Long Term Care Exam 1
Questions And Answers
2023
Licensure is always done at the ______ level and is/is not required - ANS-state; is
reasons LTC is in... [Show More] turbulent times: - ANS-1. Intensified competition among providers
2. There is an increased need to operate in highly efficient, cost effective manner due to
high reliance on third party payers/government funding
3. There is a greater integration in the health care industry- LTC cannot survive in their
limited sphere. (LTC providers want to integrate and demonstrate outcomes that are
consistent with integration. You have to join ACO's and integrated systems for
discharging patients).
4. There is a very small percentage of people who have LTC insurance
Long Term care definition: - ANS-Long-term care (LTC) is assistance given over a
sustained period of time to people who are experiencing long term inabilities or
difficulties in functioning because of a disability.
what is the new term used for LTC? Why? - ANS-Long term services and supports
(LTSS)
Because long term care is not just a nursing home anymore, we have a ton of
supportive services now-so we are broadening the term.
What are ADL's and what are examples - ANS-Activities of Daily Living: the ability to
perform basic, personal care tasks.
Examples: toileting, dressing, eating, hygiene, bathing, ambulating, walking, transferring
(get in and out of bed/a chair)
what are IADL's? examples? - ANS-Instrumental Activities of Daily Living: ability to
perform more complex activities that are necessary for independent living
Examples: more complex-interactions with others or your environment: cooking, driving,
managing finances, managing medications, housekeeping/chores, laundry, grocery
shopping
what is acuity level? - ANS-severity of functional limitations
what are ADL's and IADL's used for? - ANS-1. to assess acuity level
2. to determine appropriate LTC services (depending on resident needs)
Historically, long term care was provided by who? - ANS-family, friends, or
religious/community organizations
Almshouses: - ANS-Almshouses cared for those with no family- eventually turned into
nursing homes.
-A public charity that served indigent groups
-Met a variety of needs, including shelter, food, and some basic functional assistance
-For people who had no family to help them, funded and run by local governments
-Lumped everyone into this house who needed help (mental illness, old, poor, orphan,
homeless, etc.)
-Horrible place with bad conditions
As the LTC care system developed, the role of the government increased with these
two acts: - ANS-Social Security act of 1935 and Older americans act of 1965
Medicare and medicaid was made in what year? - ANS-1965
As the LTC system developed, what started to be in greater demand and a secure
source of revenue for nursing homes and other facilities? - ANS-Medicare and Medicaid
in 1965.
There was also a greater demand for nursing homes after passage of medicaid and
medicare
______ pays 62% of LTC (primary payer of LTC) - ANS-Medicaid
Impact of Government Regulations on the LTC system: - ANS--Extensive regulations
are intended to ensure care is of sufficient quality and at a low price
-Regulations have influenced availability of services (if providers feel the regulations are
too costly to implement, those service providers will decrease)
-Providers will find a market that are more lucrative and less regulated, like assisted
living.
Because of the success of the LTC system: - ANS-1. improvements in medical care
means people are living longer
2. increased need for LTC services
3. need for LTC over a longer period of time
Public and private payers have reduced covered lengths of stay in hospitals in an effort
to reduce health care costs. How did public and private do this? - ANS-Public:
(Medicare)- DRG's based on whatever category you diagnose them, that's how you get
them reimbursed. DRG's want to get people stable and discharged from hospitals
quickly.
Private: (Managed care)- going from different types of fee for service to managed care
concepts to cut reimbursement to providers and limit access to services.
Quicker and Sicker: - ANS-Patients are discharged "quicker and sicker" to LTC facilities
(patients are discharged from US hospitals more rapidly and less stable).
-this increased the acuity of residents because we can now treat a wide variety of
complicated chronic diseases- and we are keeping people alive longer.
-Development of new types of care delivery
-trend toward integrated systems (hospitals and nursing homes work more closely to
each other)
Consumers of long term care: (are they patients, residents, or clients?)
1. in acute or subacute settings
2. in LTC institutions
3. those who receive community based care (living in their own home)
4. in respite care - ANS-1. patients
2. residents
3. clients
4. patient
____% of consumers of LTC are younger disabled, and ____% are frail older adults -
ANS-43% and 57%
why would someone be in a nursing home for a short period of time? - ANS-because
they had a fall or something and a nursing home can provide 24/7 care and therapy until
a person is well enough to go back home
Younger disabled: - ANS-stroke, early onset alzheimers before 65, born with congenital
abnormality, other disability before 65
Consumers of LTC: - ANS-Older adults (65+) -> currently 9 million need ltc and
projected to increase to 12 million by 2020. Old people's needs are very diverse, not all
need LTC
Non elderly (less than 65)-> either physically handicapped or mentally ill/intellectual
disability
Disability rates increase by ____ - ANS-age
who are the heaviest individual users of the full range of LTC services? - ANS-The non
elderly population (less then 65) because they will use more services, they need it for a
longer period of time because they have a longer time until death because they're
young
The current system of long term care providers has developed in response to: - ANS-1.
Need (consumers who would meet criteria to be in a nursing home)
2. demand (consumers who are using the service-already in a nursing home receiving
services)
3. financing
True or false: types of providers, regulations, roles of each in the system, and their
names are always changing - ANS-true
Providers of long term care: - ANS-nursing facilities, subacute care, assisted
living/residential care, elderly housing, and home and community based services (home
health care, adult day care, hospice care), independent living
nursing facilities: - ANS-offer room, board, 24/7 nursing care, and all therapies. provide
a broad range of personal, social, and medical services to assist people with functional
or cognitive limitations. (nursing, rehab, custodial care). nursing homes, skilled nursing
facilities
subacute care: - ANS-provide highly skilled nursing care, therapies, and more medical
supervision than nursing facilities but less than hospitals. Stop in the middle between a
hospital and a nursing home. Short term, to rehabilitate and go back to prior living
arrangement
Comprehensive, cost-effective inpatient level of care for a person with an acute illness,
injury, or exacerbation of a disease process
Provides services to patients who require frequent assessments and/or procedures to
manage their condition
Between acute and long-term care
assisted living/residential care: - ANS-provides assistance and limited health care
services in a homelike atmosphere. Will not have nursing available 24/7
elderly housing: - ANS-creates a physically supportive environment to promote an
independent lifestyle
home and community based services: - ANS-care provided in the community (home)
1. home health care: nursing and therapies primarily
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