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Community Health > Home Care > Flashcards

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
Q

Medicare Criteria for Reimbursement:

What is medicare documentation?

A

Medicare documentation: OASIS, Medicare Plan of Care

26
Q

Skilled Nursing Services:

Who is it performed by?

A

Performed by either a registered nurse (RN) or a licensed practical nurse (LPN).

27
Q

Skilled Nursing Services:

What are examples?

A

Examples: administering IV/IM medications, vaccines, tube feedings; changing dressings; and teaching about medications or diabetes care.

28
Q

Skilled Nursing Services:

What is NOT skilled nursing care?

A

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
Q

Intermittent and part-time service:

How is it defined by medicare?

A

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
Q

Outcomes and Assessment Information Set (OASIS):

Any home health agency seeking Medicare certification is required to do what?

A

Any home health agency seeking Medicare certification is required to meet the Medicare Conditions of Participation (CoP) prior to certification.

31
Q

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?

A

This includes compliance with the OASIS collection and transmission requirements

32
Q

Outcomes and Assessment Information Set (OASIS):

What does it measure?

A

Measures outcomes for quality improvement and client satisfaction with care

33
Q

Outcomes and Assessment Information Set (OASIS):

What is it considered?

A

Cost-effective, quality care

34
Q

Outcomes and Assessment Information Set (OASIS):

A collection of data items that encompass

A

sociodemographic

environmental

support system

health status

functional status attributes of adult patients

35
Q

Types of OASIS Assessments:

When can OASIS assessments be completed and turned in?

A

OASIS assessments to be completed and turned in within 48 hours of visit

36
Q

Types of OASIS Assessments:

OASIS assessments to be completed and turned in within 48 hours of visit and occur at:

A

Start or Resumption of Care

Recertification (60 days)

Discharge from Agency

Transfer to Inpatient Facility

Death or Discharge from Agency

37
Q

Nursing Diagnosis:

What is it?

A

A clinical judgment about individual, family, or community responses to actual or potential health problems/life processes

38
Q

Nursing Diagnosis:

What does it provide the basis for?

A

Provide the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable

39
Q

Nursing Diagnosis:

What does it do in a consistent manner?

A

Describe, document, and quantify daily practice in a consistent manner

40
Q

OMAHA System: What is it?

A

A comprehensive, orderly, nonexclusive, mutually exclusive taxonomy designed to identify diverse clients’ health-related concerns

41
Q

One of the best approaches to nursing diagnosis in home care

A

OMAHA System

42
Q

OMAHA System:

What was it developed for?

A

Developed for home care practice, not for inpatient care

43
Q

Goals of the OMAHA System:

To develop what?

A

To develop a structured and comprehensive system that could be both understood and used by members of various disciplines and foster collaborative practice

44
Q

Goals of the OMAHA System:

What is it?

A

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
Q

OMAHA System includes:

A

Problem Classification Scheme

Intervention Scheme

Problem Rating Scale for Desired Outcomes

46
Q

Client Goals includes what?

A

Include health promotion, maintenance, and restoration

47
Q

Client Goals:

To help clients do what?

A

Help clients function at the highest possible level by maximizing the level of independence and self-care abilities

48
Q

Client Goals:

To prevent what?

A

Prevent complications in chronically ill persons and help minimize the effects of disability and illness

49
Q

Telehealth:

What is it?

A

Telehealth is a form of electronic communication used to deliver

50
Q

Telehealth:

What does it include?

A

Acute care and specialty consultations

Home telenursing

Electronic referrals to specialists in expert health facilities

51
Q

Home Care Visit:

Includes:

A

Initiating the visit

The actual visit

Termination of the visit

Post-visit planning

52
Q

Home Care Visit:

Initiating the visit- what should be included

A

Preparation

Equipment

Directions

Personal safety

53
Q

Home Care Visit:

Actual visit- what should be included

A

Assessing for risk of medication errors

Assessing for risk of falls

Assessing for risk of abuse and neglect

54
Q

Home Health Nursing Case Management:

What does each client receive?

A

Case manager for each client

55
Q

Home Health Nursing Case Management:

What is the case manager responsible for?

A

Responsible for coordination of other professionals and paraprofessionals involved in the client’s care

56
Q

Home Health Nursing Case Management:

What does the case manager do?

A

Case conferencing with team members (Medicare mandate — every 60 days)

Supervising paraprofessionals

57
Q

Home Health Nursing Case Management:

What must they be knowledgable for?

A

Knowledge of reimbursement for service

58
Q

Caregivers as Partners:

Who is included in the home health care team?

A

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
Q

Type of services

A

Home Care Services

Private Care Services

Hospice and Palliative Care
Community Programs

Research Center

Medicaid Long-term Care - MLTC

60
Q

Future of Home Care:

What are they going to address?

A

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
Q

Future of Home Care

What is there a possible development of?

A

Possible development of a national community-based long-term care benefit

Community Health (12 decks)

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