Regulating Institutions

Question 1

Nursing Homes

Answer 1

-Skilled nursing care by licensed professionals
-Rehab & permanent residents

Question 2

Medicare

Answer 2

-People 65 or older
-Certain younger people with disabilities
-People with End-Stage Renal Disease (requiring dialysis or transplant)

Question 3

Medicaid

Answer 3

-Low income individuals
-administered by states, according to fed requirements.
-funded jointly by states & federal govt.

Question 4

Assisted living

Answer 4

-Get own apt + meals & services but no skilled nursing
-Usually not covered by any insurance
-Long-term care insurance

Question 5

Home Care Agencies

Answer 5

-Licensed medical professionals
-In-home care – aides provide companionship and assistance w/ activities of daily living (ADL)

Question 6

Nursing home problems

Answer 6

Poor infection control, food sanitation, quality of care, & pharmacy consultation + accident hazards

Question 7

Estate of Michael Patrick Smith v. Heckler (1984)

Answer 7

Rule:
Under the Medicaid Act, the Secretary of Department of Health and Human Services has a statutory duty to be adequately informed about the quality of participating state health care facilities, including the quality of patient care.

Facts:

-Federal-state partnership for Medicaid certification
-P alleges fed forms evaluate only physical facilities & theoretical ability to provide quality care
-No onsite visits & little emphasis on actual patient care

Holding:

Nothing in the Act indicating that the state’s function of surveying nursing facilities is limited to the quality of the facilities.
-Responsibility for ensuring that patient care is being adequately delivered.
-Ongoing duty of supervision to ensure compliance as well as being informed of patient care at the time of certification