Practice Issues Part 3&4 Flashcards
What are the two goals of Healthy People 2030?
Increase the quality and years of healthy life and eliminate health disparities among Americans
What are the five reportable diseases?
HIV, TB, gonorrhea, chlamydia and syphilis
What does physical therapy do?
Works on strength training and rehab
What does occupational therapy do?
Works on fine motor skills
What happens in home health?
An RN comes 3x a week or so for quick check in
What are the two requirements for hospice?
Have a diagnosis that will be terminal within 6 months and only be receiving comfort measures
What is the indication for sending someone to a SNF?
Inability to perform ADLs
Which third-party payer sets the standard for reimbursement and cutting costs?
Medicare
Which part of Medicare covers NP services?
Medicare B
What does Medicare A cover?
Inpatient services and related, such as SNF or home health related to a hospitalization
What does Medicare B cover?
Outpatient services, labs and diagnostics, medical equipment
NPs and CNSs receive what % of physician reimbursement for services provided in collaboration with an MD?
85%
What % does Medicare pay of a pt’s bill and what % does the pt pay?
Medicare pays 80%; patient pays 20%
What does Medicare D cover?
Drugs
Which two forms of Medicare require the pt to pay?
D and B
What is Incident-to Billing?
Billing under the provider # in order to get full physician fee
Is Incident-to Billing allowed in the inpatient setting?
No
What form of reimbursement varies from state to state?
Medicaid
What does QSEN stand for?
Quality and Safety Education for Nurses
What are the six key competencies of QSEN?
Patient-centered care, teamwork and collaboration, evidence based practice, safety, quality improvement and informatics
What three components does credentials encompass?
Education, licensure and certification
What does licensure establish?
That a person is qualified to perform in a particular professional role