicare does cover ____-acute care

sub

22

A level of care or rehabilitation that no longer requires inpatient admission but cannot be provided at home

Subacute care settings (ex- skilled nursing facilities "SNF")

23

Some eligibility for sub acute care?

IV meds
enteral tube feedings
Wound care
PT and OT (show certain amount of activity first)
chemo
dialysis
TPN
ventilator support

24

A range of services that addresses the health, personal care and social needs of individuals who lack some capacity of self-care

long term care setting

25

Is most long term care provided by a health care professional?

No

26

who is most homecare provided by?

family/ friends with or w/o formal caregivers

27

for medicare coverage, physician must certify that the patient is homebound and that intermittent skilled care is necessary and needs to be provided by who?

nurse, PT or ST (speech therapist)

28

what is PACE?

Program for All-Inclusive Care for the Elderly

29

What does PACE do?

freestanding adult health center with pharmacy, recreational therapy, PT, OT and a full service medical clinic

30

Who qualifies for PACE?

Over 55, live within the area, be eligible for nursing home care and demonstrate ability to live safely at home when not at a PACE center

31

With increase use of skilled nursing facilities, ____________ are seeing decrease in long-stay business

nursing homes

32

Issues with nursing homes

Hard to get PMH
first contact with acute changes not by skilled provider
lack of advanced directives

33

Patients admitted to a nursing home must receive physician assessment within _______ of admission and then every _________

48-72 hours
30-60 days

34

what must be sent with the patient to the nursing home?

A copy of the patient’s entire record from a hospitalization and any recommendations and physician orders

35

how often must a licensed nurse assess each resident?

Daily