1. MNA Working in Long Term Care Chapter 1

2. Long Term Care Centers  Board and Care Homes Can be in a home setting Can be part of a nursing facility SUPPORTIVE CARE Meals, housekeeping, laundry, transportation, medication reminders

3. Long Term Care Centers  Assisted Living Residence Home like setting, apartment like Provides housing, personal care, health care, social activities. Assistance with ADL. Residents

4. Long Term Care Centers  Nursing Centers Require continuous care LTCF Licensed Staff Provide: medical, nursing, dietary, rehab care recreation and social services, laundry and housekeeping Residents

5. Long Term Care Centers  Nursing Centers Skilled Nursing Facilities SNF More complex care provided

6. Purposes and Goals of Nursing Centers Promote Physical and Mental Health Eat properly Exercise Prevent communicable disease Treat chromic illness Rehab or restorative care

7. Purposes and Goals of Nursing Centers Promote Physical and Mental Health Eat properly and Exercise Do as much for themselves as possible Encourage appetite Quality of life

8. Purposes and Goals of Nursing Centers Promote Physical and Mental Health Prevent Communicable Diseases Disease spread from one person to another Hand washing

9. Purposes and Goals of Nursing Centers Promote Physical and Mental Health Treat chromic illness Slow or gradual onset No cure acute illness Sudden onset Should recover

10. Purposes and Goals of Nursing Centers Promote Physical and Mental Health Rehab or restorative care Return to highest possible level off functioning Begins on admission Entire staff involved

11. OTHER SERVICES provided by Nursing Centers Hospice Alzheimer’s Unit Rehab and Sub-acute care

12. Accreditation JCAHO Standards and practices Improves quality of care Yearly review

13. Nursing Center Organization Owned by person or corporation Local, state and federal regulations Must have a medical director Nursing is a major department

14. Organizational Structure ADMINISTRATOR DO ENVIRONMENTAL SERVICES DO FINANCE PAYROLL DO NURSING - RN Floor Charge Nurse - RN Shift Supervisor - RN HOUSEKEEPING RN LPN Nursing Assistant

15. Registered Nurse 2 year degree - Associate 4 year degree - Bachelors Assess, plan, implement, evaluate nursing care Must pass Licensing exam Must continue education DO NOT Diagnose

16. Licensed Practical Nurse LPN (Also called LVN) 12 -18 month Program Community College or Technical School Must pass Licensing exam Must continue education Under the supervision of an RN

17. Nursing Assistant 75 hour program Required by the Omnibus Budget Reconcilation Act of 1987 (OBRA) 59 classroom, 16 hours clinical Must pass a state exam to be placed on registry Must continue education Under the supervision of an RN, LPN

18. Nursing Assistant State Exam Written exam – 75 questions Performance exam – 5 skills Must be taken within one year of course completion 3 attempts

19. Nursing Care Functional Nursing Tasks and jobs Team Nursing Team led by RN Delegation based on staff ability and patient need Primary Nursing Primary RN is responsible for Total Care

20. Health Care Team Activities Coordinator Dentist Dietician Lab Tech Physical Therapist Pharmacist Respiratory Therapist Podiatrist Social Worker Radiology Tech

21. Payments Private Insurance Group Insurance Medicare Medicaid Health care payment program sponsored by the federal govt and operated by the states. Available to low income, blind, disabled, elderly Federal health care insurance program for 65 or older

22. Payments DRG – Diagnosis Related Groups Managed Care - Limits

23. Review Helping persons return to their highest physical and mental functioning is called? rehabilitation

24. Review Persons in a LTCF are referred to as ? residents

25. Review Which facility provides 24 hour nursing care? Nursing center (LTCF)

26. Review When does rehab start? On admission

27. Review What is the nursing center goal or purpose? Promote Physical and Mental Health

28. Review Who is the person “in charge” in a health care facility? Administrator

29. Review Who is the person in charge of the nursing department? DON

30. Review A health care program for the dying person is ? Hospice

31. Review An illness with slow, gradual onset, usually no cure is called? chronic

32. Review Who would qualify for Medicaid? Low income, blind, disabled, elderly

33. Review Doctors are part of the nursing team. True or False

34. Review Nursing assistants often supervise others. True or False

35. Review Medicare is for persons age 65 and older. True or False

36. Review All nursing centers must be JCAHO accredited. True or False

37. Review DRG are used to control the cost of health care. True or False

38. Review Residents are often encouraged to work at the LTCF to lower the cost of their health care. True or False

39. Review Nursing assistants must pass a state exam in order to be put on the state registry True or False

40. Review What is ADL? Activities of Daily Living

41. Questions??