Long-Term Care Administration

Short Answer:

1. In some situations, there can be limited healthcare options and access specifically for individuals with Medicaid. Explain one of those reasons. 1 point

2. If you are caring for someone with dementia, it is important to know their life story. Explain what that means. 1 points

3. You are helping a resident and his son fill out paperwork for admission to the nursing home when they begin asking you questions about Advance Directives. In particular, they are asking questions about the Kentucky Living Will and the EMS Do Not Resuscitate (DNR) forms. Write below how you would explain each of these documents to the resident and his son. You must, at minimum, include their primary purpose, differences and any similarities. 3 points

a. Primary purpose of each:

b. Differences:

c. Similarities:

4. Nursing facility care is typically “need” driven and not “want” driven. Explain what is meant by this. 2 points

For questions 5, 6, 7 and 8, utilize the three (3) supplemental documents as needed.

5. What is the Medicaid case mix rate for St. Joseph’s Home for the Aged? 1 point ____________

6. Mr. Wright was discharged from the hospital and admitted as a resident at McCreary Health and Rehabilitation Center. He has both Medicare and Medicaid. His stay is currently covered under Medicare Part A as a skilled resident because he is receiving occupational therapy 5 days a week for a total of 500 minutes per week (rehabilitation very high) Plus tracheostomy care (an extensive service). He has an ADL score of 8. 6 points

Fill in the following information for Mr. Wright’s current reimbursement:

a. RUG Category: _______________________________

b. RUG IV: ________

c. Daily Rate:

7. Mr. Wright is no longer receiving any type of therapy but continues to receive tracheostomy care. His ADL score is the same. 3 points

Fill in the following information for Mr. Wright’s new reimbursement:

a. RUG Category: _________________________________

b. RUG IV: _______

c. Daily Rate: _______

8. Mr. Wright has exhausted his Medicare Part A benefits and will now have his nursing facility stay paid by Medicaid. 6 points

a. What rate, per day, will the facility now receive for Mr. Wright’s stay?

b. What is the DIFFERENCE in reimbursement rate for Mr. Wright, PER DAY, from his first daily rate (5c, when first admitted to the nursing facility) to today (7a, as a Medicaid stay)? _______

c. What will be the LOSS/GAIN in revenue for the next 30 DAYS? ________

9. Explain in detail what you have learned about Medicare and payment or coverage for longterm care

services. Examples of information I am looking for are eligibility, Title, some services covered in longterm care continuum, services that are not covered, components of the plans, where funding comes from, oversight, requirements for provider eligibility, etc. You must provide at least 5 of these. They must be specific to a component of longterm care. 5 points

a.

b.

c.

d.

e

10. What is the difference between each of the following in Kentucky? You must provide at least two

correct differences for each listed below. 5 points

a. Two differences between assisted living and nursing facility care:

b. Two differences between adult day care and assisted living:

Multiple choice: 3 points each

1. Answer:

Which of the following requires a physician’s signature as a medical order?

a. Living Will

b. POLST

c. EMS DNR form

d. Power of Attorney

2. Answer:

Incompetent managers, uneducated staff and lack of community oversight have contributed to the poor image of nursing facilities.

a. True

b. False

3. Answer:

Home health care is viewed as an alternative to nursing homes for consumers who need more personal, intermittent care services as opposed to 24-hour medical care.

a. True

b. False

4. Answer:

Women compose the majority of elders in the United States.

a. True

b. False

5. Answer:

Elders prefer to remain in their homes as they age.

a. True

b. False

6. Answer:

The long-term care administrator must be aware of and ensure that the institution follows the patient’s wishes regarding medical care under which of the following circumstances?

a. Under any circumstances

b. Under no circumstances; the scope of medical treatment is decided by the physician, not the patient

c. When the patient is competent and does not present a danger to others by refusing treatment

d. When the patient has the financial means to pay for treatment

7. Answer:

Assisted living facilities are required to provide nursing care.

a. True

b. False

8. Answer:

Continuing care retirement communities provide a range of services from residential to nursing home care.

a. True

b. False

9. Answer:

The availability of funding and the resident’s geographic location determine access, level of care and choices for individuals needing healthcare services.

a. True

b. False

10. Answer:

Hospice services are for individuals with a terminal illness, providing treatment that improves quality of life but not the extension of life.

a. True

b. False

11. Answer:

Hospice care can be provided in the home, in an inpatient respite facility or a general inpatient unit.

a. True

b. False

12. Answer:

Advanced directives, such as do-not-resuscitate orders and no artificial nutrition, are required for eligibility of admission to a long-term or acute care facility.

a. True

b. False

13. Answer:

Dementia and/or Alzheimer’s patients do not experience stressors from the physical environment.

a. True

b. False

14. Answer:

OBRA ’87, also known as the Nursing Home Reform Act, created Resident Rights in nursing facilities.

a. True

b. False

Bonus (1 point each):

1. What is the “study of aging?” (correct spelling required)

2. What organization both provides the federal exam for licensed nursing home administrators and also accredits long term care academic programs? (acronym acceptable)