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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
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SNF Resource Utilization Group Categories:
___mins: Medium
___mins: High
___mins: Very High
___mins: Ultra High
- 150mins
- 325mins
- 500mins
- 720mins
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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
-
Program of all inclusive care for the elderly (PACE)
-purpose?
-paid by?
- -non residential daytime care
- -medicare part A
-
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
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Hospice:
-life expectancy of less than __ months
-patient chooses to not pursue what?
-medicare part__ pays 100%
- -6 months
- -curative measures
- -medicare part A
-
Nursing Home/LTC:
-purpose is residential and custodial care
-does medicare pay?
-medicaid may trigger ___ ___
-
Adult Day Care:
-Purpose is to prevent institutionalization, not medical services
-Does medicare pay?
no, medicaid might
-
Continuing Care Retirement Community/continuing Life Care Community:
Purpose: provide a continuum of care wihting campus of connected facilities:
-who pays?
private pay
-
"Aging in Place"
-provides support for living at one's home or apt.
-Subsidized support services: name some
-meals on wheels, homemake services, OATS
-
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
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All eligible persons over 65 years automatically receive part A of Medicare, but seniors must directly choose to enroll in Part _, _, and _.
B,C,D
-
Part B pays for ___% of physician fees, __% of PT services, as well as other tests and procedures.
80%; patient responsible for other 20%
-
Therapy Cap on Part B for PT: _____
PT is paired with _____
- $1860 yearly
- paired with SLP
-
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)
-
Part D= ____
-senior pays monthly premiums and copays
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