Personal Care Contract Case Study

1. Home Healthcare Case: Given what you have learned about the accessibility and financing of home care services, are such services as readily available to other consumers as they were to Joan and Jerry? In this particular case regarding Joan and Jerry, and the availability of home health care services compared to that of others is a quite simple. Lack of knowledge and understanding is of the utmost detrimental in medical terms due to the fact that there are many programs that are available to help those with disabilities or home bound. In this case, perhaps Joan and Jerry 's daughter should have been more involved with the medical needs of both her parents. Especially due to the age of her father who was in desperate attempt to keep his disabled wife comfortable in their home. Home health care services are readily available to covered members of Medicare/Medicaid or other third-party payers. Although in Joan 's later days of life, her medical needs were being attended to by home health care professionals, perhaps her life could have been extended and foreseen medical conditions that could have prevented another stroke. "Being an informal caregiver plays a huge role in providing care and relief to long-term consumers (Pratt, 2010)." If Jerry would have taken advantage of home health care and it 's available services at an earlier stage, then perhaps he would not have to have had a hip replacement by having more rest to take care of himself. "As with other forms of long-term

All of the health care programs in Michigan have an income test and some of the programs also have an asset test. These income and asset tests may vary with each program. For some of the programs, the applicant may have income that is over the income limit and still be able to obtain health care benefits when their medical expenses equal or exceed their deductible (formerly known as spend-down) amount.

Taking care of the individuals that are getting older takes many different needs. Most of these needs cannot be given from the help of a family. This causes the need of having to put your love one into a home and causing for the worry of how they will be treated. It is important for the family and also the soon to be client to feel at home in their new environment. This has been an issue with the care being provided for each individual, which has lead to the need of making sure individuals have their own health care plan.

Many nursing homes assume in error that if a patient has stopped making progress towards recovery then Medicare coverage should end. In fact, if the patient needs continued skilled care simply to maintain his or her status then the care should be provided and is covered by Medicare.In fact, patients often receive an array of treatments that don 't need to be carried out by a skilled nurse but that may, in combination, require skilled supervision.Even in cases where the SNF initially treats the patient as a Medicare recipient, after two or more weeks, often, the SNF will determine that the patient no longer needs a skilled level of care and will

Consequently, to qualify for Medicaid, which is designed for beneficiaries with low income, one must receive a monthly income below the average poverty level, which is around $2,000 per month and have no cash assets, in order for Medicaid to cover long-term care facilities. When applicants spend down his or her assets, Medicaid will look at any “financial gifts” made within the past 5 years; this could result in the denial of benefits depending on the number of months the gift could have paid for a long-term care facility (Fischer, 2011).

It is necessary to involve the individual in the plan of care and support. Encourage the individual to make choices. This includes their needs, their culture, their means of communication, their likes and dislikes, wishes and feelings, advance directives, beliefs and values, involvement of their family and other professionals. This should be considered and documented. Also, there must be evaluation in assessing effectiveness in the plan of care.

When it comes to a grantor’s assets and the need for Medicaid long-term care services, the Medicaid program has a five-year look back period. Being that a revocable trust can be cancelled at any time and the assets are still under the control of the grantor, to become eligible for Medicaid, the grantor must meet the income requirements as well as transfer any asset that put them over the requirement to another individual or entity. In addition, even though an individual does not have control of assets and an irrevocable trust cannot be cancelled, this rule applies for irrevocable trusts as well. The five-year look back period means that an individual is not eligible for Medicaid benefits if the asset transfer or gift is made within the five years of their application. Being that the need for long-term care services can often happen abruptly and

Per the Health Care Safety Net Increased Eligibility Amendment Act of 2005, its first manifest goal proposes that individuals 18 years of age or younger whose total gross income is more than 200% but less than 250% of the federal poverty guideline will be afforded reasonably priced healthcare and medical services. In addition, the act’s second goal proposes that the Mayor will create a thorough plan within 180 days of its enactment that outlines specific eligibility criterion for the aforementioned individuals whose gross income is more than 200% but less than 250% of the federal poverty guideline (Health Care Safety Net Increased Eligibility Amendment Act of, 2005). The individual’s total gross income will represent all money received, including but not limited to cash.

In order to qualify for Medicaid individuals must meet certain regulations. Eligibility depends on each state, age and whether the individual is a U.S. Citizen, blind, pregnant, single parent, or suffers from any disabilities; all of this plays a huge role in the Medicaid eligibility criteria. Although, some immigrants may be able to benefit from this program, if the immigrant is a woman whose labor and delivery of child is taken care of inside the U.S. that is enough to make them eligible for Medicaid (Medicaid, 2012). Even though the states are allowed to provide their own regulation guidelines along with other decisions for this health program, there are certain mandatory federal requirements that must be met by each state in order to receive funding. Some of those requirements include; inpatient hospital service, prenatal care, vaccines for children, rural health clinic services, transportation services and many others that according to the federal government are extremely essential for the management of this program ("What is medicare/medicaid?," 2012).

The issues including states incorporate standard-value protection scope for people with prior conditions, family scope that incorporates subordinate individuals up to age 26, extended audit of premium rates, required proportions of back up plan uses on wellbeing administrations, shopper help or ombudsman workplaces, diminished boss shares for retirees between ages 55-64, and patients' rights to advance denied scope.

Usually Medicare does not pay for long-term care; it will only pay for medically necessary skilled nursing facilities or home health care. With Medicare certain criteria has to be met for certain conditions for Medicare to pick up the cost. Medicare also does not pay for any kind of long-term care that helps assist with activities of daily living. This kind of care includes dressing, bathing, and using the bathroom. Medicare Advantage plans can offer limited skilled nursing facility and home care coverage if the patient’s long-term care is medically necessary. Medicaid offers coverage for both medical and non-medical associated long-term care, but the person will only qualify if they have less than $2000 in assets and income that is inadequate to pay for the cost of their care. If a veteran is at least 70% service connected disabled the Veterans Administration will pay the costs of long-term care for life. Long-term care that is not provided by the government is usually paid out-of –pocket by family members. Most people choose the option of home health care because long-term care is too costly.

Certain assets of the beneficiary are exempted from determining eligibility under for SSI and Medi-Cal purposes (generally the same items). (42 U.S.C.A. § 1382b and 42 U.S.C.A. § 1396p(h) and Cal. Code Regs. tit. 22, § 50418.) Exempted assets are listed in the statute and generally include those assets listed under “Permissible Distributions” in the section below, Allowed Distributions. Those resource limits are $2,000 for an individual or $3,000 for a couple. (20 C.F.R. § 416.1205, Cal. Code Regs. tit. 22, § 50419 and Cal. Code Regs. tit. 22, § 50420.) Also, for eligibility purposes, the income and resources of a minor child are deemed to include the income and resources of the parents. (20 C.F.R. § 416.1202(b).)

Can Mr. Grant receive appropriate Medicare healthcare services at his home? If not, Why? Is Mr. Grant’s medical condition so severe that he can no longer have visitations to his home?

During my work as a medical scribe I had to sign a contract with a similar agreement. This contract was meant to teach me that my work was to assist the patient that came into the hospital and to have honor for the duties I was to be performing. Pride in the job I was performing and for those I wished to help allowed me to sustain this agreement and refrain from putting the personal information of patient’s in any unauthorized hands. My hope to become a good physician and to maintain integrity in my work was tested during my scribing days and this allowed me to work and uphold the professionalism that I possessed during work and in my everyday life.

Some people might say care planning is the most natural thing in the world, so why do we need policies and legislations in place to show us how to do it? (Care planning in health and social care – Marjorie Lloyd - page 1).