Question

Nursing Facilities and Home Health Care are the chosen facilities

·      Describe the roles and responsibilities of the administration in the nursing facilities and home health care

·      Identify and list the sources of financing available to consumers for the various programs provided by your chosen facilities. Identify the key public and private sources of reimbursement available. Also discuss the role played by managed care and its impact on long-term care reimbursement.

·      Describe the various government and private resources available that assist in developing and maintaining quality improvement programs in your chosen facilities. Describe the ways in which quality and cost are controlled in your chosen facilities. Also discuss the ethical aspect of access to care in the facilities, including rationing.
Based on your observations and learning from the two facilities, discuss the changes brought in the long-term care system to make it reach full status as a competition-driven system. You may include the following points in your discussion:

·      Discuss the changes made in the control mechanisms (external and internal) in order to control the management, financing, and quality in the long-term care systems.

·      Discuss the changes taking place in long-term care reimbursement system in order to provide better reimbursement options both to consumers and providers.

·      Discuss the changes made in the efforts of providers to accommodate changing magnitude of the day-to-day needs of long-term care consumers.

Answer 1

   *A nursing Home administor is a licensed health care professionals..Health care administrators coordinate the activities of health organization's.They communicate by other employees and make goals and strategies for acheivement..Because they are responsible for budgeting,scheduling,information management,marketing in health care..They will make all regulations and it can be represent to boardmeeting..
   Administrator must be educated and know the home health issues..They are responsible for developing policies for patient care with the commuication of other staffs and officers.They will see the patient outcomes by meeting their needs.They will supervise the mumber and their qualification for implementing the care and treatement in medical,nursing and rehabilitation needs for patient.
Home health care patient need long-term care.Nursing administrator responsible for patient getting community based care for offering medical,health,psycho-social,rehabilitation,personal care service provided to each patient.Nursing home administrator also responsible for planning,organizing,managing the facility and functions of particular unit.There are two skilled nursing facilities:
-short-term is for skilled facilities
-Long term is for people who need 24/7 care and for full time facility.
*Source of financing through medicaid,medicare,Quality Assurance Assessment Program and Patient stay.
      Medicaid regulated by federal government for more than 65 yrears oldpeople.It is divided by 4parts:
Part A service for inpatient hospitalization and skilled nursing facility service
Part B service for Outpatient and doctor visit.
Part c is Advantage plans
Part D is for drug plans
Medicaid program run for nursing facility service under state and federal government.This service for skilled and rehabilitation service..Medicaid won't limit the days of coverage..
Quality Assurance assessment Program.This service for securing additiponal federal dollars to provide rate increases the cost for medicaid services.This is a Tax program with out this budget process it will go to zero percent.
Patient stay requires seeking individual nursing facility.the medicaid client retain 60 dollar per month and income for non-personal item.the resident have to share the cost of care.
Federal and state medicaid programs established reimbursement policies to reduce the nursing home costs and growth in nursing home expenditures
   Long term reimbursement is for long term care patients including nursing facilities.It can cover skilled nursing facilities of general acute care hospitals,hospice care,acute and Transtitional inapatient care administrative days and intermediate care for disabled.It was established by federal social security Act.The providers providing reimbursement by add-on to the Medi-cal reimbursement rate for the additional cost of health care coverage.
   *The health care Financing Adminstration and State govenment are incharge for developing community based long term care services to meet the needs and quality services and outcomes for patient.The department of health and human service develop the fund and research for Consumer-Centered Care Service