Understanding Healthcare Settings

1. Understanding Healthcare Settings Chapter 1

2. Standard/s 1Professionalism, Residents’ Rights, and Independence • Differentiate between the services and careers in a long-term care (LTC) setting. Document allowable length of stay, payment options, and regulation of LTC facilities in written, oral, and digital artifacts. Research and document educational requirements as well as state and national guidelines governing practicing professionals (such as licensing, certifications, training, and compliance) in a long-term care (LTC) setting.

3. Objectives • Structure • LTC • Residents • Policies and Procedures • Survey • Medicare and Medicad • Terms

4. 1. Discuss the structure of the healthcare system and describe ways it is changing • Providers • Doctors • Nursing staff • Psych Services • Dietary • Rehab • Now you think of some other Providers – what about at an acute care facility? • Holistic Care

5. Traditional Healthcare System

6. 1. Discuss the structure of the healthcare system and describe ways it is changing • The following major changes have a serious impact on how health care is provided: • Increased use of expensive technology • Rising costs of health care • New ways to control costs of care

7. 2. Describe a typical long-term care facility REMEMBER: There are many different models of long-term care facilities, including facilities for residents with dementia and facilities with assisted living wings.

8. Think about these questions: What services do you think all long-term care facilities offer? What services might some long-term care facilities offer for residents with different needs?

9. Residents in Long-term Care Facilities • 89% are over 65 • 54% are over 85 • 11% are younger than 65 • 70% are female • More than 90% are white and non-Hispanic • About 1/3 come from a private residence • Over 50% come from a hospital

10. Think about this question: Why is important for an NA to know what kinds of residents he will likely be caring for? REMEMBER: Residents with different lengths of stay may have different care needs.

11. Residents with a length of stay of six months or more • Make up over 2/3 of residents • Require 24-hour care • Did not have caregivers able to give enough care at home

12. Residents with a length of stay of less than six months • May be admitted for terminal care (will die in the facility) • May be admitted for rehabilitation or temporary illness (will recover and return to the community)

13. Think about this question: How might care for a resident admitted for temporary care be different from care for a resident who will live in the facility for years? REMEMBER: Many residents in LTC lack outside support. This means it is very important for NAs to care for the whole person - addressing social and emotional needs as well as physical needs.

14. 4. Explain policies and procedures The following are common policies and procedures in long-term care facilities: • All resident information is confidential. • Resident’s care plan must be followed. • NAs only perform tasks in job descriptions. • NAs report to a nurse. • NAs should not discuss personal problems with residents or families. • NAs should not accept gifts and money from residents or families. • NAs must be dependable.

15. REMEMBER: It is very important for NAs to ask questions about policies and procedures or review the procedure manual when they are unsure about care.

16. 5. Describe the long-term care survey process • Surveyors use these methods to study residents’ care and determine how their needs are being met: • Interview residents and their families • Observe staff interactions with residents and care given • Review residents’ charts • Observe residents’ meals

17. Think about these questions: Why is it very important for NAs to tell the truth when asked questions by surveyors? What should an NA do if she doesn’t know the answer to a surveyor’s question?

18. REMEMBER: Surveys conducted to the Joint Commission are not affiliated with state inspections. Facilities participate in Joint Commission surveys on a voluntary basis.

19. Bell Work • List one fact about each of the following healthcare settings: • Home health care • Assisted living facilities • Adult day services • Acute care • Subacute care • Outpatient care • Rehabilitation • Hospice care

20. Standard/s 1Professionalism, Residents’ Rights, and Independence • Differentiate between the services and careers in a long-term care (LTC) setting. Document allowable length of stay, payment options, and regulation of LTC facilities in written, oral, and digital artifacts. Research and document educational requirements as well as state and national guidelines governing practicing professionals (such as licensing, certifications, training, and compliance) in a long-term care (LTC) setting.

21. Facts About Medicare and Medicaid

22. 7. Discuss the terms culture change and person-directed care and describe Pioneer Network and The Eden Alternative These are the core values of culture change: • Choice • Dignity • Respect • Self-determination • Purposeful living

23. The Pioneer Network • Was formed in 1997 by a small group of people in LTC • Advocates for person-directed care • Called for change in how elders are treated everywhere in the community The Eden Alternative • Was founded in 1991 by Dr. William Thomas • Seeks to improve the lives of elders and their caregivers • Creates environments that support growth and development and eliminate loneliness, helplessness, and boredom • Offers education, resources, and consulting services