Preventable Health Deterioration Of The United States Skilled Nursing Facilities

Eastabrooks, C. A., Midodzo, W. K., Cummings, G. C., Ricker, K. L., & Giovanetti, P. (2005, March/April). The impact of hospital nursing characteristics on 30-day mortality. Nursing Research, 54(2), 72-84. http://dx.doi

Medicare, the federal governments health insurance program, finances acute medical care for nearly all elderly Americans over the age of sixty-five. However, very few long-term care services are covered. Medicare finances long-term care only partially through it’s limited skilled nursing facility (SNF) and home health benefits. “Despite recent growth in spending on these benefits, much of the SNF and home-care paid for by Medicare remains short-term rehabilitative care, often related to a hospital stay or outpatient procedure. Medicare covers SNF care for up to 100 days following a hospital stay of at least three days. For homebound persons needing part-time skilled nursing care or therapy services, Medicare pays for home health care, including personal care services provided by home health aides.” (Feder, Komisar, and Niefeld) All that is not covered, the elderly are expected to cover with savings, private insurance policies, and financial support

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

The patient centered medical homes (“PCMH”) approach “focuses on keeping people well, managing chronic conditions like diabetes or asthma, and proactively meeting the needs of patients.” According to the Arkansas Department of Health, chronic diseases like cancer heart disease or diabetes affect approximately over fifty percent of adult Arkansans. Yet chronic diseases are often preventable. The high rate of chronic diseases can partly be attributed health insurance coverage—“when people don’t have health insurance they tend to avoid seeing doctors. People

When you hear the words, “Nursing Home”, what comes to mind? Sad, helpless, elderly individuals? The smell of urine? An overall, unpleasant place to reside in? Unfortunately, this generic description is accurate amongst majority of the nursing home facilities across the United States. More often than not, the elderly suffer from inhumane living conditions while residing in a nursing facility. Quite often we hear stories on the news about cases of elder abuse in the nursing home and we automatically think physical, mental, or emotional abuse from caregivers. However, the fact that these individuals are also living amongst unsanitary, inhumane conditions, and ran by a staff that includes

Many instances have been noted that healthcare providers are bringing the infection to the patients and not the patients bring the infection to the staff. Furthermore, It is well documented that nosocomial infection occurs (Rice, 2010) and hospitalized individuals face more complications and greater mortality from influenza. Healthcare providers are indirectly causing undo harm to patients that are more susceptible to infections such as influenza. “In nursing home settings, vaccination of healthcare workers has been shown to decrease morbidity and mortality among nursing home residents” (Babcock, et al., 2010, p. 459). One study suggests that there is a higher rate of occurrence of influenza among healthcare providers than residents. “In elder-care settings, influenza among staff precedes illness among residents, suggesting that health care workers introduce the virus into the setting” (Anikeeva, Braunack-Mayer, & Rogers, 2009, p. 25).

The next topic to address is the growing need for long-term care in the United States. Many Americans are faced with the dilemma that there are a limited

A reoccurring issue such as bedsores is something nursing home facilities try their best to prevent. Unfortunately, the rate at which it is occurring in our nursing home is 12%, a little higher than that of the national average. This is a number that we as a facility are not proud of, and as Director of Quality Improvement, new strategies will be implemented to improve the quality of care in which our patients are receiving. This simple plan mimics that of the FOCUS PDSA and can be broken down into a few steps in order to be better assessed. The first step involves creating a team of employees to research and better understand the main source of the bedsores. The second step includes developing a strategy, without any errors, within the team

Many chronic conditions can greatly affect an individual physically with some sort of chronic pain, mentally with depression, and socially by rendering them unable to work (Harris & Wallace, 2012). These effects can thus put strain on families and society as more individuals suffer from various chronic conditions. In recent years, many of those working as health care professionals, such as primary care providers (PCPs) are affected greatly by the widespread prevalence of chronic disease in the US. For PCPs, approximately 75% of their patients schedule visits for multiple chronic illnesses (Zamosky, 2013). This has caused a shift in health care to focus on tertiary prevention in limiting comorbidities and issues associated with chronic diseases. PCPs face challenges by having less time to treat chronic disease because they only having have approximately eighteen minutes to deal with on average seven issues for each patient (Zamosky, 2013). Since the Affordable Care Act (ACA) was implemented, insurance companies can no longer deny coverage or charge more for people with preexisting conditions which includes those with chronic diseases (ObamaCare Facts, n.d.). The ACA helps people with chronic illnesses to obtain insurance; however, since these people are insured

Health care in the United States is currently facing a looming crisis that requires an urgent response of intervention. With the baby boomers population on the rise, there will ultimately be an increased need for long-term care (LTC) services. Pratt (2015) defines baby boomers as “the name given to the large number of people born in the period following World War II, between 1946 and 1964” (p. 17). According to Mikulaschek (2013), “Beginning in 2010, the roughly seventy-eight million baby boomers began turning sixty-five at a rate of three to four million per year leading to growing concerns over meeting their healthcare demands” (p. 86). This brings the number from about forty million in 2010 to seventy-two million in 2030 causing them to account for almost twenty percent of the total U.S. population (Mikulaschek, 2013, p. 96; Pratt, 2015, p. 17). This alarming rate will correspond to the increasing number of elderly individuals with chronic conditions who depend on LTC services for daily functioning (Pratt, 2015, p. 17). This influx of baby boomers presents the health care industry with a plethora of issues related to costs, quality, and access to the LTC services that this population so desperately needs.

LeadingAge Texas is working with policy makers to pass the Nursing Home Quality Rate Enhancement health policy. Some of the issues addressed in the meeting regarding quality care will be addressed in this paper. How the NHQRE policy will impact the advanced nursing practice and the delivery of health care. NHQRE is a needed health policy that will increase our quality care.

"Many older people fear that a hospital stay could leave them even more disabled than they were before. Unfortunately, there's new reason to believe this fear is justified. Elderly patients who are hospitalized are at much higher risk of cognitive problems afterward, according to a study published on Wednesday in the journal Neurology."

The initiative that I have chosen for this discussion is the Skilled Nursing Facility Quality Reporting Program (IMPACT ACT 2014). This Act has been developed to implement a quality measures using a standardized assessment data, as well as, the reporting of resources used, hospitalization and discharge. The Skilled Nursing Facility Quality Reporting Program assessment based quality measures are reporting if residents that, have experienced one or more falls that ended in a major injury and residents with a pressure ulcers that have developed in their care or has continued to get worse. I believe that, this Act for health care quality would ensure that residents of long term care facilities would receive better care (Centers for Medicare & Medicaid

The Nursing home (NH) residents are at a higher risk of carrying MRSA than others because of the high pervasiveness of comorbidities, sustained skin sores, and recurrent exposure to antibiotics (Bellini et al., 2015, p. 401). Social activities in nursing homes can attribute the cross-transmission of MRSA among the residents, as well as nursing homes and hospitals influence each other due to the frequent admissions from one site to another (Bellini et al., 2015, p. 401). NH residents typically display various comorbidities and more prominent functional reliance, requiring more involved, contact care from health care workers, and they are more exposed to health care worker interaction than hospitalized patients due to the fact they stay longer in NHs compared to

Susan, I agree we need to start focusing on wellness as a preventative measures to decrease healthcare cost. I have seen where the same patient that have recurrent visit in the hospital every 2 months and their visits becomes a revolving door. But the question is asked, is literacy the reason for these patients not taking care of themselves? Patients who are illiterate have difficulty understanding their health and does not understand the importance of preventative healthcare. I have seen patients that comes in the facility who are known diabetic comes in with the same reoccurring problem with elevated blood sugar and elevated AIC level every 30-60 days. Prior to be discharged they receive diabetic education and within 2 to 3 months they return