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Some facilities ar ereferred to as ____ because they "extend" or continue care started in the hospital.
Extended-care facilities (ECF's)
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Facilities that are considered ECF include:
- Subacute-care or transitional facilities
- Medically complex care facilities
- Short-term rehabilitation units
- Long-term care (LTC) facilities (nursing homes)
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Subacute-care facilities provide an "in-between" levels of care. (This term oftern refers primarily to level of reimbursement.) These facilities are also called
- transitional care
- continual care facilities
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Nurses working in these settings often have previous experience in an
- intensive care unit
- emergency department
- acute medical-surgical unit
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Nusing functions in subacute-care include
- IV therapy
- cardiac monitoring
- ventilator care
- tube feeding of nutrients
- perioneal dialysis
- management of severe wounds
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Examples of clients in subacute-care facilities include
people recovering from extensive surgery, strokes, or hip fractures
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A specialized step in the continuum of care is the ____. This unit cares for clients who require more speicalized, high-tech care than is provided in trational skilled nursing facilities (SNFs) but who do not require hospitalization or care in subacute units.
medically complex nursing unit
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Nursing procedures for medically complex care units include
- IV therapy
- specailized wound care
- some daily nursing care
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The medically complex unit is often a section in the
skilled nursing facility (SNF)
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Facilities may have short-term rehabilitation units specially designed to serve residents who are recovering from
- accidents
- joint surgery
- acute illnesses
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Short-term rehabilitation units usually provide
physical, occupational, and speech therapy, as well as other services
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Long-term care facilities include ____. Both types are licensed by the state, commonwealth, or province, and must follow prescribed regulations.
- skilled nursing facility
- intermediate care facility
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Long-term care facilities provides
- room
- board
- and a range of nursing care
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The ____ provides 24-hour care and must always have a licensed nurse on duty.
skilled nursing facility (SNF)
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The skilled nursing facility (SNF) provides
- rehabilitation services
- special diets
- access to pharmacy and laboratory services
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Nursing care in the skilled nursing facility (SNF) may include such procedures as
- IV therapy
- enternal feeding
- ostomy care
- wound care
- pain management
- diabetes management
- bowel and bladder retaining programs
- physical rehabilitation
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Intermediate care facilities (ICF) provides fewer services and less expensive care than SNF. IFCs provides ____. A licensed nurse is not required to be on duty 24 hours a day, although a nurse is usually required to be on call.
- room
- board
- some nursing care
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LTC residents can elect the meal program they prefer. The ____ must oversee the client's dietary intake to make sure that the client is receiving sufficient nutrition.
case manager
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A good facility has many ____ available, including physical, occupational, and van transportation for shopping or recreation, and resident councils are common.
activities and services
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Federal law requires each state to have an LTC ____ to provide assistance and information to residents and families.
ombudsperson
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Most clients in LTC facilities are designed as ____ and are protected by law from abuse or neglect. The ombudsperson is responsible for protecting client rights.
vulnerable adults
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Client complaints are referred to the facility's
local administration
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Payment for long-term care, private insurance and other third party payors, such as Medicare, may cover all or part of the cost of
LTC facilities
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A facility's future reimbursement will be based on quality of care provided (how well the facility performs on pre-established quality measures).
Pay for Performance (P4P)
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Quality Improvement Organization (QIO), the goal is to improve care provided to Medicare recipients. Functions of QIOs include:
- Providing educational materials to facilities for staff development
- Guidance for quaility improvement for facility managers and staff (to improve care) by providing monitoring techniques and intervention strategies
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Each client in a facility for any length of time should have a ____ who oversees the client's name.
case manager or care manager (CM)
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The CM is the local advacate for the client and must ensure that the client is recieving appropriate care. The CM often evaluates the client's money management skills, and the CM or a family member may be designed as the client's ____, receiving the client's monthly check and disbursing funds appropriately.
payee
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The ____ programs have developed several centers to accommodate groups with special needs. The ultimate goal is to provide safety for clients.
centers of excellence (COE)
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A ____ may be designed for a specific group. These buildings may contain free-standing apartments and may have no supervision or only minimal supervision. Pays subsidid rent on a sliding scale, based on income. Meals and activities may be provided.
congregate housing
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A person may live in a ____, which provides room, board, and minimal supervision. Adult foster care is often available for selected groups of clients. Many people with mental illnesses and or physical disabilities live here.
board-and-care home
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In this facility, clients are supervised regarding medications and are often required to participate in a treatment program or to work or volunteer a specific amount of time. Meals and activities are included.
supervised group home
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Provide more services for older clients or for those with disabilities. Personnel from the facility usually check on each resident at least daily. Each apartment or room has a signal bell, so the resident can easily call for help in an emergency.
other types of congregate living facilities, senior apartment complexes
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for persons who are terminally ill may be provided to individuals in congregate living facilities. Most care is provided in the client's own home.
hospice care
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