Care Delivery and Reimbursement Methods Flashcards
Discuss the objective of the initial client assessment.
The initial assessment must be a comprehensive and thorough attempt to develop an accurate profile of the client’s problem. The initial assessment may be done on an intake assessment form containing pre-established questions or may be the construction of a written narrative of their social history.
In either case, it will cover the background of the current problem, current condition, living arrangements, relationships, and work experience. Part of the assessment must include the reason the client is seeking help as well as the initial or presenting problem.
Discussion of the problem leads to what the client requires to bring stability and resolution. The client’s personal strength’s (i.e., education) and environment (e.g., family support) should be documented. Assessment of the client’s ability to reason and understand options is part of the assessment. The assessment is the foundation for the development of an individual plan for service or treatment.
Define the 8 categories covered in the initial assessment meeting with the client.
1) Cognitive Function must be assessed to determine if the client can speak for themselves or if they need a proxy present to answer questions or participate in decision making.
2) Diagnosis/medical conditions must be captured and a determination made of areas that may require the case manager’s intervention.
3) Medications are an area where the case manager con detect potential problems with drug administration of interactions and arrange assistance if financial barriers exist.
4) Care Assess involves evaluation of services for coordination of the services, obtaining providers or transportation and negotiating costs.
5) Functional Status covers activities of daily living (ADL), instrumental activities of daily living (IADLs), and fall prevention.
6) Social Situation evaluates the patient’s support system and arranges social work intervention if needed.
7) Nutritional Status impacts the overall health of the patient and the effectiveness of medication.
8) Emotional Status is the recognition of depression and other emotional discarders that can negatively impact the well-being of the patient, care plan and desired outcomes.
Describe the process a case manager uses to conduct a mental status examination (MSE).
Case managers use observation in order to document a client’s mental status. The client’s situation, actions, speech and appearance are taken into accounting an abbreviated assessment (e.g., eminent hospitalization) or over an extended period of multiple interviews in order to document their mental status and capabilities in relationship to the services to be provided.
It is important to always use a standardized form/questions in order to understand the client’s emotional and cognitive processes.
The MSE is not a separate, independent action, but is part of the overall intake process. Aside from general appearance, the case manager will not subtle visual clues and verbal clues about the client’s thought process, impulse control, cognitive functioning and intelligence level, reality level and suicidal or homicidal tendencies.
Active listening for both how and what the client says is important. Input from others is often necessary when the client either cannot provide information (e.g., about past events) or does not perform at an intellectual level in order to communicate for themselves (due to chronological age or from the effects of their disease).
Detail the 3 areas of determining the functional status of a patient.
Activities of Daily Living (ADL) include basic functions such as the ability to dress, bathe, feed and toilet oneself. The level of independence is based in part on environmental factors: are stairs involved, is equipment needed to provide mobility, etc.
Instructional Activities of Daily Living (IADLs) include the ability to do housework, shop, and prepare meals. Barriers in any of these areas may affect the ability to heal effectively or obtain/prepare food.
Full Prevention looks at the history as well as their future.
Discuss the rationale
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