CHAPTER 1: UNDERSTANDING

HEALTHCARE SETTINGS

LEARNING OBJECTIVES

Discuss the structure of the healthcare system in regards to past, present, and future

Describe a typical long-term care facility

Describe residents who live in long-term care facilities

Explain policies and procedures

Describe the long-term care survey process

Differentiate between Medicare and Medicaid

Discuss the terms culture change, person-directed care, Pioneer Network, and The Eden Alternative

TRADITIONAL HEALTHCARE SYSTEM

THE TYPICAL LONG-TERM CARE FACILITY Long-term care facilities (LTCFs) Activities of daily learning (ADLs) Therapies Wound care Care of different tubes Nutrition therapy Management of chronic diseases

RESIDENTS WHO LIVE IN LONG-TERM CARE FACILITIES

Age Gender Race Residence prior to admission• Length of stay

POLICIES AND PROCEDURES

Policy vs. procedure

Common policies

LONG-TERM CARE SURVEY PROCESS Survey

The Joint Commission

MEDICARE AND MEDICAID

Centers for Medicare & Medicaid Services (CMS)

Medicare Part A Part B Part C Part D

Medicaid

CULTURE CHANGE, PERSON-DIRECTED CARE, PIONEER NETWORK, AND THE EDEN ALTERNATIVE Culture change Choice Dignity Respect Self-determination Purposeful living

Pioneer Network Person-directed care

Eden Alternative

REVIEW

Structure of healthcare

Long-term care facility

Residents who live in long-term care facilities

Policies and procedures

Survey process

Medicare and Medicaid

Culture change, person-directed care, Pioneer Network, and The Eden Alternative