Managing the Long-Term Care Facility
Practical Approaches to Providing Quality Care
Häftad, Engelska, 2016
1 439 kr
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Fri frakt för medlemmar vid köp för minst 249 kr.Practical approaches to the operation of long-term care facilities Managing the Long-Term Care Facility provides a comprehensive introduction to the growing field of long-term care. Taking a continuum-of-care approach, the text covers every aspect of long-term care. Readers will develop a robust knowledge of the issues faced by people experiencing physical and or mental changes. Topics covered include the biological and psychosocial implications of ageing, marketing long-term care, facility operations, and information technology for health care, among many others. By integrating all aspects of long-term care, the book is an invaluable resource that will aid students and professionals in preparing for career advancement and licensure exams.The book is also is designed to help students prepare for the National Nursing Home Administrator exam. Pedagogical elements help guide readers through the content, and summaries and discussion questions to drive home lessons learned. Builds expert knowledge of all aspects of long-term care management, including operations, human resources, patient advocacy, and information systemsEmphasizes the latest understandings of the long-term care continuum and patient-centered care for diverse populationsDelivers practical approaches to providing quality care to individuals and making a positive impact on community wellbeingPrepares readers for and National Nursing Home Administrator's licensure examManaging the Long-Term Care Facility: Practical Approaches to Providing Quality Care provides real-world guidance for students in healthcare administration, health and human services, gerontology, nursing, business and medical programs, in both domestic and international markets. Nursing home administrators, administrators-in-training and preceptors will find this book an effective training tool in the nursing facility setting.
Produktinformation
- Utgivningsdatum2016-04-15
- Mått175 x 234 x 33 mm
- Vikt930 g
- FormatHäftad
- SpråkEngelska
- Antal sidor600
- FörlagJohn Wiley & Sons Inc
- ISBN9781118654781
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REBECCA PERLEY is owner and CEO of AIT Exam Prep, a company that prepares administrators-in-training to pass the California and federal nursing home administrator licensure exams. She is a member of the Executive Faculty in the Health Care Administration Department of California State University, Long Beach and has been a guest lecturer for the State of California, Nursing Home Administrator Program.
- List of Tables, Figures, and Exhibits xxiiiIntroduction xxviiAcknowledgments xxxiiiAbout the Editor xxxvAbout the Contributors xxxviiChapter 1 Public Policy: Historical Overview of Long-Term Care 1Erlyana Erlyana, Jean Schuldberg, and Marian LastKey Demographic Trends of Older Americans 2Demographic Bulge 2Lower Acuity Among the Aging 3Longevity and Healthier Lifestyles 3Socioeconomic Status of Older Adults 3Gender Imbalance 4Diversity in Culture and Ethnicity 4Same-Sex Marriage and LGBTQ+ Gender Identity 5Impacts on Long-Term Care Continuum 5Long-Term Care and Public Policy 6What Is Long-Term Care? 6What Is Public Policy? 7Rationales (Goals) for Public Policy 7Why Public Policies for LTC? 8Highly Vulnerable Population 8Negative Perceptions in Costs and Quality 9Resources Are Limited—Unaffordable and Limited Supply 11Nonviable Financing Protection Mechanism, Both Public and Private Financing 13Critiques of Public Policy 14Key Historical Milestones and Major Long-Term Care Policies 15Federal Policies 15State and Local Government Policies 19Important Policies Affecting LTC Professionals and Paraprofessionals 22Examples of State-Specific Laws 24The Patient Protection and Affordable Care Act (PPACA) and LTC 25Summary 27Key Terms 27Review Questions 28Case Study 28References 29Chapter 2 Long-Term Care Continuum 33Marian Last, Jean Schuldberg, and Kenneth MerchantThe Long-Term Care Continuum Defined 33Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) 34Medical Acuity 35The Long-Term Care Continuum 35Aging in Place 35The Private Home Environment: Aging in Place 38Informal Supports 38Private-Duty Aide 39Home Care 39Home Health Care 39Home Modifications 40Federal Housing Programs 41Shared Housing Programs 41Congregate Housing 42Veterans Affairs Supportive Housing (VASH) 42Community Resident Environments 42Continuing Care Retirement Community (CCRC) 42Active Living Communities 43Naturally Occurring Retirement Community 43Community Support Programs 44Adult Social Day Care 44Adult Day Health Care 44Hospice and Palliative Medicine 44Intergenerational Caregivers 45Respite Care Programs 45Congregate and Home-Delivered Meal Programs 46Other Community-Based Programs Organizations That Provide Assistance 46Transitional Housing From Home Community to Formalized Home Care Facilities 50Board and Care and Adult Care Homes 50Intermediate Care Facilities (ICF) 51Assisted Living Facilities 51Twenty-Four-Hour Nursing Care 51TheWorkforce in Care Facilities 53Administrators 53Physicians 54Nurses 55Licensed Versus Certified Healthcare Personnel 56Therapeutic Specialists 58Social and Quality of Life Specialties 58Summary 59Key Terms 60Review Questions 64Case Studies 64Case Study #1: Community Care 64Case Study #2: Skilled Nursing 65References 65Chapter 3 Resident Advocates, Diversity, and Resident-Centered Care 69Ann WyattWhere Does Quality Start? 70Nursing 71Housekeeping 73Therapeutic Recreation 73Volunteers 74Dietary 75Social Work 75Other Disciplines and Departments 76Quality Assurance and Performance Improvement 76Resident Councils 77Family and Friends 77National Nursing Home Ombudsman Program 79Advocacy Organizations 80Diversity 81Changing the Culture: Person-Centered, Person-Directed Care 83Mount St. Vincent 83The Live Oak Regenerative Community 84The Eden Alternative 84Wellspring 85The Green House 85The Household Model 86Planetree 87Advocacy and Dementia Care 87The Pioneer Network 87The Role of Philanthropy 88The Language of Culture Change 88Summary 89Key Terms 89Review Questions 90Case Studies 91Case Study #1 91Case Study #2 92Case Study #3 95References 96Acknowledgments 97Chapter 4 Physical Environment of Long-Term Care 99Andrew Alden, Jeffrey Anderzhon, and Sarah MoserHistory of Long-Term Care Design in the United States 99Origins of the Acute Care Hospital and Aged Care 99Governmental Oversight and Influence on Long-Term Care 102The Medical Model of Aged Care 102Traditional Nursing Home Components 103Resident-Centered Care Model 104Development of Contemporary Long-Term Care Environments 105Exploded Corridor Floor Plans 105Household Model Development 106Contemporary Nursing Home Components 107The Long-Term Care Culture Change Movement (Resident-Centered Care) 109Technology of Long-Term Care 110Behavioral Monitoring 111Ambulatory-Assistance Devices 111Communication Technology 111Building Code Requirements 112History and Importance 112Americans With Disabilities Act 112Going Beyond ADA 113Fire-Resistance Rated Construction 113State and Local Regulatory Agencies 114International Building Code (IBC) 114National Fire Protection Association and the Life Safety Code (LSC) 115Authorities Having Jurisdiction (AHJ) 116Occupational Safety and Health Administration (OSHA) 116History and Importance 116OSHA Components 116Standards and Compliance Requirements for Administrators 117Lockout/Tagout 117Recordkeeping Rules 117Citations and Penalties 118Preventative Maintenance Programs 118History and Importance 118Useful Life 119Maintenance Items 119Preventative Maintenance Software 119Infection Control Programs 119Emergency Preparedness 120History and Importance 120Steps for Emergency Preparedness 121Emergencies and Preparations 121Egress Procedures 123Assisted Evacuation 124Testing 124Training and Drills 124Survey Process 125Nursing Home Oversight 125Summary 125Key Terms 126Review Questions 129Case Studies 130Case Study #1 130Case Study #2 130References 130Chapter 5 Human Resources:Managing Employees in Long-Term Care 133Sonja Talley and Carissa PodestaCore Human Resources Functions in Long-Term Care 133Administrative Partner 134Business Partner 134Strategic Partner 134Outsourcing Human Resources 134Human Resources Challenges in Long-Term Care 135Workforce Availability 135Contingent Workforce 135Turnover 136Composition of Workforce 136Managing Diversity 137Workforce Planning 138Direct Care Staffing 138Recruiting 139Job Descriptions 140Referral Programs 140Screening and Selection 140Training 142Orientation 143Mandated Training 143Employee Relations 146Employee Communications 146Employee Suggestion Program 147Open-Door Policy 147Legal Rights and Benefits 148At-Will Employment 148Union Organization 148National Labor Relations Act (NLRA) Requirements 149Occupational Safety and Health Act (OSHA) Requirements 150Worker Safety Programs 151AmericansWith Disabilities Act (ADA) Accommodation 152Discrimination and Harassment 153Retaliation 154Summary 155Key Terms 155Review Questions 159Case Studies 159Case Study #1 159Case Study #2 160References 160Chapter 6 Reimbursement in the Long-Term Care Environment 163Robert MillerPayer Sources 164Government Programs 164Managed Care 171Private Pay 173Long-Term Care Insurance Plans 174Supplemental Insurance Plans 175Reimbursement Methods 175Prospective 175Retrospective 176Resident-Related Items 182Medicaid 182Summary 188Key Terms 189Review Questions 196Case Study 197References 198Acknowledgments 198Chapter 7 Compliance and Risk Management 199Rebecca LowellCompliance Today 200Overview of LTC Regulations 200Federal LTC Statutes 200State LTC Statutes 201Who Does the Long-Term Care Provider Serve? 201Compliance and Accountability 202Government Tools 203Surveys 203Five-Star Incentives 203Corporate Integrity Agreement 204Corporate Compliance Program (CCP) 204Whistle-Blower Litigation 204Primary LTC Risk Areas 205Criminal Prosecution 205Regulatory Risks 205Civil Litigation 206Compliance Program Necessities 206ACA Guidelines 2062000 Office of Inspector General (OIG) Guidelines 2072008 Supplemental Office of Inspector General Guidelines 209Quality of Care 209Submission of Accurate Claims 215Anti-Kickback Statute (AKS) 217Physician Relations 219Anti-Supplementation 220Medicare Part D 220HIPAA 220Effective Risk Management 221Quality Assurance and Risk Management 221Root Cause Analysis 224Analyze the Data 224Identify the Root Cause(s) 224Recommend and Implement Solutions 225Reassess to Determine Efficacy 225Compliance Through Documentation 226Medical Record 226Employment Files 228QA Studies and Audits (Often Referred to as Quality Assurance Performance Improvement or QAPI) 228Billing Records 229Incident Investigation/Reporting 229ContractsWith External Resources 229Summary 230Key Terms 230Review Questions 232Case Studies 232Case Study #1 232Case Study #2 232References 233Chapter 8 Legal and Ethical Issues 235Rebecca Lowell and Eduardo GonzalezHealth Care as a Business235Payer Sources 236Private Pay 237Scope of Expectations 237Legal Responsibilities 238Initial State Licensure 238ContractsWith Federal and State Governments 238Other Federal Laws and Their Ethical Implications 239Agencies 240Department of Health and Human Services (DHHS or HHS) 240State Health Departments 240Department of Justice (DOJ) (Federal and State) 240Office of Civil Rights (OCR) 241Adult Protective Service (APS) 241Long-Term Care Ombudsman (Ombudsman) 242Privately Funded Agencies 242Employees 242Court of Public Opinion/Media 243Principal Areas of Focus 243Abuse and Neglect 243Abuse/Neglect Investigation and Reporting 244Residents’ Rights 246Civil and Regulatory Ramifications 247Health Insurance Portability and Accountability Act (HIPAA) 248Physician and Vendor Relationships 249Advance Care Planning 254Other Important Issues to Consider 259Practical Solutions to Complicated Problems 260Policies, Procedures, and Protocols 260Bioethics Committee 260Training/Evaluation/Discipline 260Reporting Process 261Audit 261Summary 262Key Terms 262Review Questions 265Case Studies 265Case #1 265Case #2 266References 266Chapter 9 Marketing and Public Relations 269Janice Frates and Susie MixAssessing Local Demand for Long-Term Care Services 269Public Perceptions and Public Relations 272Naming and Vocabulary 272Addressing Suspicions and Fears 273Customers and Their Needs 273Families 273Third-Party Payers 275Identifying Customer Needs 278Market Segmentation 278Competition 280Positioning 280Marketing Approaches 280Collaboration 281Referral Agents 281Networking 282Public and Private Oversight of Long-Term Care Services Providers 283Customer Services and Retention 284Preplacement Evaluation 284Customer Service 285Resident Ambassadors 285Monitoring Customer Satisfaction 286Marketing Plan 286Return on Marketing Investment (ROI) 289Customer Buying Behavior 289Branding 290Ethical Marketing 290False Promises 291Advertising and Promotional Activities 291Social Media 291Crisis Management 294Summary 295Key Terms 296Review Questions 297Case Studies 298Case Study #1: SNF Marketing in a Post-ACA World: Memorial Hospital of Gardena (California) 298Case Study #2: Skilled Nursing Facility Marketing in the Future 299Case Study Review Questions 300References 300Acknowledgments 302Chapter 10 Health Information Systems 303Abby Swanson KazleyPrevalence of Use 304Regulations, Laws, and Standards 305Record Retention Requirements 308Health Information Technology Applications 309Advantages of Health Information Technology Use in Long-Term Care 313Disadvantages of Health Information Technology Use in Long-Term Care 316Electronic Devices 318Implementation and Conversion to Health Information Technology 319Staff Training 321Summary 323Key Terms 323Review Questions 325Case Studies 325Case Study #1 325Case Study #2 325References 325Acknowledgment 328Chapter 11 Biological and Psychosocial Aspects of Aging: Implications for Long-Term Care 329Barbara WhiteNormal Physical ChangesWith Aging 329Skin Changes 330Sensory Changes 336Immune System 338Gastrointestinal System 340Musculoskeletal System 341Respiratory and Cardiovascular Systems 342Frailty Syndrome 342Urinary Tract 343Neurological Changes 343Health Promotion, Disease Prevention 345Common Psychosocial Changes With Aging 345Losses and Isolation 345Depression 346Anxiety 347Sleep Pattern 347Illness Presentations in Older Adults 348Responses to Medications in Older Adults 349Changes in Absorption, Distribution, Metabolism, Elimination, and Action 349Inappropriate Drug Prescribing 350Polypharmacy 350Changes in Older Adult and Family Relations in Long-Term Care 350Why Move to Long-Term Care Placement 350Caregiver Burden 351Suicide 352Acquired Conditions as Consequences of Long-Term Care Placement 353Interventions to Maintain Quality of Life After a Move to Long-Term Care 353Initial Orientation/Transition 353Personal Possessions 354Staffing 354Feelings of Self-Worth, Independence, and Choice 355Assessment and Care Planning 355Summary 356Key Terms 357Review Questions 363Case Study 364References 364Acknowledgment 366Chapter 12 Resident-Centered Clinical Operations 367Paige HectorClinical Operations 367Role of the Administrator 367Critical Thinking and Clinical Judgment 368Federal and State Regulations 369Policies and Procedures 369Admission to Facility 370Care Plan 371Medical Record Audit 377Rehabilitation 382Evaluations 382Treatment Plans 383Supportive Devices 383Documentation 383Interdisciplinary Focus 384Dos and Don’ts 384Subjective Versus Objective 385Late Entry 386Summarizing Event Entry 386Complaints 387Contributory Negligence 388Resident, Patient, and Family Education 388Documentation 389Care Conference 389Leave of Absence (LOA) 389Community Survival Skills Assessment 390Provider Order 390Role of Payer Source 391Summary 391Key Terms 391Review Questions 394Case Study 394References 395Acknowledgment 395Chapter 13 Facility-Centered Clinical Operations 397Paige HectorWeekly Operations 397Wound Rounds 397Nutrition at Risk 398Falls 398Restorative Nursing 399Monthly Operations 399Medical Record Audit 400Pharmacy 402Recapitulation (Recap) 403Nursing Assistant Flow Sheets 404Quarterly Operations 404Individual Discipline Summaries 404Changes of Condition 405Notifications 406Alert Charting 40624-Hour Report 406Process 408Shift Change 408Stand-Up Meeting 409Purpose 409Color-Coding System 410Part I—General Issues 410Part II—Clinical Review 415Challenges With Electronic Medical Records 423Summary 424Key Terms 424Review Questions 425Case Study 425References 426Acknowledgment 426Chapter 14 Facility Operations and Performance Improvement 427Rebecca Perley, Jim Kinsey, Paige Hector, and Jill HarrisonFacility Operations 427Role of the NHA 428Daily NHA Rounds 430Preadmission 431Preadmission Screening and Resident Review (PASRR) 431Financial Reimbursement for Treatment 431Facility Tour 431Documentation Required for Admission 432Physician Order 432Medication Administration Record (MAR) 432Evidence of Being Free of Tuberculosis 432History and Physical (H&P) 433Discharge Summary 433Admission Packet 433Identification of Parties 433Consent to Treatment 433Resident Rights 434Financial Arrangement 434Transfers and Discharges 434Bed Hold Policy 434Personal Property and Funds 434Photographs 435Confidentiality of Medical Information 435Facility Rules and Grievance Procedure 435Admission Agreement 435Resident-Directed Move-In 435Orientation to the Facility 436Resident’s Adjustment, Grief, and Loss 436Resident Assessment Instrument Process 436Minimum Data Set (MDS) 437Care Area Assessment (CAA)438Care Plan 438Care Plan Conference 438Identifying and Honoring the Resident’s Voice 439Nursing 439Dietary 439Social Services 440Activities 440Performance Improvement 440Quality Assurance (QA) 440Performance Improvement (PI) 441Quality Assurance and Performance Improvement (QAPI) 441Five Elements of QAPI 441Quality Assessment and Assurance (QAA) 442Quality Measure/Indicator Reports 442Program for Evaluating Payment Patterns Electronic Report (PEPPER) 443Data Management 443Process-Oriented Context 444Run Charts—Just Plot the Dots! 446Variation 446Strategies for Improvement: The Fun Stuff! 449Surveys 453Survey Management 453Initial Certification Survey 454Traditional Survey 454Quality Indicator Survey (QIS) Process 456Minimum Data Set (MDS) Survey 458Exit Conference 458Form 2567 458Scope and Severity 459Informal Dispute Resolution (IDR) 461Summary 462Key Terms 462Review Questions 465Case Study 466References 466Acknowledgment 468Chapter 15 Financial Issues and Tools 469Robert MillerFinancial Issues and Financial Tools 470Budgets 470Budget Development 473Profit or Loss 479Staff 485Revenue Enhancement 488Level of Services Provided to Residents 490Intensity of Services to the Residents 490Future Directions 492Level of Care 493Affordable Care Act 493Summary 494Key Terms 495Review Questions 502Case Study 503References 504Acknowledgment 504Chapter 16 International Comparisons and Future Trends in Long-Term Care 505Erlyana ErlyanaGrowth of Elderly Population 506Increase in Longevity and Disability 507Increase in Long-Term Care Expenditure 508International LTC Policies 510Germany 510Japan 511Italy 512South Korea 513Future Trends of LTC in the United States 514Anticipated Growth of LTC Needs 514Trends in Supply and Use 515Future Predictions for LTC 516Summary 517Key Terms 517Review Questions 518Case Study 518References 519Index 523