| This service enables indivs of all ages to remain in the comfort and security of their home while receiving health care | Home health care |
| System that classifies pt by age, diagnoses, and surgical categories; used to predict the use of hospital resources, including the length of stay | Diagnosis-related Groups (DRG) |
| A process in which the gov't evaluates and recognizes an indiv, institution, or educational program a meeting certain predetermined standards | Certification |
| a process whereby a professional association or non governmental agency grants recognition to a school or institution for demonstrated ability in a special area of practice or training | Accreditation |
| Allows for pt and care provider interaction and monitoring through the use of telephones, computers, televisions, and two-way monitors | teleheatlh services |
| A federal program that requires agencies go be certified as meeting the federal conditions of participation, which set forth the specific requirements for organization, staffing, training, types of services covered, and agency eval | Medicare |
| Pays for home care services to indigent and low-income people of all ages | Medicaid |
| For qualified coverage by Medicare, a health maintenance organization(HMO), or various types of insurance, the pt must be: | Homebound |
| Unable to leave the home or needing a great deal of effort to travel to appts to see health care provider | Homebound |
| What aspects contribute to feelings of worth and dignity for home health pts? | -Family support
-Familiar surroundings
-Participation in the care process |
| Pts 65yr account for what percentage of home health? | 82% |
| What percentage of home health is comprised of 85yr older? | 26% |
| Home health care preserves: | Indiv independence and integrity and keeps families together |
| PPS | Prospective payment system(apart of Tax Equity & fiscal Responsibility Act)
-Pays a set rate based on diagnosis |
| IPS | Interim Payment System(Balanced Budget Act of 1997 (BBA)) |
| What 3 factors attributed to quadrupled Home Health care from 1980-1991? | -Shorter hospitalizations
-more seriously ill pt's discharged to home
-Increased acceptance of the delivery of higher technological care in the home |
| Home health agencies have to comply with federal, state, and local laws and regulations via the following: (4) | -Licensure by the state
-Certification by the state certifying that the federal gov' designates
-Certificate of need
-Accreditation by an outside agency that evaluates and judges how well the agency meets certain standards that the accrediting organization sets |
| Gives legal permission to agencies operate within that state. Regulations vary. Not all states have such laws | Licensure by state |
| The federal gov't sets the rules that govern certification. Only certified agencies are permitted to receive Medicare payments | Certification by the state certifying body that the federal gov't designates |
| Some states grant this according to rules nd formulas that state regulators devise. Cost of starting and running agency, availability of personnel, & need for their service is considered | Certificate of need |
| Home care agencies are classified by: | tax status(profit/non-profit)
location(freestanding/institution-based)
governance(private or public) |
| Handles ethical issues that arise in the home | Ethics Committee |
| They provide assistance with pt's emotional, financial, and household problems thus allowing the nurse more time to perform nursing interventions | Social Worker |
| Most agencies are obtaining a separate Medicare certification to provide: | Hospice Care |
| The 3 common types of home IV Therapy | -antibiotics
-hydration
-TPN (total parenteral nutrition) |
| Additional types of IV medications provided by home care | Analgesics (pain)
chemotherapeutic agents
hormones
antiemetic agents (prevent nausea/vomit) |
| Pt receives home care based on what timeframe before needing recertification by face-to-face visit with Dr | 60 Days |
| The LVN provides nursing care under the direction of the RN who responsibility is development of | The plan of Care |
| Skilled nursing services revolve around 4 major goals | -Restorative
-Improvement
-Maintenance
-Promotion |
| Returning to a previous level of functioning as appropriate and realistic | Restorative |
| Achieving better health and a higher level of functioning than at admission | Improvement |
| Preserving functional capabilities and independence by maintaining current level of health | Maintenance |
| Teaching healthy lifestyles that keep the effect of illness or disability to a minimum and prevent the recurrence of illness | Promotion |
| For physical therapy services what does Medicare require for reimbursement? | Restorative treatment |
| What does Medicare require for reimbursement for Speech-Language Therapy? | A Master's prepared clinician who has been certified by the American Speech and Hearing Association |
| The nurse is required to make the initial eval and admission visit within __ of the home health referral | 24-48hr |
| The guidelines and techniques used to meet the needs of the home care clients and continuously improve the quality of care provided | Quality management |
| The 3 major elements of quality management | -Structural Criteria
-Process Criteria
-Outcome Criteria |
| The agency's overall organization, philosophy, policies, procedures, bylaws, personnel practices, supervision, orientation, contracts, and physical facilites | Structural Criteria |
| Evaluation of care delivery. Authorities scrutinize the activities of the health professionals and paraprofessionals and support in the mgmt of pt care, documentation, and pt care conferences | Process Criteria |
| Measurement of change in pt behavior, the results of pt care in terms of changes, health indicators, and satisfaction. Care standards and expected outcomes are integral parts of this area | Outcome Criteria |
| Types of services covered(by Medicare) and length of coverage are delineated further in guidelines developed by | The Health Care Financing Administration (HCFA) |
| They determine and arrange for a mix of home care, therapy services, counseling, supplies and equip for a pt (commonly a nurse or social worker) | A case Manager |
| HMOs | Health maintenance organizations |
| PPOs | Preferred provider organizations |
| The role of the LVN in the nursing process for home health care (4) | -Participate in planning care for pts based on pt's needs
-Review pt's plan of care and recommend revisions as needed
-Review and follow defined prioritization for pt care
-Use clinical pathways, care maps, or care plans to guide and review pt care |
