Podcast
Questions and Answers
Which of the following is a requirement for Medicare qualification for home health care?
Which of the following is a requirement for Medicare qualification for home health care?
What is one of the main benefits of home health care for patients?
What is one of the main benefits of home health care for patients?
Which professional roles primarily provide home health nursing care?
Which professional roles primarily provide home health nursing care?
Which of the following best describes the official definition of home health care?
Which of the following best describes the official definition of home health care?
Signup and view all the answers
Which of the following perspectives on home health care emphasizes the importance of family support?
Which of the following perspectives on home health care emphasizes the importance of family support?
Signup and view all the answers
What is a primary function of the LPN/LVN in home health care?
What is a primary function of the LPN/LVN in home health care?
Signup and view all the answers
Which of the following is a requirement before Home Health Aide (HHA) services can be provided?
Which of the following is a requirement before Home Health Aide (HHA) services can be provided?
Signup and view all the answers
What is one of the goals of physical therapy according to the content?
What is one of the goals of physical therapy according to the content?
Signup and view all the answers
Which therapy requires a master’s-prepared and certified clinician for Medicare reimbursement?
Which therapy requires a master’s-prepared and certified clinician for Medicare reimbursement?
Signup and view all the answers
In the home health process, who generally conducts the initial evaluation and admission visit?
In the home health process, who generally conducts the initial evaluation and admission visit?
Signup and view all the answers
What was the primary effect of Congress enacting the Prospective Payment System (PPS) in 1983?
What was the primary effect of Congress enacting the Prospective Payment System (PPS) in 1983?
Signup and view all the answers
Which of the following is NOT a requirement for a home health agency to receive Medicare payments?
Which of the following is NOT a requirement for a home health agency to receive Medicare payments?
Signup and view all the answers
What was a significant outcome of the Balanced Budget Act passed in 1997?
What was a significant outcome of the Balanced Budget Act passed in 1997?
Signup and view all the answers
What are some of the major goals of skilled nursing services in home health care?
What are some of the major goals of skilled nursing services in home health care?
Signup and view all the answers
Which of the following accurately describes the benefits of telehealth services in home care?
Which of the following accurately describes the benefits of telehealth services in home care?
Signup and view all the answers
What is the primary purpose of discharge planning in the context of home healthcare?
What is the primary purpose of discharge planning in the context of home healthcare?
Signup and view all the answers
Which of the following is NOT a major element measured in quality management for home care clients?
Which of the following is NOT a major element measured in quality management for home care clients?
Signup and view all the answers
Which is a requirement for Medicare beneficiaries to receive home health care services?
Which is a requirement for Medicare beneficiaries to receive home health care services?
Signup and view all the answers
What is a key consideration in the nursing process for home health care?
What is a key consideration in the nursing process for home health care?
Signup and view all the answers
Which reimbursement source covers basic home care services alongside additional aide and personal care services?
Which reimbursement source covers basic home care services alongside additional aide and personal care services?
Signup and view all the answers
What is the primary goal of long-term care services?
What is the primary goal of long-term care services?
Signup and view all the answers
Which of the following services is NOT typically offered by home health agencies?
Which of the following services is NOT typically offered by home health agencies?
Signup and view all the answers
What is a key requirement for an individual to qualify for the Program of All-Inclusive Care for the Elderly (PACE)?
What is a key requirement for an individual to qualify for the Program of All-Inclusive Care for the Elderly (PACE)?
Signup and view all the answers
Which statement best describes palliative care?
Which statement best describes palliative care?
Signup and view all the answers
Which population was estimated to require long-term care services most frequently in 2012?
Which population was estimated to require long-term care services most frequently in 2012?
Signup and view all the answers
Study Notes
Home Health Nursing Care
- Home health care services all ages, providing care in the comfort of their own home.
- It improves family support, familiarity, participation in care, and shortens hospital stays, preserving individual independence.
- Services include skilled nursing, physical/occupational therapy, respiratory therapy, medical supplies/equipment, wound care, and IV administration.
- Medicare patients must be homebound (unable to leave home easily or needing significant effort to travel).
- Common qualifying conditions: Stroke, COPD, fractured hips, joint replacements, heart failure, diabetes, and hypertension.
- LPN/LVNs provide most care, while RNs oversee and manage cases.
Defining Home Health Care
- Official: Services in a patient's home promoting health.
- Patient: Skilled, individualized care in a familiar environment.
- Family: Promotes integrated care; focuses on adaptation, wellness, and emotional support.
- Provider: Uses all disciplines, challenging professional independence and communication skills.
Historical Overview of Home Health Care
- Driven by legislation (Medicare, Medicaid, Social Security Act) since 1965 to today, primarily for seniors and low-income individuals.
- 1966: Medicare implementation introduced a standardized medical model with reimbursement limits.
- 1983: Prospective Payment System (PPS) for hospitals encouraged earlier discharge, increasing demand for home care.
- 1997: Interim payment system aimed to curb costs through limit removal, leading to service reductions.
- 2000: Prospective payment system for home health incentivized efficiency, leading to rising use again.
- Growing since 1990s but expected to shrink somewhat from 2017 onward.
Home Health Care Agencies
- Agencies vary by funding sources (e.g., Medicare, Medicaid, private pay).
- Compliance with federal, state, and local laws is critical, including licensure, certification, and possible certificate of need and accreditation.
- Agencies are classified by tax status (profit/nonprofit), location (free-standing/institutional), and governance (private/public).
- Telehealth is increasingly popular, offering convenience, cost-effectiveness, and accessibility in rural areas.
Changes in Home Health Care
- Use of ethics committees, psychiatric nurse clinicians, social workers, pain specialists, and hospice programs (per-diem payments).
- Newer services: Pet care programs and home infusion therapy (IVs, antibiotics, etc.).
- Health promotion services (respiratory therapy, nutrition, podiatry, dental care) may not be covered by Medicare.
Service Components
- Medicare requires a physician-signed treatment plan (frequency, duration, disciplines).
- Recertification every 60 days with a face-to-face visit.
- Four major skilled nursing goals: Restorative, improvement, maintenance, and promotion.
- Provider attributes: Proficiency, organization, independence, communication, and cultural sensitivity.
Role of LPN/LVNs
- Supervised by RNs, offering flexibility, compassion, and teamwork.
- Functions include teaching (bowel/bladder care, glucose monitoring, medications, etc.), psychosocial support, and procedural assistance (IVs, dialysis).
Typical Home Health Process
- Patient referrals come from physicians, hospitals, or directly by the patient.
- RN performs initial evaluation within 24-48 hours.
- Evaluation includes psychosocial factors, environment, functional impairments, support systems, and adherence to treatments.
- Care plan is documented and signed by the physician.
- Visits are scheduled based on orders requiring 30-45 minutes.
- Documentation is often electronic.
Quality Assurance
- Aims to meet patient needs and improve care.
- Measured by structural (agency structure), process (care delivery), and outcome criteria (patient behavior changes/satisfaction).
- Uses Joint Commission principles: patient outcomes, processes and integration, staff motivation and competencies.
Reimbursement Sources
- Medicare and Medicaid are primary.
- Medicare requires certification, face-to-face visits, and adherence to conditions of participation.
- Medicaid is state-administered and requires services.
- Third party and private pay are supplementary.
- HMOs/PPOs have contracts with providers.
Cultural Considerations
- Crucial in home care.
- Requires awareness of personal biases and cultural values when communicating.
- Strategies to overcome cultural barriers are vital.
Long-Term Care Services
- Services support personal needs (acute/chronic illness/injury).
- Goal is maximum independence, focuses on quality of life in all settings.
- Factors: Physical and psychological impairment, ethnicity, social/spiritual needs.
- Variety of care settings (home, community, residential, institutional).
Residential Care Settings
- Assisted living: Apartments with personalized care options.
- Continuing care retirement communities (CCRC): Range, from independent living to skilled nursing, lifetime commitment.
- Subacute units: Bridge between acute and long-term care.
- Long-term care facilities: Nursing homes; provide 24-hour care, often with multiple health issues; residents, not patients; interdisciplinary approach and team to meet all needs.
Rehabilitation Nursing
- Focuses on restoring health or adapting to chronic illness/injury.
- Goals involve maximizing quality of life, adjusting to altered lifestyles, promoting wellness and preventing complications and achieving the highest degree of independence.
- Models of rehab teams: Multidisciplinary, interdisciplinary, transdisciplinary, focusing on collaboration and individualized goals.
- Rehabilitation nurses are critical educators, advocates, and caregivers.
Hospice Care
- Philosophy of comfort and quality of life for terminally ill patients.
- Historical roots in European hospices.
- Medicare reimbursable.
- Criteria: Prognosis of 6 months or less.
- Interdisciplinary team approach: Medical director, nurse coordinator, social worker, spiritual coordinator, volunteers, bereavement coordinator, pharmacist, nutrition consultant, hospice aides.
- Goals: Symptom control, patient/family involvement, living life fully, and caregiver support.
- Palliative care vs. curative care: Palliative relieves symptoms.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
This quiz covers essential aspects of home health nursing care services provided to patients of all ages in their homes. It highlights the importance of individual independence, family involvement, and the various types of skilled services available, while discussing qualifying conditions for home health care. Test your knowledge on the roles of LPNs, LVNs, and RNs in managing home health care.
