HSA 3223 Management of Long Term Care Facilities

Chapter 1 Discussion

Discussion: Explore at least two of the items below for your original post. Please make sure every question is covered by one student.

What factors have led to the development of the long-term care system as it currently exists?

What are some of the strengths and weaknesses of the current long-term care system?

Who uses long-term care services, and why do they use them?

Who are baby boomers and what is their impact on the long-term care system?

What is, and has been, the role of informal caregivers in the long-term care system?

What is a continuum of care and where do long-term care services fit in that continuum?

I would challenge you to dig a little deeper as to what LTC services look like for the aging American. Long term care is the unwanted step-child of the continuum, and is traditionally not seen as part of the US healthcare system ~ but the problem isn’t going away…

Bezaitis, A. (Nov/Dec.,2009). The Future of long-term care

Aging Well: 2 (5),14. Retrieved from: http://www.todaysgeriatricmedicine.com/archive/110909p14.shtml

Morley, J. (2017). The future of long term care.The Journal of Post Acute and Long Term Medicine. 18,(1), 1–7. DOI: DOI Article (Links to an external site.)

7. What types of services make up institutional and noninstitutional care?
8. What impact have government regulations had on the financing of long-term care?

HSA 3223 Management of Long Term Care Facilities

Chapter 3 Discussion

Ladies and gentlemen ~ The problems related to finding the ideal long-term case solution is complex. I believe we can agree on this. I would propose though, that you are the generation that will have to tackle this problem. BEFORE starting this posting, please view a TED talk by Futurist Ari Wallach Link (Links to an external site.) that explores a way of thinking for the (very) longterm planning~ for our purposes, think about LONGTERM CARE. He challenges us to determine what we are working for ~ What is our desired end outcome? some say to goal is “happy and healthy aging”, others want aging in place, others look only at the bottom line, and the list goes on….

Choose either option 1 or option 2 to expound on.

Option1:

The “ideal” long-term care system discussed in Chapter Three would base eligibility for services on functional needs rather than financial needs. Find the criteria for eligibility for Medicaid coverage for a nursing facility in your state (you can get the eligibility standards directly from the state or from a nursing facility).

Do they measure functional need vs. financial need?

How close do they come to the “ideal” criteria?

How would you change them if you could?

In your discussion, you are free to be innovative and imaginative. Just be prepared to support any arguments you make with citations. While your answer should relate to the materials in the text, you do not have to agree with them. In fact, the more thought you put into your response, the better the overall discussion will be.

Option 2:

It is highly likely that you know someone, perhaps a family member, who has had reason to use some portion of the long-term care system, or maybe you have been involved with the system on someone’s behalf. If not, talk with someone who has. Based on that experience, discuss the following two-part question:

What did you, or the person needing the services, find to be most difficult about getting or using those services? Possible answers might involve learning about available services, determining financial eligibility, the impersonality of the system, the lack of coordination, etc. You get the idea.

If you could improve the long-term care system to remove the difficulty you discussed above, what one thing would you change?

HSA 3223 Management of Long Term Care Facilities

Chapter 5 Discussion

Part 1: Answer two questions from the list below

1. Define and compare postacute and subacute care?
2. Where is subacute care provided, and by whom?
3. What types of services are included in subacute care?
4. How and why did subacute care develop?
5. How is subacute care financed?
6. What regulations apply to subacute care?
7. What is the difference between care management and case management?

Part 2:

In reference to the case at the end of this chapter, consider the following:

1. How can subacute care meet the needs of such different patients as David and Joyce?
2. Should both be included in a single care category, or should different levels of care be created for them?
3. Is subacute care really a response to patient needs, or is it a way of increasing financing for providers?

NOTE: This question applies to the overall system, but applying it to the case will assist you in seeing the implications for those using the system. Your opinion on this is welcome, just support it with facts/references. Let’s challenge each other and sharpen each other as we learn together!

HSA 3223 Management of Long Term Care Facilities

Chapter 8 Discussion

Option 1:

This part of the text focuses on the providers of long-term care. Some of them are institutional in nature, some are noninstitutional, and some are a combination of the two forms. One of the most enduring and difficult questions facing the system is how to balance the use of institutional and noninstitutional services.

How should the long-term care system balance institutional and noninstitutional forms of long-term care?

What factors should be taken into account?

Option 2:

Choose a long-term care provider and identify the following:

The services it offers

Who its consumers are (age, conditions, geographic base, etc.)

Anything that sets it apart from its competition

Any other relevant information.

If you work for a long-term care provider, choose a type other than the one for which you work (i.e., if you work in a nursing facility, contact an organization providing home care, assisted living, etc.). You do not actually have to visit the organization, although that is not a bad idea. You can get the needed information from a phone call, from publicity brochures and annual reports, or from their web site.

HSA 3223 Management of Long Term Care Facilities

Chapter 9 Discussion

Answer at least two of the following questions:

(AS A CLASS, all questions must be answered at least once before repeating questions)

1. Why has the long-term care field not been subject to strong competition in the past? Why has that changed?
2. What is the difference between cooperation and integration?
3. What is an integrated health network?
4. What is an integrated health system?
5. Under what circumstances might a long-term care organization choose to join an integrated system? An integrated network?
6. What are some of the potential economies of scale resulting from integration?
7. What are some of the benefits of integration for long-term care consumers?
8. How are management and governance of an integrated system or network different from management and governance of an individual organizational entity?
9. Why are information systems so important to integration efforts?
10. Why is planning so important to integrated networks or systems?

HSA 3223 Management of Long Term Care Facilities

Chapter 10 Discussion

Answer at least two of the following questions:

(all questions must be answered at least once before repeating questions)

1. Why are long-term care providers subject to so much external control by government agencies?
2. What is the difference between a law and a regulation?
3. What is the difference between licensure and accreditation?
4. What problems are identified (by providers) with government regulation of long-term care?
5. How do the three usual quality measurement methods (process, structure, and outcomes) differ?
6. Why are government programs such as Medicare and Medicaid so concerned with regulating cost?
7. What other types of regulation (not specific to long-term care) apply to long-term care providers and their employees?
8. What groups of long-term care practitioners are subjected to specific controls, such as licensure?
9. What are the most common accreditation agencies, and what provider organizations do they accredit?

HSA 3223 Management of Long Term Care Facilities

Chapter 11 Discussion

Answer at least two of the following questions:

(all questions must be answered at least once before repeating questions)

1. What do we mean when we say that the long-term care system is reimbursement driven?
2. Who is covered by Medicare? Medicaid?
3. What long-term care services does Medicare cover? What restrictions are placed on them?
4. What long-term care services does Medicaid cover? What restrictions are placed on them?
5. What is the spend-down provision of Medicaid, and why is it controversial?
6. What is the purpose of waiver programs?
7. What are public/private partnerships?
8. Why has managed care taken hold more slowly in long-term care than in other segments of health care?
9. What are the most common forms of managed care organizations?
10. What is the managed care consumer bill of rights, and why is it needed?

HSA 3223 Management of Long Term Care Facilities

Chapter 13 Discussion

Answer at least two of the following questions:

(all questions must be answered at least once before repeating questions)

1. What are the most common problems faced by consumers when suffering disabling conditions or otherwise needing long-term care services?
2. What is rationing (explicit and implicit), and what are some of the ways in which it occurs?
3. What does the Patient Self-Determination Act of 1990 do for consumers? What does it require of providers?
4. What is meant by the autonomy–beneficence conflict?
5. What is the difference between competency and rationality, and how does that difference affect decision making in long-term care?
6. What is informed consent, and whose responsibility is it?
7. What are the functions of ethics committees in long-term care?
8. What are the most common types of ethical issues relating to daily life in a long-term care facility?
9. What constitutes abuse in a long-term care setting? How might it be avoided?
10. How is management ethics different from other types of long-term care ethics? How is it similar?

HSA 3223 Management of Long Term Care Facilities

Chapter 15 Discussion

Answer at least two of the following questions:

(all questions must be answered at least once before repeating questions)

1. What are the basic components of leadership?
2. What are the characteristics of leaders most commonly desired by people?
3. What skills are needed to be a successful leader?
4. How does one go about learning or improving leadership skills?
5. Why is managing organizational change important?
6. What are some barriers to successfully changing an organization’s culture?

HSA 3223 Management of Long Term Care Facilities

Chapter 18 Discussion

Choose either Option 1 OR Option 2 to expound upon

Option 1:

How do you see advances in information technology impacting the way in which long-term care administrators function, now and in the future?

Try to relate to what you have learned in the different chapters covered in this part, integrating issues of governance, management, technology, etc., as well as calling on your own experience.

Option 2:

Answer at least two of the following questions:

(all questions must be answered at least once before repeating questions)

1. Why is marketing appropriate for long-term care organizations? Why have such organizations not embraced it more quickly and fully in the past?
2. How do public and/or community relations differ from marketing?
3. What is the relationship between strategic planning and marketing?
4. What is involved in conducting a self-assessment as part of market planning? An external assessment?
5. What are the four growth strategies identified in the chapter, and when might they be used?
6. What are the four consolidation strategies identified in the chapter, and when might they be used?
7. What are the four elements (the four Ps) of the marketing mix?
8. What is meant by branding?

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Chapter 19 Discussion

Follow the instructions under Discussion Board Rubric and Discussion Guidelines and APA Tips to create your post and respond to at least one other student. Answer the following question(s) and reply to at least one student’s post. Internal citations and references are required.

Original post is due by midnight on Thursday and responses are due by midnight on Sunday.

Answer at least two of the following questions:

(all questions must be answered at least once before repeating questions)

1. What are the major challenges that have faced the long-term care system in recent years?
2. How successfully has the system responded to those challenges?
3. What challenges remain unmet?
4. What types of new problems have been created by the solving of current problems?
5. What impact will the predicted increase in consumers’ involvement in their care have on providers?
6. What changes can be expected in terms of long-term care financing?
7. What will changes in technology mean to long-term care providers and consumers?
8. What are the most likely ethical challenges to be faced in the near future?

HSA 3223 Management of Long Term Care Facilities

Chapter 20 Discussion

Follow the instructions under Discussion Board Rubric and Discussion Guidelines and APA Tips to create your post and respond to at least one other student. Answer the following question(s) and reply to at least one student’s post. Internal citations and references are required.

Original post is due by midnight on Thursday and responses are due by midnight on Sunday.

Answer at least two of the following questions:

(all questions must be answered at least once before repeating questions)

1. What challenges and opportunities are future long-term care managers likely to face?
2. What skills will those managers need, and how can they acquire such skills?
3. What is meant by an organization’s service community, and how can long-term care organizations best deal with that community?
4. Why should long-term care providers become involved with integrated systems or networks? What are some of the possible types of involvement?
5. What is meant by a learning organization, and how can a manager move toward achieving such an organization?
6. What is a change agent, and how can a manager become one?
7. What are some of the ways in which long-term care managers can act proactively to improve the overall system?

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