Post-Acute Care

Documentation and communication are constant challenges that healthcare providers face when seeking continuity of care for their patients. Every time a patient moves from a hospital to a nursing home, or from a skilled nursing facility to home health or hospice, the staff that cares for the patient is at risk for a gap in patient care and communication. Home health and hospice agencies rely heavily on Medicaid and other insurance for reimbursements in order to continue to provide care for their patients and keep the doors to their agencies open. Thorough and timely documentation is the key to ensuring proper reimbursement for nursing services and other therapies provided from insurance agencies. This same

With today’s technology and the specialized skills of doctors, nurses, and therapists, patients who need long term care of acute problems can obtain these services at institutions known as postacute care providers. One type of facility that falls under this title is the Long Term Acute Care Hospital (LTACH) (Munoz-Price, 2009, p. 438). This paper will discuss services provided by LTACHs, the role of the Chief Nursing Officer (CNO) in these facilities, and Medicare reimbursement effected by patient satisfaction surveys.

One of the aims of the Patient Protection and Affordable Care Act (ACA) of 2010 is improved integration and coordination of services for primary patient care. The patient-centered medical home (PCMH) is one of the approaches by which improvements can be established. The patient-centered medical home model is particularly well-suited for people who have chronic illness. The design of the patient-centered medical home model departs substantively from traditional reimbursement policies, in that, the ACA provides for incentives and resources to enable care coordinators to be directly recognized and compensated for their care coordination work. Care coordinators are most often registered nurses who through their work that aligns with ACA engage in quality improvement work, cost-effectiveness measures, and patient advocacy. To bring the ACA model to a human scale, the authors present a case study of a care coordinator at a patient-centered medical home in rural Maine. The table provided below provides a basic textual analysis of the study as it is published in the professional nursing journal.

Care measurements depend on numeric data and patient feedback. Raw data can be sourced from the primary software program, such as the hospitals Health Information Management System, and processed through big data analytics. Insurance and Medicare claims are also sources of raw data. Patient feedback is continually elicited through the nationally recognized Centers for Medicare and Medicaid Services (CMS) patient survey. All

Competition in the home health field is intense, particularly in rural areas, where the need for services is in more demand. Because services are expensive to provide, it is critical for agencies to generate a volume of visits sufficient to cover fixed expenses plus make a small profit. Competition is primarily between another company Care One, Inc., a multicounty operation that has been established in the area for well over 10 years. AHHS surpassed them in total number of visits after its second year of operation and has been progressively growing. Many of the physicians in the area, however, continue to use Care One, and Care One receives more referrals from the local hospitals than AHHS. Currently AHHS has 32 employees, including 15 registered nurses, 8 nursing aides, 1 physical therapist, I speech language therapist, and 7 administrative staff.

I attended an Arizona Health Care Association (AZHCA) regulatory and quality meeting. The AZHCA is a non-profit professional association of skilled nursing facilities (SNF), assisted living centers (ALF), and businesses that represent the profession of long term care. It was formed to promote standards and ethics in the profession of long term health care, and to advocate quality care for nursing facility and assisted living residents. Their goal is to strengthen the ability of its member facilities to deliver quality care to meet the needs of Arizona’s elderly and disabled residents. They do this by working closely with federal and state agencies and community partners to develop, amend, and implement reasonable legislation, regulatory policies, and standards of care.

Following the IRB review and approval, data will be collected using a multipronged approach. Resident medical charts will be

According to the U.S. Department of Health and Human Services (HHS), the aging population is likely to impact the necessary size and composition of the health care workforce (Center for Health Workforce Studies, 2006). There are now 35 million people over the age of 65 in the United States. It is estimated that about 1.6 million older adults will be living in nursing homes with almost half of the residents being over the age 85 years old (Kovner, Brewer, Fairchild, Poornima, Kim, and Jadjukic, 2007). The purpose of this paper is to he identify of facility and number of residents being care for. What would be the role of the nurse practitioner in this facility and the regulatory issues as it supports this role?

In home health care, the patient is assessed to determine what types of services are needed such as skilled nursing care, therapy, home health aide services, and medical social services. The case mix adjustment is based on this assessment along with the patient's current condition. There are 153 case-mix groups that the patient can be classified under. In a skilled nursing facility the case-mix adjustment is assigned based on the resident's assessment along with the relative weights staff time data associated with their care. In a skilled nursing facility the PPS also allows for a geographical adjustment based on the hospital wage index for the facility's location. There is also a three-year transition adjustment that is part of the PPS for skilled nursing facilities. This a blend of the facility-specific payment rate and the federal case mix adjusted rate. Home health care PPS does not allow for this transition adjustment or the geographical adjustment. Instead there are adjustments for outlier payments, beneficiaries who only need a few visits, and beneficiaries who are readmitted within the 60-day episode. If a beneficiary only requires four or fewer visits during the 60-day episode, the PPS will be based on a standardized, service-specific per-visit amount that is multiplied by the number of

Redesigned Care processes for reliable delivery and 100 percent evident best practices after four months.

Recovery is a huge amount of work that will require you to invest in yourself before you try to help someone else. Post-Acute Withdrawal Syndrome is a set of symptoms including mood swing, anxiety, irritability, depression, and cravings which can last months into recovery. To be a good counselor you have to possess strong and well defined bounds. Boundaries are learned in recovery and in order to be concrete they need to be practiced.

Reimbursement for these facilities and programs is shifting to a quality and acuity-based system, meaning the better care a facility provides, the better the reimbursement will be. This new reimbursement system is aimed at benefiting those receiving care but does not take into consideration the costs associated with providing such care. Additionally, this program is not just centered around medical care, but also considers the quality of life long-term care facilities and programs provide for their patients (TN Division of TennCare). Long-term facilities and programs focus their attention to the maintenance and monitoring of health conditions in individuals, and now these facilities and programs must do so while documenting every aspect of care – from when and what types of medicines are being given to the number of showers an individual takes each week to the portion of meals an individual is eating. While this may sound essential in the maintenance and monitoring of conditions, the extensive charting required under the new reimbursement system also takes caregivers away from providing additional

Prediction: The Chief Clinical Informatics Officer will create method to include schedules, protocols, follow-up and compliance reports in order to standardize EHR documentation. With the utilization of the nursing audit tool and sharing the outcomes with the individual nursing staff to assist

A surgical nurse is responsible for monitoring and ensuring quality healthcare for a patient following surgery. Assessment, diagnosis, planning, intervention, and outcome evaluation are inherent in the post operative nurse’s role with the aim of a successful recovery for the patient. The appropriate provision of care is integral for prevention of complications that can arise from the anaesthesia or the surgical procedure. Whilst complications are common at least half of all complications are preventable (Haynes et al., 2009). The foundations of Mrs Hilton’s nursing plan are to ensure that any post surgery complications are circumvented. My role as Mrs Hilton’s surgical nurse will involve coupling my knowledge and the professional

Once data is collected it can be used by numerous health care providers and decision makers to monitor the health and needs of individuals and populations, as well as contribute to the analysis of the health system. Users including hospitals, health care practitioners, government, professional associations, researchers, media, students, and the general public. Having the correct and up-to-date coded data is critical, not only for the delivery of high-quality clinical care, but also for continuing health care, maintaining health care at an optimum level, for clinical and health service research, and planning and management of