Better Care Together Case Study

This episode of care occurred in a community setting. Sara has a diagnosis of Alzheimer's disease. She live alone, has no children and is a diabetic. Sara does not speak English and her first language is Polish. Sara support worker developed a close relationship with Sara but said recently her dementia as gotten wrong and she sometimes does not remember who she is. Sara has cellulitis on her legs and was refusing to let the support worker change her dressing. She kept saying it was ok and she didn't want it to be changed. The student nurse and the district nurse tried reassuring Sara and explaining why it was importance to treat her leg but she just became more agitated and aggressive. The district nurse and support worker knew it was important

This letter serves as a written notice of Loving Hearts Home Healthcare Inc. appeal to the overpayment amount of $5,034.90, which was identified in the overpayment notification letter. Specifically, those claims billed for Marjorie Savage that have been labeled with a discrepancy code 911. The notification letter provided the following explanation for the discrepancy code, which resulted in an overpayment:

As part of an ongoing effort to improve access to healthcare in rural areas, WeCARE Family Clinic are proposing the start-up of our new family medicine practice in Plains, Georgia. The business will be owned and managed by myself, Dr. Ieshia O. Roberts, MD as a sole proprietorship. I will be responsible for ensuring the general health of my patients and creating a viable and profitable medical practice. Throughout the year, my staff and I will work closely with advisors from Phoebe-Sumter Medical Center to get the clinic on a sound financial and operational footing, using this medical clinic business plan as a guiding management tool.

Correct Care Solutions, LLC. (CCS) is contracted to provide medical, dental and mental health services to the correctional population housed at the Mecklenburg County Sheriff’s Office (MCSO). The SOW agreement between MCSO and CCS is dated November 1, 2008. Per the agreement, a quality assurance plan requires an “outside” correctional health professional to conduct a peer review of inmate health care services with documentation of deficiencies and plans of corrective actions on an annual basis. The American Correctional Association (ACA) was contacted to conduct a compliance audit of the inmate health services operation for SOW agreement between MCSO and CCS.

Progress b: Ms. Messerli checked in Crossroads residential aftercare on 11/10/16. CPSW spoke with Ms. Messerli's counselor and he reported that Ms. Messerli was checked in 11/10/16 and was discharged on 11/13/16. On Sunday 11/13/16, her roommate at Crossroads informed the resident manager that Ms. Messerli left at 11pm Saturday evening and did not return. Ms. Messerli was discharged immediately at staff request from staying out overnight without a pass. He stated that Ms. Messerli did not complete any UA's at the Crossroads. Also, he reported that Ms. Messerli participated one group counseling session at Crossroads before her discharge date. The recommendation from Crossroads residential aftercare are:

Mrs Gale is a 70 year old widow and retired unskilled worker. The patient lives alone and relies on her son to provide basic care, medication and meals. Mrs Gale has a history of weight fluctuation owing to lifestyle but is currently at risk of malnutrition due to Parkinson’s disease. Mrs Gale shows signs of early dementia and suffers from poor mobility and pain caused by arthritis. Mrs Gale also has mild depression triggered by loss and has become socially isolated. All names have been changed as per the Nursing and Midwifery Council confidentiality guidelines (2008).

Care Matters LLC does not have an overall feedback loop with which it gathers information regarding efficacy. Most of the clients the agency works with are motor vehicle accident survivors who need extensive medical treatment. They are entitled by Michigan No Fault Insurance to a case manager to assist them with coordinating their medical care (Sinas, 2011). The case managers work with many different doctors, insurance companies, and claims adjusters. As such, most of their feedback takes place within outside arenas.

Health Information Exchange (HIE) has become a major component in today’s healthcare. Health information exchange provides a secure way for providers to appropriately access and electronically share a patient’s medical information. Therefore, reducing duplicate testing, minimizing medication errors and providing a link among electronic health records (EHR) in order to provide quality healthcare.

Mr. Clyde Pinegar lives with his daughter, Ronda Eustice and her family. Ms. Eustice is the primary caregiver and has lived with Mr. Pinegar for several years. Mr. Pinegar requires assistance with most of his ADLs due to history of hip and knee surgery.

I am expected to attend weekly care plan meetings every Thursday. In the past I was an observer in the weekly care plan meetings. Now, I am a full participant as I am the person who schedule the meeting over the phone and gather all the books and sheets before the meeting begins. Also, Cobble Hill also has a resident council meeting in which I had the opportunity to attend. I also attend a dementia meeting which is once a week. In addition to the various meetings that I attend, there are also in-services that are mandated for all staff to attend such as, a town hall meeting, which is a reminder about Cobble Hill policy and procedures such as infection control, HIPAA, safety and emergency protocol.

The client was referred to the DUI-II Phase II Aftercare program by his Probation Officer, Sasha Becker, and Gary Matthews, Case Manager of the DUI Phase I program, following successful completion of Phase I.

Dr. Robert Master, the founder of Commonwealth Care Alliance (CAA), had created the company with the vision to ‘bring high-quality and personalized care to people with complex medical and behavioral needs, resulting in improved health and better self-management of chronic illness, thereby reducing hospitalizations and institutionalizations.' Therefore, the main objective was to provide care outside the walls of hospitals and institutions to make it easier for the chronically ill and disabled to receive the attention they

Co-ordination of care Once a care plan has been agreed it is important that all the services that the resident needs are effectively co-ordinated. Many end of life care cases are complex and involve residents receiving care from many different professionals from many different agencies and organisations. A lack of communication and co-ordination can result in the unnecessary hospitalisation of care home residents in contradiction of their wishes to be cared for, and to die, in their care

The next portion of this analysis is the evidence that the situation provides. Care aids in Canada have a document that outlines competencies needed in order to provide the public with safe, competent and ethical care (HCA Core Competency Profile, 2014). Upon my analysis of this document, the care in the situation had not met competencies 1.0: Health and Caring, 3.0: Communication Skills, 5.0: Safety, and 6.0: Responsibility, Accountability and Ethical Behavior. I begin to question what the ramifications are for care aids that do not meet these standards in Canada. Is it possible that the care aid has forgotten the competencies in which she is required to meet? It could be that the care aid isn’t educated about dementia and wasn’t aware of

There is a social dilemma that our youth, individual with disabilities and the elderly communities are facing. With the focus geared toward our youth and foster care programs; community based care is a vastly growing program designed to decrease the amount of displaced youth and reconnect them with their families. Equipping families with the necessary resources and support services to provide adequate care for their children is a great benefit to society as a whole.