NOT ON STUDY GUIDE FOR EXAM 3 - Week 12: Long Term Care

Question 1

Long Term Care

Answer 1

describes a variety of services, including medical and nonmedical care, provided on an ongoing basis to people of all ages who have a chronic illness of physical, cognitive, or developmental disability.

Question 2

Costs of LTC: Medicaid

Answer 2

• Primary payer for LTC services.

- Large differences across states.

Question 3

Costs of LTC: Medicare

Answer 3

Would not cover unless there was some skilled need

Question 4

Costs of LTC: Private LTC insurance

Answer 4

-Relatively few people have purchase this insurance

Question 5

Costs of LTC: Out-of-pocket spending

Answer 5

Accounts for 22% of national spending for LTC

Question 6

Program for All-Inclusive Care for the Elderly (PACE)

Answer 6

• Provide community services to people 55 or older who would otherwise need a nursing home level of care.
• Participants must meet the criteria for nursing home admission, prefer to remain in the community and be eligible for Medicare and Medicaid.

Question 7

Adult Day Services

Answer 7

• Community-based group programs designed to provide social and some health services to adults who need supervised care in a safe setting during the day.
• They offer caregivers respite from the responsibilities of caregiving, and most provide educational programs, support groups, and individual counseling for caregivers.

Question 8

Continuing Care Retirement Communities

Answer 8

• Provide full range of residential options, from single family homes to skilled nursing facilities (SNFs) all in one location.
• Allows community members to make the transition between levels without disrupting moves.
• The average monthly cost for living at a CCRC is $2672.

Question 9

Residential Care/Assisted Living

Answer 9

• Provides housing and services for close to 1 million older adults in the United States.
• Almost one half of older adults would move to an assisted living community if they could no longer care for themselves.
• RC/AL is viewed as more cost effective than nursing homes while providing more privacy and a homelike environment.

Question 10

SNF’s (Nursing Homes)

Answer 10

Delivery of around-the-clock for those needing specialized care

Question 11

Characteristics of Nursing Homes

Answer 11

Includes up to two levels of care: skilled nursing care (subacute) and chronic care (long term, custodial)

Question 12

Characteristics of Nursing Homes: Subacute Care

Answer 12

• Short term
• More intensive and more costly
• Most frequent site of post-acute care
• Length of stay usually no more than 1-3 months

Question 13

Characteristics of Nursing Homes: Chronic Care

Answer 13

• Long term
• May not need intensive care but still need ongoing 24 hour care.
• Residents are predominately women, >80 y/o, widowed and dependents in ADL’s and instrumental ADL’s.

Question 14

More RN direct-care time per resident in nursing facilities is associated with

Answer 14

• Fewer pressure ulcers
• Fewer hospitalizations
• Fewer UTI’s
• Less weight loss
• Fewer catheterizations
• Less deterioration in the ability to perform ADLs

Question 15

Nursing Assistants

Answer 15

-Provide the majority of direct care in nursing homes and significantly contribute to the quality of life for residents

Question 16

Resident Bill of Rights

Answer 16

• Residents have rights under both federal and state law
• LTC Ombudsman Program is a nationwide effort to support the rights of both the residents and the facilities
• Each facility is required to post the name and contact information of the ombudsman assigned to the facility

Question 17

Quality of Care in SNF’s

Answer 17

• Nursing homes are one of the most highly regulated industries in the US.
• Advanced practice nurses are linked to improved quality of care in nursing homes.

Question 18

Interventions to Reduce Acute Care Transfers (INTERACT)

Answer 18

An exemplary program for reducing frequency of transfers to the acute hospital from nursing homes.

Question 19

The culture change movement

Answer 19

To improve the lives of residents and staff by centering facilities’ philosophies, organizational structures, environmental designs, and care around practices that support residents’ needs and preferences.

Question 20

Nurses and LTC

Answer 20

• Play a key role in improving quality of care in nursing homes through EBP and leadership in quality improvement initiatives.
• The need for expert nursing is the most essential service provided.