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LEAD I > 06: Financing Long-Term Care > Flashcards

06: Financing Long-Term Care Flashcards

1
Q

Which of the following is not included in Long-term Services and Support (LTSS)?

A. Health
B. Social
C. Housing
D. Transportation
E. Nutrition

A

E

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2
Q

Why is long-term care important to consider?

A
  • Medical advancements and technology are finding more ways to maintain life
  • Life expectancy is increasing
  • “Baby Boomers” aging
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3
Q

What are the three general settings for LTSS?

A
  • Institutions
  • Home-based
  • Community-based
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4
Q

This type of LTSS has 24 hours of high level medical care by skilled professionals, healthcare aids and orderlies.

A. Nursing home
B. Skilled nursing facility
C. Home-based care
D. Community-based care

A

B

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5
Q

This type of LTSS has 24 hours of custodial care for ADL assistance.

A. Nursing home
B. Skilled nursing facility
C. Home-based care
D. Community-based care

A

A

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6
Q

This type of LTSS can be formal or informal, and can include professional services provided in the home.

A. Nursing home
B. Skilled nursing facility
C. Home-based care
D. Community-based care

A

C

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7
Q

This type of LTSS provides shelter (shared or private rooms) and meals in a small facility.

A. Nursing home
B. Skilled nursing facility
C. Home-based care
D. Community-based care

A

D

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8
Q

A non-residential facility that supports the health, nutritional, social support and daily living needs of adults in a professionally staffed, group setting is called…

A

Adult Day Service(s)

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9
Q

A facility combining housing, personalized supportive services, and health care designed to meet the needs of those who need help with ADLS is called…

A

Assisted living

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10
Q

This type of LTSS provides care for individuals with terminal illness and their support systems during and after the dying process.

A

Hospice

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11
Q

Temporary surrogate care given to a patient when the patient’s primary caregiver must be absent is called…

A

Respite Care

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12
Q

True or false: Medicaid pays for about 48% of LTSS.

A

True

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13
Q

True or false: Medicare covers home health services (skilled care) and custodial care.

A

False

Covers home health care but NOT custodial care.

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14
Q

Private long-term care (LTC) insurance has a large deductible that is measured in nursing home days.

For a 90-day deductible that is $272 per day, what wold the cost of the 90 days be?

If the copay is $105 per day after the 90-day deductible, what would the TOTAL cost for the year be?

A

$24,480 for 90 days

For year: 24,480 + (275 x 105) = $53,355 for one year

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15
Q

True or false: Medicaid coverage of home and community-based services can be provided at the state’s discretion.

A

True

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16
Q

Which of the following is NOT covered under Medicaid for LTC?

  • Home health aids
  • Personal care attendant
  • Transportation
  • Adult day services
  • Home prepared meals
  • Home delivered meals
  • Case management
  • Rehab
  • Home modifications
  • Respite care
A
  • Transportation
  • Home prepared meals

All others are covered!

17
Q

What is the eligibility criteria for Medicaid coverage for LTC?

A
  • Low income
  • limited assets
  • Functional need
  • Must be receiving SSI
18
Q

What is the difference between Medicaid and Medicare coverage for LTC?

A

Medicare doesn’t cover personal/custodial care services

19
Q

What is the most common reason for nursing home placement?

A

Absence of informal caregiver

20
Q

What is the states’ obligation under the US Supreme Court Olmstead decision?

A

Provide services to persons with disabilities in community settings versus institutions

21
Q

Which ACA LTC program provides additional federal payment for beneficiaries transitioning from institutional care to the community?

A

Money Follows the Person Demonstration

22
Q

Who provides the most informal care in the home?

A

Family and friends

23
Q

What is the largest payer of LTC services?

A

Medicaid

24
Q

Which LTC is the most costly for the healthcare system? Why?

A

Nursing home/SNF - 24 hours of care

LEAD I (10 decks)

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