Jewel_UNIT 1_ Health Care Organization Post-acute Care

kms013's version from 2016-02-01 16:10


Question Answer
Post acute care is everything after...going to hospital for acute issue
Hospitials developed initially, feed, let people die there w/o care
WE have evolved in health care long term care delivery system when...people had insurance, could pay for health care
2 common ways of "going too far"/abusing health care as a provider:saying you deliever something you don't 2. exagerrating the need the pt has for the service you provide
Types of post acute care:informal care, formal care
what are examples of informal care?families, voluntary agencies (Heart Association, etc--- they have a wealth of research/resources);
characteristics of informal caregivers: WORKING WOMEN: 61% of women, 58% are b/w ages of 18-49, 59% work full/part tiem outside home; 5/6 caregivers rate their health as excellent, very good, or good
characteristics of recipients of informal careOLD PEOPLE: 65% are female and 42% are widowed; 80% are at least 50 yo; avg age is 66; Most common reason for informal care for older recipients is "old age" and for younger recipients it is mental illness or depression
caring for family vs doing what you need to do....divided loyalty
formal care examples:professional services (PT, OT), non-professional services (CNA --limited scope so not considered in the skilled/professional mix), residential services (provide you shelter/food)
Questions to ask 1. ID the need of pt 2. Access 3. Benefits
formal care settings: (2)residential vs non-residential (both can be financially prohibiting)
Non_residentialhome health, hospice, adult day care, adult foster care, senior centers, meals on wheels
residentialassisted living, skilled nursing, sub acute care (long term acute care), in patient rehab
Formal Care: Service Options: (6)Health care, Mental Health care, restorative care, custodial care, respite care, pallative care
Health caremanagment of chronic conditions, assitance w fxl impairments, coordination of other needed services
Mental health carepsychological/psychiatric, behavioral (wandering/combativeness), mental retardation
restorative careintegrates restoration of fx into daily care routine of pt (resident, client)
Custodial careemphasizes fxl maintenance throughADL assistance and routine fxl ex such as ROM & ambulation; usually provided by CNAs or techs: MANTAINING (not really progressing)
respite careeither community or insitution-based LTC service which takes over the care of a pt temporarily so that informal cargivers may have some time off; often have qualifying characteristics; RELIEF/TEMPORARY of burden or care
palliative carecare directed at the relief or alleviation of p! and suffering (+/- end of life situation); RELIEF of suffering
formal care: other provisionskilled/ nonskilled --- the reference is to the training you get
Skilled care for home healthPT, OT, Nursing, SLT, Dietecian, pharmacy, social work
Skilled care for: hospicemedicine, nursing, pastoral care, social work, couseling, rehav therapy,
Skilled care for: adult day servicesnuring, social work, PT, OT, Rehab therapy
nonskilled care for: home healthhomemaking, personal services
nonskilled care for: hospicehoemaking, personal hygien, volunteer companions
nonskilled care for: adult day servicestransportation, meals, personal care
medical, rehabilitation, and non-medical care to those who cannot access ____community based services (nursing, PT,OT, Speech, Dietetics, Pharmacy, Personal care assistance
Do medicare/medicaid benefits apply to home health care?Yes. Home health care refers to "can only leave house for bare essentials.--HOMEBOUND"
hospice careend of life care, holistic services (palliative medical care, comfort, couseling, spiritual care, legal assistance, bereavement support of family), can be institutional or community based; involves a lot of legal planning because the pt is bout to die
Do medicare/medicaid benefits apply to Hospic care?Yes.
Skilled Nursing Facilities (SNF)Medically oriented care provided by a licensed nurse, including monitoring of orecovery from acute or unstable chronic conditions, evaluation of care needs, injections, wound care, tube feedings, airway managment (include PT, OT, SLP +/- other services (pt goes and stays- need continual medical things that need to be addressed-- nurses and MDs always involved, but the question is how much)
Locations of SNFunit in acute hospital, free-standing facility, nursing home CMS-certified to admit Medicare pts for skilled services
Regulatory controls for SNFSstate licensed and regulated; may or may not be a JCAHO accredited
JCAHO oint Commission on Accreditation of Healthcare Organizations
SNF: Short term vs long term careSHORT TERM: less than 90 days, (level of serviece- RN level of skill avaliable 24/7...LONGTERM: longer than 90 days; can rely on LPN and NA most of the time
SNF service basedShort term are those with post acute conditions who:require rehab at a less intesnse level than is offered in an inpatient rehab setting AND are not read for discharge home
inpatient rehab is a post acute care option. what is its abbrv.CIRF
SNF service base: Long termthose with chronic conditions (elderly, mentally retarded, developmentally disabled, permanent injury or disability at any age, terminal diseases (AIDS, cancer))
Short term focus service objectivespromote fxl independence, prevent or delay institutionalizatiion, provide support ot familes and caregivers
Long term focus service objectivescustodial care in the absence of capacity to care for self or recieve care provided by members of the community; occasional rehav services provided
SNF Focus area: Specialzed Care Facilities:Alzheimers, mentally retarded, ventilator (staff are trained specifically to deal with the population served)
Long Term Acute Care Hospitals (LTACH)a form of SNF that offers services above and beyond the usual SNF services (monitoring & procedures for more critically ill pts) may be located within an acute care hosptial, OR may be located as a specialized unit within a general SNF
Inpatient rehabilitation facilites (IRF)Those with post-acute recovery medical and rehabilitaton needs, must be able to tolerate at least 3 hrs of therapy services daily
Goal for Inpatient rehabilitation facilites (IRF)discharge to the community
Administrative issues relevant to PT & OT practiceReimbursement (prospective payment), staffing & supervision, Quality of care & outcomes, Least restrictive environment