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Home Care Flashcards

Exam 2

1
Q

Medicare Home Health Benefit:

A

Brief visits, temporary care; no reimbursement for health promotion or long-term care

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2
Q

Home Care Financing

Who pays?

A

Corporate

Private insurance

Governmental third-party payers

Medicare, Medicaid, military health system, Veterans Administration

Individual clients and families

Charitable care from home care agencies

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3
Q

Home Care Financing

What is HIPS?

A

HIPS-homebound, intermittent, part-time, skilled

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4
Q

Home Care Financing

What is Balanced Budget Act and Medicare Prospective Payment System:

A

Payment rates based on client characteristics and need for service led to the closure of many Medicare certified agencies

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5
Q

Home Care Financing

What- I don’t get it?

A

Cost and number of visits declined; rates of wound healing, incontinence and psychosocial problems increased

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6
Q

Home Care Financing

What is there an increase of? A decrease of?

A

Decreased patient contact; increased documentation

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7
Q

Home Health Agencies include:

A

Voluntary nonprofit

Hospital based

For profit proprietary agencies

Gov and city agencies

Noncertified agencies

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8
Q

Home Health Agencies:

Voluntary nonprofit: What are they? How are they financed?

A

charitable;

exempt from paying taxes;

financed with nontax funds; VNAs

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9
Q

Home Health Agencies:

Hospital-based: What are they? How are they financed?

A

part of hospital as a separate department;

nonprofit or generate revenue

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10
Q

Home health Agencies?;

For-profit proprietary agencies:

A

individual owners,

often part of large regional or national chain administered through corporate headquarters;

pay taxes on profits

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11
Q

Home health Agencies?;

Noncertified agencies: What are they? How are they funded?

A

private; funding from direct payment by the client or insurers;

governed by individual owners or corporations

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12
Q

Clients and Families:

Who are the clients?

A

Client as the individual and family (and significant others)

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13
Q

Clients and Families:

When are most clients admitted for home care?

A

Most clients admitted to home care after hospitalization

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14
Q

Clients and Families:

Most common diagnoses:

A

Essential hypertension,

heart failure,

diabetes,

chronic skin ulcers,

osteoarthritis

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15
Q

Caregivers

Who are informal caregivers? What kind of care do they give?

A

Family members as informal caregivers:
personal care to sophisticated skilled care

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16
Q

Caregivers

What is a primary caregiver?

A

Primary caregiver: daily tasks of care

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17
Q

Caregivers

What is a Secondary caregiver?

A

Secondary caregiver: intermittent responsibilities

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18
Q

Caregivers:

What kind of burdens do they assume?

A

Caregivers assuming enormous burdens: physical, psychological, economic

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19
Q

Medicare Criteria for Reimbursement:

What about service type?

A

Service type and frequency reasonable & necessary

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20
Q

Medicare Criteria for Reimbursement:

How is the client?

A

Client homebound

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21
Q

Medicare Criteria for Reimbursement:

What is on the Medicare forms?

A

“Plan of care” on Medicare forms

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22
Q

Medicare Criteria for Reimbursement:

What is the client in need of

A

Client in need of skilled service (observation, assessment, teaching, performing selected procedures)

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23
Q

Medicare Criteria for Reimbursement:

How is the service offered? How long is episode of care?

A

Service intermittent and reasonable

Episode of care: 60 days

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24
Q

Medicare Criteria for Reimbursement:

How is admission?

A

Admission: assessment using OASIS

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25
Medicare Criteria for Reimbursement: What is medicare documentation?
Medicare documentation: OASIS, Medicare Plan of Care
26
Skilled Nursing Services: Who is it performed by?
Performed by either a registered nurse (RN) or a licensed practical nurse (LPN).
27
Skilled Nursing Services: What are examples?
Examples: administering IV/IM medications, vaccines, tube feedings; changing dressings; and teaching about medications or diabetes care.
28
Skilled Nursing Services: What is NOT skilled nursing care?
Any service that could be done safely by a non-medical person (or by patient) without the supervision of a nurse, is not skilled nursing care.
29
Intermittent and part-time service: How is it defined by medicare?
Medicare defines part-time or “intermittent” as skilled nursing care that’s needed or given on fewer than 7 days each week or less than 8 hours each day over a period of 21 days (or less) with some exceptions in special circumstances
30
Outcomes and Assessment Information Set (OASIS): Any home health agency seeking Medicare certification is required to do what?
Any home health agency seeking Medicare certification is required to meet the Medicare Conditions of Participation (CoP) prior to certification.
31
Outcomes and Assessment Information Set (OASIS): Any home health agency seeking Medicare certification is required to meet the Medicare Conditions of Participation (CoP) prior to certification. What does this include?
This includes compliance with the OASIS collection and transmission requirements
32
Outcomes and Assessment Information Set (OASIS): What does it measure?
Measures outcomes for quality improvement and client satisfaction with care
33
Outcomes and Assessment Information Set (OASIS): What is it considered?
Cost-effective, quality care
34
Outcomes and Assessment Information Set (OASIS): A collection of data items that encompass
sociodemographic environmental support system health status functional status attributes of adult patients
35
Types of OASIS Assessments: When can OASIS assessments be completed and turned in?
OASIS assessments to be completed and turned in within 48 hours of visit
36
Types of OASIS Assessments: OASIS assessments to be completed and turned in within 48 hours of visit and occur at:
Start or Resumption of Care Recertification (60 days) Discharge from Agency Transfer to Inpatient Facility Death or Discharge from Agency
37
Nursing Diagnosis: What is it?
A clinical judgment about individual, family, or community responses to actual or potential health problems/life processes
38
Nursing Diagnosis: What does it provide the basis for?
Provide the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable
39
Nursing Diagnosis: What does it do in a consistent manner?
Describe, document, and quantify daily practice in a consistent manner
40
OMAHA System: What is it?
A comprehensive, orderly, nonexclusive, mutually exclusive taxonomy designed to identify diverse clients’ health-related concerns
41
One of the best approaches to nursing diagnosis in home care
OMAHA System
42
OMAHA System: What was it developed for?
Developed for home care practice, not for inpatient care
43
Goals of the OMAHA System: To develop what?
To develop a structured and comprehensive system that could be both understood and used by members of various disciplines and foster collaborative practice
44
Goals of the OMAHA System: What is it?
Guide practice decisions, sort and document pertinent client data uniformly, and provide a framework for an agency-wide, multidisciplinary clinical information management system capable of meeting the needs of practitioners, managers, and administrators
45
OMAHA System includes:
Problem Classification Scheme Intervention Scheme Problem Rating Scale for Desired Outcomes
46
Client Goals includes what?
Include health promotion, maintenance, and restoration
47
Client Goals: To help clients do what?
Help clients function at the highest possible level by maximizing the level of independence and self-care abilities
48
Client Goals: To prevent what?
Prevent complications in chronically ill persons and help minimize the effects of disability and illness
49
Telehealth: What is it?
Telehealth is a form of electronic communication used to deliver
50
Telehealth: What does it include?
Acute care and specialty consultations Home telenursing Electronic referrals to specialists in expert health facilities
51
Home Care Visit: Includes:
Initiating the visit The actual visit Termination of the visit Post-visit planning
52
Home Care Visit: Initiating the visit- what should be included
Preparation Equipment Directions Personal safety
53
Home Care Visit: Actual visit- what should be included
Assessing for risk of medication errors Assessing for risk of falls Assessing for risk of abuse and neglect
54
Home Health Nursing Case Management: What does each client receive?
Case manager for each client
55
Home Health Nursing Case Management: What is the case manager responsible for?
Responsible for coordination of other professionals and paraprofessionals involved in the client’s care
56
Home Health Nursing Case Management: What does the case manager do?
Case conferencing with team members (Medicare mandate — every 60 days) Supervising paraprofessionals
57
Home Health Nursing Case Management: What must they be knowledgable for?
Knowledge of reimbursement for service
58
Caregivers as Partners: Who is included in the home health care team?
Caregivers are often family members and friends. They must be considered members of the home care team and offered appropriate support if their commitment to care for a loved one at home is to be successful.
59
Type of services
Home Care Services Private Care Services Hospice and Palliative Care Community Programs Research Center Medicaid Long-term Care - MLTC
60
Future of Home Care: What are they going to address?
Community-based long-term care to address needs of the frail elderly or severely disabled for extended home care New lines of business to meet changing needs and payment issues
61
Future of Home Care What is there a possible development of?
Possible development of a national community-based long-term care benefit

Community Health (16 decks)

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