Lecture 2 Flashcards

1
Q

What model is the basic expectation from medical care that it will make a difference. Why geriatric care can be frustrating because their conditions may not get better.

A

Therapeutic model

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2
Q

What model is usually associated with social services. Plan of care developed to address identified deficits and allows patient to enjoy as normal a lifestyle as possible.

A

The Alternative Model

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3
Q

What are 2 things that a good geriatric care requires?

A

Communication

Rely on other healthcare professionals

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4
Q

Insurance-type program

People are entitled to after contributing a certain amount

A

Medicare

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5
Q
A welfare program
Eligibility based on need/poverty
To become eligible
Must prove illness
Exhaust personal resources
Big payer of nursing home care
A

Medicaid

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6
Q

what public program is associated with nursing homes

A

medicaid

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7
Q

is medicare all inclusive?

A

No, out-of pocket expenses still >20% income

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8
Q

If you don’t enroll in Medicare when you are 65 what will happen?

A

10% fee for each 12-month period that you could have had medicare Part B but didn’t take it

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9
Q

What is medicare- part A?

A

Hospital insurance

Covers most medically necessary hospital, skilled nursing facility (100 days worth), home health and hospice care

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10
Q

when can you get on medicare part A?

A

free if you have worked and paid Social Security taxes for at least 40 calendar quarters (10 years)

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11
Q

if there coverage for medications for medicare part A?

A

No

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12
Q

Medicare part A covers 20 days of skilled nursing then facility after a hospitalization of at least 3 days 100% for the first 20 days and __% for the last 80 days

A

80

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13
Q

do you have to pay for medicare part B?

A

Yes, monthly premium

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14
Q

Is there pharmacy coverage with medicare part B?

A

No

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15
Q

what medicare cover prescription drug coverage. Provided only through private insurance companies that have contracts with the government- it is never provided directly by the government

A

Medicare D

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16
Q

Allows private health insurance companies to provide Medicare benefits
Must offer at least the same benefits as Original Medicare

A

Medicare C “Medicare Advantage Plans”

17
Q

what is the major public payer for long-term care?

A

Medicaid

18
Q

In order to get medicaid what must you have?

A

Nothing

19
Q

Medicare gives the same amount of compensation per admissions based on the ____________

A

admitting diagnosis- Diagnosis-related group (DRG)

20
Q

Does medicare cover readmissions within 30 days?

A

No

21
Q

Medicare does cover ____-acute care

A

sub

22
Q

A level of care or rehabilitation that no longer requires inpatient admission but cannot be provided at home

A

Subacute care settings (ex- skilled nursing facilities “SNF”)

23
Q

Some eligibility for sub acute care?

A
IV meds
enteral tube feedings
Wound care
PT and OT (show certain amount of activity first) 
chemo
dialysis
TPN
ventilator support
24
Q

A range of services that addresses the health, personal care and social needs of individuals who lack some capacity of self-care

A

long term care setting

25
Q

Is most long term care provided by a health care professional?

A

No

26
Q

who is most homecare provided by?

A

family/ friends with or w/o formal caregivers

27
Q

for medicare coverage, physician must certify that the patient is homebound and that intermittent skilled care is necessary and needs to be provided by who?

A

nurse, PT or ST (speech therapist)

28
Q

what is PACE?

A

Program for All-Inclusive Care for the Elderly

29
Q

What does PACE do?

A

freestanding adult health center with pharmacy, recreational therapy, PT, OT and a full service medical clinic

30
Q

Who qualifies for PACE?

A

Over 55, live within the area, be eligible for nursing home care and demonstrate ability to live safely at home when not at a PACE center

31
Q

With increase use of skilled nursing facilities, ____________ are seeing decrease in long-stay business

A

nursing homes

32
Q

Issues with nursing homes

A

Hard to get PMH
first contact with acute changes not by skilled provider
lack of advanced directives

33
Q

Patients admitted to a nursing home must receive physician assessment within _______ of admission and then every _________

A

48-72 hours

30-60 days

34
Q

what must be sent with the patient to the nursing home?

A

A copy of the patient’s entire record from a hospitalization and any recommendations and physician orders

35
Q

how often must a licensed nurse assess each resident?

A

Daily