Case MGMT 2 Test

  1. Skilled Nursing Facility: post acute 24 hour care after a minimum __ day hospital stay. Payed 100% by Medicare_ for the first __ days and 80% for the next __ days.
    • 3 day hospital stay
    • Medicare part A
    • 20 days
    • 80 days
  2. SNF Resource Utilization Group Categories:
    ___mins: Medium
    ___mins: High
    ___mins: Very High
    ___mins: Ultra High
    • 150mins
    • 325mins
    • 500mins
    • 720mins
  3. Inpatient Rehab Facility:
    Purpose: 24 hour care
    Paid by______
    Previous functional status of?
    Tolerance of __ hrs of therapy/day
    Decreased safety: must identify risk within last __-__ weeks.
    • -Medicare A
    • -recent documented change in condition;
    •  must have higher level of function
    • -3 hrs per day (may be split after first week)
    • -2-4wks
  4. Program of all inclusive care for the elderly (PACE)
    -paid by?
    • -non residential daytime care
    • -medicare part A
  5. Home Health:
    -available if pt. is _______
    -paid by?
    -does it have to be linked by hospital stay?
    -_______ is extensive document completed at admission, every__days, and upon discharge
    • -homebound
    • -medicare part A
    • -no
    • -OASIS every 60 days
  6. Hospice:
    -life expectancy of less than __ months
    -patient chooses to not pursue what?
    -medicare part__ pays 100%
    • -6 months
    • -curative measures
    • -medicare part A
  7. Nursing Home/LTC:
    -purpose is residential and custodial care
    -does medicare pay?
    -medicaid may trigger ___ ___
    • -no
    • -spend downs
  8. Adult Day Care:
    -Purpose is to prevent institutionalization, not medical services
    -Does medicare pay?
    no, medicaid might
  9. Continuing Care Retirement Community/continuing Life Care Community:
    Purpose: provide a continuum of care wihting campus of connected facilities:
    -who pays?
    private pay
  10. "Aging in Place"
    -provides support for living at one's home or apt.
    -Subsidized support services: name some
    -meals on wheels, homemake services, OATS
  11. How does a senior become eligible for Medicare:
    • -over 65 y.o.
    • -person or spouse has worked 40 quarters (10years) and paid into MED/EE/OASDI/EE
  12. All eligible persons over 65 years automatically receive part A of Medicare, but seniors must directly choose to enroll in Part _, _, and _.
  13. Part B pays for ___% of physician fees, __% of PT services, as well as other tests and procedures.
    80%; patient responsible for other 20%
  14. Therapy Cap on Part B for PT: _____
    PT is paired with _____
    • $1860 yearly
    • paired with SLP
  15. Part _: Seniors may choose to recieive Medicare Advantage that allows an intermediary (BlueCrossBlueShield) to modify rules, regulations, and payment system. ___ is predominent delivery model.
    • part C
    • HMO's (health maintenance organizations)
  16. Part D= ____
    -senior pays monthly premiums and copays
Card Set
Case MGMT 2 Test