Term
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Definition
| It is a variety of services that includes medical and non-medical services for the disabled or chronically ill patients. |
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Term
| Where can long term care be provided? |
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Definition
| home, in community, in assisted living |
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Term
| Long term care can last a few weeks or may go on for a few years. Why might you enter temporary long term care vs ongoing long term care? |
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Definition
| Rehab from a hospital stay or recovery from an illness |
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Term
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Definition
| - services that can only be given by or under the supervision of a skilled medical professional |
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Term
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Definition
| - services that can be given safely and reasonably by individuals who are neither skilled nor licensed personnel. |
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Term
| What are assisted living facilities? |
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Definition
- a generalized care model
- includes a number of services
- aka residential care
- provides a gap between home care and nursing homes |
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Term
| What personal care services are available in assisted living facilities? |
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Definition
- meals
- housekeeping
- security
- comfort
- transportation
- medication administration assistance
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Term
| Who regulates assisted living facilities and who pays from them? |
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Definition
- the state regulates it, not federal
- Elderly bear the full cost, medicaid, medicare, and private insurances do not cover the costs. |
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Term
| Do assisted living facilities have a medical director? |
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Definition
- very few do
- most have outpatient physician or a physician may visit on site |
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Term
| What are some of responsibilites of the AL facilities pharmacy provider? |
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Definition
- continuity of medication packaging
- provides medication carts, treatment carts
- onsite medication delivery
- consultation services |
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Term
| How can the pharmacy return and credit medications? |
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Definition
| only when packaged as a unit dose |
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Term
| How are medications paid for in an assisted living facilities? |
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Definition
- 3rd party insurances, or medicare part D
- very few medicaid residents
- the facility bears no responsibility for medication cost |
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Term
| What are the rules and regulations for pharmacy practice in an assisted living facility? |
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Definition
- no federal rules or regulations
- each state enforces their own rules
- MI has very minimal rules |
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Term
| What is a nursing home facilities? |
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Definition
| - facilities for individuals who require extensive assistance with personal care and health services |
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Term
| What will limit the growth of nursing home admissions? |
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Definition
| Assisted living facilities and home care options |
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Term
| Whats the difference in regulation between non-skilled and skilled nursing facilities? |
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Definition
Non-skilled: liscensed by only the state
Skilled: liscensed by federal and state |
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Term
| How are skilled nursing homes initial paid for? And then what is it switched to? |
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Definition
- Medicare Part A
- switched to medicaid or private pay |
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Term
| What is a major problem of resource utilization groups? |
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Definition
- Medication costs are not factored in
- facilities pay the same for level of care regardless of discrepancies in drug costs |
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Term
| What is the administrator responsible for on the nursing home health team? |
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Definition
- overall operation of the nursing home
- must have accredited LTC Administration license |
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Term
| What are the medical director responsiblities on the nursing home health team? |
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Definition
- resident care policies and the coordination of medical care
- must be actively licensed physician |
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Term
| What are the physicians responsibilities in the nursing home health team? |
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Definition
- responsible for the direct care of residents
- may work with PAs or NPs
- will often have a majority of residents in a facility |
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Term
| What is the director of nursing's responsibility on a nursing home health team? |
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Definition
- oversight of all nursing services
- must have an RN degree
- must have an RN available 24/7; only RN's can start an IV |
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Term
| What do all pharmacy providers utilize in a nursing home setting? Why? |
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Definition
- a unit dose system
- provides ability to return to stock
- provides safety and accuracy for nurses administering medications. |
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Term
| What are challenges to pharmacy billing services in LTC? |
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Definition
- cross over billing
- Medicaid switch to medicare part D
- mulitple formularies
- one payer source changes to multiple
- PA/non-covered drugs |
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Term
True or False:
There is a federal mandate for monthly medication review by a licensed pharmacist in a nursing home. |
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Definition
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Term
| Whats included in an analysis performed in monthly MRR? |
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Definition
- supporting diagnosis for medications
- dosage considerations
- drug interactions
- duplicate therapy
- Adverse drug reviews
- drug food interactions
- untreated conditions
- alternative therapy
- allergy screening |
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Term
| What are other consultant pharmacist services? |
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Definition
- quality assurance reports and meetings: infection control
- cost containment reporting
- liaison between facility and pharmacy |
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Term
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Definition
Drug Utilization Review
- review of drug use to determine the appropriateness of the drug therapy. |
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