Question 1

Medicaid pays for home care services for people who have low incomes.Who administers the Medicaid program?

Accepted Answer

Medicaid is administered by the state.Medicare is a federal program.

Question 2

Nurses who work in home settings rather than a hospital setting require a different level of ability to be technically proficient,self-motivated,and innovative.This requires a higher level of what quality?

Accepted Answer

The independence of home care practice can be difficult for nurses who depend on the security of the institutional setting.

Question 3

For physical therapy services to be reimbursed by Medicare,what must be the goal of the therapy?

Accepted Answer

The goals of treatment must be restorative in order for Medicare to provide reimbursement.In some cases,the goals can be preventive or maintenance for other payer sources.

Question 4

The initial evaluation and admission visit is made by an RN,who has been provided with general orders by a physician before the visit.This visit must be made within how many hours of the referral?

Accepted Answer

The initial evaluation and admission visit made by an RN must be made within 24 to 48 hours of the referral.In some cases,if nursing will not be providing any services,the physical therapist may conduct the admission visit.

Question 5

What became effective in 1966 by an act of legislation that revolutionized home care?

Accepted Answer

When Medicare became effective in 1966,it revolutionized home care by changing it to a medical rather than nursing model of practice,defining and limiting services it would reimburse,and changing the payment source and even changing the reason home care was provided.

Question 6

When implementing quality assurance-specific criteria,measurements are developed for three criteria: structural,process,and outcome.How is this method of assessment different from previous methods?

Accepted Answer

In the past,measurements of quality in an agency,the care delivered,and the staff were all subjective.The quality assurance--specific criteria measurements are objective.

Question 7

How often must the homecare treatment plan be recertified in order for the patient to continue to receive services?

Accepted Answer

Medicare and Medicaid home care services are based on the medical model of treatment and depend on the physician for entry into the formalized system.Medicare requires a plan of treatment signed by the physician,outlining all disciplines,treatment,frequency,and duration.These orders must be recertified every 60 days.

Question 8

When should discharge planning begin for a patient receiving home care services?

Accepted Answer

Discharge planning for home care begins on admission.

Question 9

A major change to Medicare reimbursement was implemented in 1983.The new system paid a set rate according to diagnosis.What was the new payment system based upon?

Accepted Answer

The new payment system introduced in 1983 provided reimbursement based upon set rates that were determined by diagnosis-related groups (DRGs).

Question 10

Complete documentation is essential and must include an accurate picture of the type and quality of care given,as well as the effectiveness of the plan of care.Which model should be followed to best provide adequate documentation?

Accepted Answer

Documentation that follows the nursing process model provides an accurate picture of the type and quality of care.

Question 11

The patient,family,social service agency,hospital,physician,or another agency all can provide the entry point to the home health care system.What is the entry point for the home health care system called?

Accepted Answer

The entry point for home health care system is by referral.This can come from the patient,family,social service agency,hospital,physician,or another agency.

Question 12

If solely for this reason,Medicare will not cover home health aide visits.What is that reason?

Accepted Answer

Medicare will not pay for visits made solely for household chores.

Question 13

How long is the average home health care visit by the skilled nurse?

Accepted Answer

Skilled nursing visits typically take 30 to 45 minutes.

Question 14

The LPN/LVN may provide many services to the patient in the home.Several of these are high-level skills.Under whose supervision should these high-level skills be directed and performed?

Accepted Answer

The LPN/LVN must always work under the supervision of an RN.

Question 15

During a time of acute illness,the family may become extremely distressed and neglect the needs of other family members.On what does the family seem to focus?

Accepted Answer

During times of acute illness,the family may become extremely distressed and focus only on the patient.The nurse can refer family members to an appropriate resource.

Question 16

What is an eligibility requirement for an individual to qualify for Medicare services?

Accepted Answer

Beneficiaries of service must be at least 65 years of age.

Question 17

Speech therapy goals include minimizing speech disorders and maximizing rehabilitation of speech abilities.To be reimbursed by Medicare,who must provide these services?

Accepted Answer

To be reimbursed by Medicare,speech therapy must be provided by a master's-prepared clinician.Other payers will sometimes reimburse services provided by a bachelor's-level clinician.

Question 18

The evaluation and admission process for entry to the home health care system includes physical and psychosocial examination,explanation of the patient's rights,and evaluation of family,home,and nursing interventions.What is the normal minimum time for the admission visit?

Accepted Answer

The admission process typically takes a minimum of 1 hour.

Question 19

After the patient is admitted to the home health services system,a treatment plan is drafted cooperatively with the physician and is signed.A separate,detailed care plan is always required for which disciplines?

Accepted Answer

A separate,detailed care plan is always required for the home health aide.

Question 20

Medical social services focus on the emotional and social aspects of illness.What is another area of service?

Accepted Answer

Coping with stress and crisis intervention are also part of medical social workers' services.

Quiz 36: Home Health Nursing