Post-Acute Care

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.

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

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?

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

This essay discusses and reflects upon patient care in the post anaesthetic care unit (PACU) and is linked to my experiences on placement. It discusses how my approach to patient care has been challenged and analyses how evidence based practice can create a change in the way patients are cared for. It reviews the processes of managing the perioperative environment and evaluates the implications for practice when applying a change in healthcare. Wicker and O’Neill (2010) state that “The lack of immediate medical support in the recovery room means that practitioners work in a more autonomous role than any other area of the operating department” (p.379). By reflecting upon my experiences I am able to link practical and theoretical aspects of the operating department practitioner (ODP) job role. This will provide me with a greater understanding of professional practice and it will develop my personal knowledge and self-awareness (Forrest, 2008). Using a model of reflection is important as it provides a framework that can be systematically followed and acts as a guide through the process of reflection. For this essay I have chosen to use the Gibbs’ Reflective Cycle (1988) as it provides a methodical guide to reflection using a series of ordered questions that each lead to the next stage of the cycle (Forrest, 2008).

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

Common within each of these four categories is the need to collect, collate, format, and submit required data. Manual data collection is an expensive and time consuming endeavor that clinicians often outsource to billing companies or other third-party vendors. Electronic Health Records (EHR) and Anesthesia Information Systems (AIMS) are better solutions to data collection and submission. According to Dr. Emily Richardson, M.D., Chair of the Committee on Practice Quality Improvement for the ASA, there are three tiers of data categories (Emily Richardson, 2017):Tier 1: Administrative/Claims/Billing/DemographicTier 2: Registry/gross clinical (QR/ QCDR)Tier 3: AIMS/ granular

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

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.

Electronic Health Record (EHR) is an electronic version of a patients medical history, that is maintained by the provider over time, and may include all of the key administrative clinical data relevant to that persons care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports (Ehlke & Morone, 2013). The incentives from both of this articles will result in the delivery of quality care to many individuals in

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.

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.

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

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

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