Chapter 2 part 1 U.S. Healthcare System
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Questions and Answers

What percentage of the gross domestic product was spent on health care expenditures in the United States in 2018?

  • 20.5%
  • 17.7% (correct)
  • 22.1%
  • 12.5%
  • How many Americans did not have health insurance in the first 6 months of 2020?

  • 25 million
  • 35 million
  • 20 million
  • 30 million (correct)
  • What is the primary focus of the nursing profession?

  • Health promotion and disease prevention (correct)
  • Disease management
  • Pharmaceutical sales
  • Health care cost reduction
  • What is a consequence of not having health insurance or delaying health care?

    <p>Increased risk of premature death</p> Signup and view all the answers

    What is the average annual health care expenditure per person in the United States?

    <p>$11,172</p> Signup and view all the answers

    What is a key aspect of nursing's focus on health care consumers?

    <p>Interprofessional collaboration</p> Signup and view all the answers

    Why do millions of Americans with health insurance not seek preventive or needed health care?

    <p>High cost of shared expenses</p> Signup and view all the answers

    What is the value of the nursing profession?

    <p>Rooted in helping people</p> Signup and view all the answers

    What is the main challenge posed by the aging baby boomer generation to the healthcare system?

    <p>Increased need for complex nursing care and health services</p> Signup and view all the answers

    What is the consequence of the accelerating rate of nurses' retirements?

    <p>Loss of experienced nurses' knowledge and skills in all areas of practice</p> Signup and view all the answers

    What is the focus of health-related activities in a care setting?

    <p>Levels of prevention</p> Signup and view all the answers

    What is the primary role of a nurse in a primary care setting?

    <p>To identify changes in chronic conditions or the development of new acute conditions</p> Signup and view all the answers

    What is the main difference between levels of care and levels of prevention?

    <p>Levels of care describe the scope of services and settings, while levels of prevention describe the focus of health-related activities</p> Signup and view all the answers

    What is the impact of health care reform on the health care industry?

    <p>Greater emphasis on wellness and primary care</p> Signup and view all the answers

    What is the role of a nurse in wellness care?

    <p>To coordinate resources to better serve populations and communities</p> Signup and view all the answers

    What is the primary goal of developing clinical judgment in nursing?

    <p>To deliver safe, high-quality patient care in a changing health care environment</p> Signup and view all the answers

    What is the role of a nurse in a continuing care setting?

    <p>To apply gerontological nursing principles to help patients adapt to permanent health changes</p> Signup and view all the answers

    What is the consequence of the shortage and uneven distribution of physicians?

    <p>Nurses will need to provide more health care services</p> Signup and view all the answers

    What was the primary focus of developing Integrated Health Care Delivery (IHCD) systems?

    <p>Both A and B</p> Signup and view all the answers

    What is the goal of focusing on population health in IHCD systems?

    <p>To decrease health care costs through effective management of patients with chronic health problems</p> Signup and view all the answers

    What is an example of an Integrated Health Care Delivery (IHCD) system?

    <p>Accountable Care Organizations (ACOs)</p> Signup and view all the answers

    How many types of IHCDs exist?

    <p>Two</p> Signup and view all the answers

    What is the primary function of a Patient-Centered Medical Home?

    <p>To coordinate care activities and services into seamless functioning</p> Signup and view all the answers

    What is a unifying principle of Patient-Centered Medical Home?

    <p>Patient-centeredness</p> Signup and view all the answers

    What is included in the organizational structure of IHCDs that follows economic imperatives?

    <p>Combining financing with all providers</p> Signup and view all the answers

    What is the purpose of electronic health records (EHRs) in Patient-Centered Medical Home?

    <p>To ensure that patients receive care how they want it and when and where they need it</p> Signup and view all the answers

    What type of care is included in secondary care services?

    <p>Urgent care and hospital emergency care</p> Signup and view all the answers

    What is the primary goal of Integrated Health Care Delivery (IHCD) systems?

    <p>To improve health care quality and decrease overall health care costs</p> Signup and view all the answers

    What is the main focus of primary health care?

    <p>To improve health outcomes for an entire population</p> Signup and view all the answers

    What is the primary goal of health promotion programs?

    <p>To reduce the incidence of disease and minimize complications</p> Signup and view all the answers

    Who leads a team of professionals dedicated to providing proactive, preventive, and chronic care management?

    <p>A personal primary care physician or nurse practitioner</p> Signup and view all the answers

    What is the main difference between secondary and tertiary care?

    <p>The complexity of a patient's medical needs</p> Signup and view all the answers

    What is the primary reason people use health care services, such as a hospital?

    <p>For diagnosis and treatment of illness</p> Signup and view all the answers

    What is the main goal of preventive care?

    <p>To reduce and control risk factors for disease</p> Signup and view all the answers

    What is the primary source of referral for secondary health care?

    <p>A primary health care provider</p> Signup and view all the answers

    What is the primary characteristic of tertiary health care?

    <p>It is specialized consultative care</p> Signup and view all the answers

    What is the primary consequence of delays in treating or diagnosing chronic illness?

    <p>Disability and increased health care costs</p> Signup and view all the answers

    What is the main function of hospitals?

    <p>To provide comprehensive secondary and tertiary health care to patients</p> Signup and view all the answers

    What percentage of adults in the United States with a mental health condition received mental health services in 2019?

    <p>44.8%</p> Signup and view all the answers

    Which type of service integrates health promotion principles into a school curriculum?

    <p>School health</p> Signup and view all the answers

    What is the primary goal of occupational health services?

    <p>All of the above</p> Signup and view all the answers

    What type of service focuses on health promotion and health education, chronic disease assessment and management, and support for self-care and caregivers?

    <p>Nurse-managed clinics</p> Signup and view all the answers

    What is a unique aspect of block and parish nursing?

    <p>Delivering health care services to patients within their own religious communities</p> Signup and view all the answers

    What is a key feature of community centers?

    <p>They provide culturally appropriate care to underserved communities</p> Signup and view all the answers

    Which type of service provides primary health care and diagnoses and treats acute and chronic illnesses?

    <p>Physicians' offices</p> Signup and view all the answers

    What is a common service offered by nurse-managed clinics?

    <p>Disease management</p> Signup and view all the answers

    Why are school health services important?

    <p>They promote health outcomes of young people</p> Signup and view all the answers

    What is a unique aspect of community centers?

    <p>They provide services to a specific patient population</p> Signup and view all the answers

    What is the primary difference between Critical Access Hospitals (CAHs) and large urban medical centers?

    <p>CAHs have limited staff and services</p> Signup and view all the answers

    What is the role of clinical judgment in delivering patient care?

    <p>All of the above</p> Signup and view all the answers

    What is the core mission of hospitals across the country?

    <p>To deliver the right care, at the right time, in the right setting</p> Signup and view all the answers

    What is a key aspect of patient-centered care?

    <p>Treating patients with respect and dignity</p> Signup and view all the answers

    What is a characteristic of Intensive Care Units (ICUs)?

    <p>They have advanced technologies and specialized knowledge</p> Signup and view all the answers

    What is the primary focus of mental health facilities?

    <p>Treating patients with mental illnesses</p> Signup and view all the answers

    What is the role of evidence-based practice guidelines in hospitals?

    <p>To ensure that patients receive safe and effective care</p> Signup and view all the answers

    What is a challenge of delivering patient care in a stressful setting?

    <p>Achieving patient satisfaction</p> Signup and view all the answers

    What is the role of nurses in patient-centered care?

    <p>To partner with patients and families to develop individualized plans of care</p> Signup and view all the answers

    What is the purpose of quality initiatives in hospitals?

    <p>To improve patient satisfaction and outcomes</p> Signup and view all the answers

    What is the primary purpose of a Critical Access Hospital (CAH)?

    <p>To provide temporary care to patients before they are transferred to a larger hospital</p> Signup and view all the answers

    What is the role of advanced practice nurses in rural healthcare?

    <p>To use medical protocols and establish collaborative agreements with staff physicians</p> Signup and view all the answers

    Why is discharge planning important in rural healthcare?

    <p>To improve patient outcomes and reduce readmissions</p> Signup and view all the answers

    What is the goal of discharge planning in rural healthcare?

    <p>To ensure patients receive ongoing care after discharge</p> Signup and view all the answers

    What is the role of nurses in discharge planning?

    <p>All of the above</p> Signup and view all the answers

    What is the consequence of 'quicker and sicker' discharges from hospitals?

    <p>Adverse events during the immediate post-discharge period</p> Signup and view all the answers

    What is the role of case managers or social workers in discharge planning?

    <p>To select the appropriate post-hospital destination for patients</p> Signup and view all the answers

    What is the focus of rural healthcare systems?

    <p>To improve access to healthcare services in rural areas</p> Signup and view all the answers

    What is the role of healthcare payers in rural healthcare?

    <p>To reimburse healthcare providers for services provided</p> Signup and view all the answers

    What is the purpose of discharge planning in rural healthcare?

    <p>To improve patient outcomes and reduce readmissions</p> Signup and view all the answers

    What is the primary goal of discharge planning?

    <p>To prepare patients for transition to the next level of care</p> Signup and view all the answers

    Who is responsible for identifying a patient's continuing needs before discharge?

    <p>The nurse</p> Signup and view all the answers

    What is a benefit of a nurse-driven discharge planning model?

    <p>Reducing hospital readmission rates</p> Signup and view all the answers

    Why is it essential to communicate clearly about the plan of care with patients, families, and healthcare team members?

    <p>To promote effective discharge planning</p> Signup and view all the answers

    What is a barrier to effective discharge planning?

    <p>All of the above</p> Signup and view all the answers

    Why is it important to involve patients and family caregivers in discharge planning?

    <p>To ensure patients receive appropriate care after discharge</p> Signup and view all the answers

    What is the purpose of discharge instructions?

    <p>To prepare patients for transition to the next level of care</p> Signup and view all the answers

    When should discharge instructions be provided?

    <p>When the patient's treatment plan is established</p> Signup and view all the answers

    What is the primary goal of comprehensive discharge instruction?

    <p>To ensure that patients know what to do when they get home</p> Signup and view all the answers

    What is the focus of the teach-back approach?

    <p>To promote patient engagement and safety</p> Signup and view all the answers

    What is a factor that may affect a patient's ability to learn during discharge planning?

    <p>Presence of pain or discomfort</p> Signup and view all the answers

    Which patients are more in need of discharge planning?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of referrals to other health care providers?

    <p>To coordinate care for patients with complex health needs</p> Signup and view all the answers

    What is the role of the transition coach in Coleman's 'Care Transitions Program'?

    <p>To manage/facilitate the discharge of a patient to home or to a rehabilitation center</p> Signup and view all the answers

    What is the primary focus of Naylor's 'Transitional Care Model'?

    <p>To provide patients with comprehensive discharge planning and follow-up</p> Signup and view all the answers

    What is the goal of the High-Intensity Care Model (GRACE Model)?

    <p>To help patients manage their health conditions, coordinate their health care, and achieve optimal health</p> Signup and view all the answers

    Why is it important to engage patients and family caregivers in the referral process?

    <p>To facilitate the selection of care providers</p> Signup and view all the answers

    What is a key aspect of the teach-back approach?

    <p>Inviting patients to participate in the health care plan</p> Signup and view all the answers

    What is the goal of comprehensive discharge planning?

    <p>To ensure that patients know what to do when they get home, how to perform care activities, and what to do when problems develop</p> Signup and view all the answers

    What is the primary focus of discharge instruction?

    <p>To ensure that patients understand their discharge instructions</p> Signup and view all the answers

    What is the primary goal of restorative care?

    <p>To help individuals regain maximal functional status and enhance quality of life</p> Signup and view all the answers

    Why is it important to give the care provider receiving the referral as much information as possible about the patient?

    <p>To avoid unnecessary duplication of assessment and omission of important information</p> Signup and view all the answers

    What is the primary focus of home care?

    <p>To provide part-time, medically necessary skilled care and education to patients in their homes</p> Signup and view all the answers

    What is the role of the restorative health care team?

    <p>To collaborate with patients and their families to achieve optimal functioning</p> Signup and view all the answers

    What is the purpose of the OASIS assessment?

    <p>To conduct patient-specific comprehensive assessments at a patient's start of care, at 60-day follow-ups, at discharge, and before and after an inpatient stay</p> Signup and view all the answers

    What is the primary role of a home care nurse?

    <p>To help patients adapt to physical limitations and assume a daily home routine</p> Signup and view all the answers

    Why is early collaboration with patients and their families important in restorative care?

    <p>To increase the likelihood of patients following treatment plans and achieving optimal functioning</p> Signup and view all the answers

    What is the primary focus of restorative care in a rehabilitation setting?

    <p>To help patients regain functional status and enhance quality of life</p> Signup and view all the answers

    What is the primary goal of providing restorative care to patients in a home setting?

    <p>To help patients adapt to physical limitations and assume a daily home routine</p> Signup and view all the answers

    What is the importance of a clear understanding of goals for physical recovery in restorative care?

    <p>To increase the likelihood of patients following treatment plans and achieving optimal functioning</p> Signup and view all the answers

    What type of care do patients with mental illness receive in a hospital setting?

    <p>A comprehensive interprofessional treatment plan</p> Signup and view all the answers

    What is the primary reason for the lack of access to healthcare in rural areas?

    <p>All of the above</p> Signup and view all the answers

    What is the result of the massive cuts to non-Medicaid state mental health spending in 2011?

    <p>States had to cut vital mental health services for tens of thousands of youth and adults</p> Signup and view all the answers

    What is the purpose of a Critical Access Hospital (CAH)?

    <p>To provide temporary care for patients needing stabilization before transfer to a larger hospital</p> Signup and view all the answers

    What is a consequence of individuals with serious mental illnesses not receiving proper care?

    <p>They are more likely to suffer chronic disease and die earlier than others</p> Signup and view all the answers

    What is the role of a comprehensive interprofessional treatment plan in a hospital setting?

    <p>To enable patients to become more functional within their communities</p> Signup and view all the answers

    What is the percentage of physicians who practice in rural America?

    <p>About 13% of physicians</p> Signup and view all the answers

    What is the name of the act that changed the designation of some rural hospitals to Critical Access Hospital (CAH)?

    <p>The Balanced Budget Act of 1997</p> Signup and view all the answers

    What is the purpose of referrals for follow-up care at clinics or with counselors during discharge from inpatient settings?

    <p>To ensure patients receive comprehensive care after discharge</p> Signup and view all the answers

    What type of facilities offer inpatient and outpatient services for mental health care?

    <p>Psychiatric facilities located in hospitals, independent outpatient clinics, and private mental health hospitals</p> Signup and view all the answers

    What is the primary goal of home health care?

    <p>To help patients and their family members achieve independence</p> Signup and view all the answers

    What is the purpose of the OASIS assessment tool?

    <p>To measure patient outcomes and improve home health care</p> Signup and view all the answers

    What is the focus of rehabilitation?

    <p>To enable people with disabilities to reach and maintain their optimal functional levels</p> Signup and view all the answers

    What is the purpose of rehabilitation services after acute care?

    <p>To help patients and families adjust to necessary changes in lifestyle and learn to function with the limitations of their disease</p> Signup and view all the answers

    What is the primary focus of home care agencies?

    <p>To provide skilled and intermittent professional services, such as wound care and administration of medications</p> Signup and view all the answers

    What is the purpose of rehabilitation in the home setting?

    <p>To help patients and families adjust to necessary changes in lifestyle and learn to function with the limitations of their disease</p> Signup and view all the answers

    What is the focus of rehabilitation programs?

    <p>To help patients with disabilities attain independence and self-determination</p> Signup and view all the answers

    What is the goal of rehabilitation in patients with severe disabilities?

    <p>To help patients reach their maximum potential</p> Signup and view all the answers

    What is the purpose of rehabilitation services?

    <p>To prevent complications related to an illness or injury</p> Signup and view all the answers

    What is the goal of rehabilitation after acute care?

    <p>To promote early mobility in patients after surgery</p> Signup and view all the answers

    What is the primary purpose of an extended care facility?

    <p>To provide intermediate medical, nursing, or custodial care for patients recovering from acute illness or those with chronic illnesses or disabilities</p> Signup and view all the answers

    What type of care is provided in an intermediate care or skilled nursing facility?

    <p>Skilled care from a licensed nursing staff</p> Signup and view all the answers

    What is the focus of continuing care services?

    <p>Providing a variety of health, personal, and social services over a prolonged period</p> Signup and view all the answers

    What type of services are provided in nursing centers?

    <p>24-hour intermediate and custodial care, including nursing, rehabilitation, dietary, recreational, social, and religious services</p> Signup and view all the answers

    What is the purpose of elder care services?

    <p>To provide companionship, assistance with activities of daily living, and food preparation to patients</p> Signup and view all the answers

    What is the primary goal of nursing centers?

    <p>To provide intermediate and custodial care to patients</p> Signup and view all the answers

    What type of care is provided in extended care facilities?

    <p>Intermediate care</p> Signup and view all the answers

    What is the main reason for the growing need for intermediate care settings?

    <p>The focus on early discharge from hospitals</p> Signup and view all the answers

    What is included in the services provided by Medicaid-certified nursing homes?

    <p>Skilled nursing, rehabilitation, and long-term care services</p> Signup and view all the answers

    What is the primary goal of continuing care services?

    <p>To support patients in maintaining their independence and quality of life</p> Signup and view all the answers

    What is the primary focus of a skilled nursing facility?

    <p>To promote maintenance or enhancement of the quality of life of each resident</p> Signup and view all the answers

    What is a characteristic of nursing centers?

    <p>They provide a homelike environment for residents</p> Signup and view all the answers

    What is a requirement for nursing facilities to receive payment from Medicare and Medicaid?

    <p>Compliance with the Omnibus Budget Reconciliation Act of 1987</p> Signup and view all the answers

    What type of approach to care is used in nursing centers?

    <p>A systematic and interprofessional approach</p> Signup and view all the answers

    What is the goal of care in nursing centers?

    <p>To help residents reach and maintain their highest level of function</p> Signup and view all the answers

    What type of services are provided in nursing centers?

    <p>Dietary services, activities, and room maintenance</p> Signup and view all the answers

    Study Notes

    U.S. Health Care System

    • Complex and constantly changing
    • Focus on reducing costs, improving access, and ensuring high-quality outcomes
    • 30 million Americans lacked health insurance in 2020 (Assistant Secretary for Planning and Evaluation, 2021)
    • Health care expenditures in the United States totaled 17.7% of the gross domestic product in 2018, averaging $11,172 per person (Centers for Medicare and Medicaid Services, 2019a)

    Nursing Profession

    • Rooted in helping people regain, maintain, or improve their health
    • Focus on preventing illness and finding comfort and dignity at the end of life
    • Nursing promotes health, well-being, comfort, dignity, and humanity of all individuals, families, groups, communities, and populations (American Nurses Association, 2021)
    • Challenges facing nursing include:
      • Aging baby boomer generation
      • Shortage and uneven distribution of physicians
      • Accelerating rate of nurses' retirements
      • Uncertainty of health care reform

    Levels of Health Care

    • Six levels of care:
      • Preventive care
      • Primary care
      • Secondary care
      • Tertiary care
      • Restorative care
      • Continuing care
    • Each level presents different requirements and opportunities for nurses
    • Levels of care are not the same as levels of prevention (see Chapter 6)

    Integrated Health Care Delivery

    • Developed as part of the U.S. health care reform movement
    • Aims to provide a continuum of health services to a defined population
    • Goals include:
      • Improving health care quality
      • Decreasing overall health care costs
      • Focusing on population health
    • Examples include:
      • Accountable Care Organizations (ACOs)
      • Patient-Centered Medical Home model

    Primary and Preventive Health Care Services

    • Primary health care focuses on improved health outcomes for an entire population
    • Primary health care services include:
      • Regular health care visits
      • Health education
      • Proper nutrition
      • Maternal/child health care
      • Family planning
      • Immunizations
      • Control of diseases
    • Health promotion programs are designed to reduce the incidence of disease and minimize complications

    Secondary and Tertiary Care

    • Secondary health care is provided by a specialist or agency on referral by a primary health care provider
    • Tertiary health care is specialized consultative care, usually provided on referral from secondary medical personnel
    • Examples of secondary and tertiary care include:
      • Hospital emergency care
      • Intensive care units (ICUs)
      • Specialty care (e.g., cardiology, neurology, oncology)### Clinics and Community Centers
    • Clinics are often associated with schools, colleges, departments of nursing, federally qualified health centers, or independent nonprofit health care agencies.
    • Services provided by clinics include:
      • Diabetes screenings
      • Smoking cessation programs
      • Immunizations
      • Physical examinations
      • Cardiovascular checks
      • Health risk appraisal
      • Wellness counseling
      • Employment readiness
      • Acute and chronic care management
    • Community centers provide comprehensive and cost-effective primary care and supportive services to promote access to health care.
    • Services provided by community centers include:
      • Physical assessment and health screening
      • Nutrition education
      • Translation services
      • Dental care
      • Mental health services
      • Care coordination and case management
      • Specialty care (e.g., orthopedic, cardiac, or podiatric care)
      • Disease management
      • Health education

    Mental Health Services

    • Mental health facilities are located in hospitals, independent outpatient clinics, and private mental health hospitals.
    • Services provided by mental health facilities include:
      • Inpatient and outpatient services
      • Voluntary and involuntary admission
    • Patients who are hospitalized usually have short stays intended to stabilize them before transfer to outpatient treatment centers.
    • Patients with mental illness receive a comprehensive interprofessional treatment plan that engages patients and their families.

    Rural Hospitals

    • Rural hospitals face challenges in providing access to health care due to factors such as:
      • Economic factors (e.g., poverty)
      • Cultural and social differences
      • Educational shortcomings
      • Lack of recognition by legislators
      • Isolation from living in remote rural areas
    • To address these challenges, some rural hospitals have been designated as Critical Access Hospitals (CAHs).
    • CAHs provide 24/7 emergency services, have no more than 25 inpatient beds, and report an average length of stay (LOS) of 96 hours or less.

    Discharge Planning

    • Discharge planning is a coordinated, interprofessional process that develops a plan for continuing care after a patient leaves a health care agency.
    • The focus of discharge planning is to ensure that a patient transitions to the setting in which health care needs can be appropriately met.
    • Elements of discharge planning include:
      • Determining the appropriate post-hospital destination for a patient
      • Identifying a patient's needs for a smooth and safe transition
      • Beginning the process of meeting a patient's needs while the patient is still hospitalized
    • Discharge instructions prepare patients for transition from a hospital to the next level of care.
    • Patients and family caregivers are involved in the decisions about the patient's discharge destination.

    Restorative Care

    • Restorative care helps patients regain maximal functional status and enhance quality of life through promotion of independence and self-care.
    • Goals of restorative care include:
      • Regaining functional status
      • Enhancing quality of life
    • Restorative care settings include:
      • Home care
      • Rehabilitation centers
      • Skilled nursing facilities
    • The restorative health care team is interprofessional and includes the patient and family or significant others.

    Home Care

    • Home care is the provision of medically related professional and paraprofessional services and equipment to patients and families in their homes.

    • Services provided by home care include:

      • Part-time, medically necessary skilled care (e.g., nursing, physical therapy, occupational therapy, and speech-language therapy)
      • Coordination of access to and delivery of home health equipment
      • Health maintenance, education, illness prevention, diagnosis, and treatment of disease, rehabilitation, and palliative care### Home Care Nursing
    • Home care nurses deliver highly individualized nursing care to patients with permanent or temporary physical limitations, enabling them to adapt to a daily home routine.

    • Home care requires a strong knowledge base in many areas, including family dynamics, cultural competence, spiritual values, and communication principles.

    • Nurses who work in Medicare-certified home care agencies conduct patient-specific comprehensive assessments at various points, including the start of care, 60-day follow-ups, discharge, and before and after an inpatient stay.

    • The comprehensive assessment, OASIS (Outcome and Assessment Information Set), includes standardized core assessment items for an adult home care patient.

    OASIS Assessment

    • OASIS forms the basis for measuring patient outcomes and improving home health care for the purposes of outcome-based quality.
    • Data items within OASIS include sociodemographic information on the patient's home environment and informal caregivers, support system, health status, functional status, psychosocial status, and health service utilization.

    Home Health Care

    • Home health care focuses on the goal of helping patients and their family members achieve independence.
    • Home care addresses the recovery from and stabilization of an illness, identifies problems related to lifestyle, safety, environment, family dynamics, and health care practices.
    • Home care agencies provide skilled and intermittent professional services, such as wound care, administration of medications and blood therapy, and home care aide services.

    Rehabilitation

    • The World Health Organization (WHO) defines rehabilitation as the process aimed at enabling people with disabilities to reach and maintain their optimal physical, sensory, intellectual, psychological, and social functional levels.
    • Rehabilitation gives people with disabilities the tools they need to attain independence and self-determination.
    • Patients require rehabilitation after a physical or mental illness, surgery, injury, or chemical addiction.
    • The goal of rehabilitation services is to help patients and families adjust to necessary changes in lifestyle and learn to function with the limitations of their disease.

    Rehabilitation Services

    • Rehabilitation services include physical, occupational, and speech therapy, and social services.
    • Rehabilitation begins the moment a patient enters a health care setting for treatment, focusing on preventing complications related to an illness or injury, and then maximizing functioning and level of independence.
    • Rehabilitation settings include rehabilitation units within acute care centers, freestanding outpatient settings, and the home.

    Extended Care Facilities

    • Extended care facilities provide intermediate medical, nursing, or custodial care for patients recovering from acute illness or those with chronic illnesses or disabilities.
    • Extended care facilities include intermediate care and skilled nursing facilities, long-term care and assisted-living facilities.
    • In the past, extended care facilities primarily cared for older adults, but now they provide care for patients of all ages due to the focus on early discharge from hospitals.

    Nursing Centers or Facilities

    • Nursing centers or facilities provide 24-hour intermediate and custodial care, including nursing, rehabilitation, dietary, recreational, social, and religious services for residents of any age with chronic or debilitating illnesses.
    • Nursing center services provided by Medicaid-certified nursing homes offer skilled nursing, rehabilitation, and long-term care.
    • Nursing centers must comply with the Omnibus Budget Reconciliation Act of 1987 and its minimum requirements for nursing facilities to receive payment from Medicare and Medicaid.

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    This quiz covers the complexities and changes in the U.S. healthcare system, including efforts to reduce costs and improve access and quality. It also touches on the number of uninsured Americans and healthcare expenditures.

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