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Public Health

Home Health Care

QuestionAnswer
What is the fastest growing aspect of community health nursing, as well as nursing in general? home care
What is telehealth? The use of remote computer equipment to monitor the condition of a client and relay information over a telephone line or wireless connection back to a central nursing station.
What are the two broad categories of home health care services? Professional (practice driven) and technical (product driven). Most clients need a combination of both services.
What is the role of the generalist in home care? Teaching, providing direct care to clients, managing resources needed to provide care, collaborating with other disciplines in the provision of that care, and supervision of ancillary personnel.
What is the role of the advanced practice nurse in home care? Direct care to clients with complex conditions, consultation with other providers, development and evaluation of agency policy, and staff development. Also focuses on supporting and developing the system in which home care services are delivered.
For an agency to be reimbursed by Medicare for services provided to clients, it must be __________ ___________. Medicare certified, meaning that the agency meets the conditions of participation (COPs), which include rules, standards, and criteria established by the federal government.
What is accreditation? When an agency VOLUNTARILY,at their own expense, seeks to be evaluated on the basis of comprehensive criteria that influence the quality of care .
What are the two accreditation programs available to home health care agencies? The Community Health Accreditation Program (thru the NLN) and the Home Care Accreditation Program (thru JCAHO).
Because accreditation standards are so rigorous, agencies that meet accreditation standares are automatically deemed to have met what other standard? The Medicare standard.
What type of agency makes up the largest percentage of home health care agencies in the country? Proprietary agencies, meaning they plan to make a profit.
What three categories of service make up home care? Care of the ill, public health (preventive care), and specialized home care services (hight-technology care).
Traditional third-party payers do not reimburse home health care agencies for care that is exclusively ____________. preventive. These services are primarily funded by private donations and grants.
What instrument assesses a client's clinical, functional, and social dimensions of care in order to determine the reinbursement an agency will recieve? OASIS; Outcome Assessment and Information Set
What five criteria must a client meet to be eligible for Medicare home care services? Homebound, completed plan of care, in need of skilled services, in need of intermittent/part-time service only, and requiring only services deemed reasonable and necessary.
What services are considered skilled (to be eligible for Medicare home care service)? Those services provided by a nurse, physical therapist, or speech therapist.
According to Medicare regulations, when is a service considered to be reasonable and necessary? If it is appropriate to the client's diagnosis, if it meets generally accepted professional standards, and if it requires the skills of a professional to ensure safety and meet legal requirements.
What is essential to validate that the care provided is both reasonable and necessary? Comprehensive documentation
Unlike Medicare, Medicaid is jointly covered by the federal government and the ____________. states; which explains why eligibily requirements vary by state
Unlike Medicare, Medicaid covers both skilled and __________ care in the home and does not require that the client be ___________. unskilled; homebound
What does a client need to qualify for Medicaid home care? Must meet income eligibility requirements, must have a plan of care signed by a physician, and must have the plan of care reviewed by the physician every 60 days.
What purpose does documentation serve? To track the client's history,status,& progress,the basis for planning individualized care & services,to communicate info. to all health professionals involved,to justify payments,to assess quaility of care, to protect the nurse/agency from liability
Medicare mandates that case conferences occur every ___ days when more than one discipline is involved in the client's care. 60
Contrast "customer" and "consumer". The consumer is the client, the person receiving the care. The customer may also be the consumer but in many cases is the referring physician, family member, or discharge planner.
What act(1990)requires hospitals,skilled nursing facilities,home health agencies,HMOs,& hospices provide written info to patients about their options to accept or refuse medical/surgical treatment & formulate advance directives in compliance w/state law? The Patient Self-Determination Act
Rather than a cure, what is emphasized in hospice care? Quality of life.
What is the admission criteria for hospice? Diagnosis of terminal illness, a prognosis of 6 months or less, informed concent from the client to have hospice services, and a referral to hospice by the client's attending physician.
A client must meet all Medicare criteria for home care to be eligible for th hospic Medicare benefit, except WHAT? The client does not have to be homebound.
Created by: shanebarnes1978