Describe the ways in which quality and cost are controlled in your chosen facilities

Choose two long-term care facilities—one from nursing facilities, assisted living, or subacute care and another from adult day care, home health care, or hospice care, prepare a 8 page report in a Microsoft Word document including the following:Describe the roles and responsibilities of the administration in each department of your chosen facilities.Identify and list the sources of financing available to consumers for the various programs provided by your chosen facilities. Identify the key public and private sources of reimbursement available. Also discuss the role played by managed care and its impact on long-term care reimbursement.Describe the various government and private resources available that assist in developing and maintaining quality improvement programs in your chosen facilities. Describe the ways in which quality and cost are controlled in your chosen facilities. Also discuss the ethical aspect of access to care in the facilities, including rationing.Based on your observations and learning from the two facilities, discuss the changes brought in the long-term care system to make it reach full status as a competition-driven system. You may include the following points in your discussion:Discuss the changes made in the control mechanisms (external and internal) in order to control the management, financing, and quality in the long-term care systems.Discuss the changes taking place in long-term care reimbursement system in order to provide better reimbursement options both to consumers and providers.Discuss the changes made in the efforts of providers to accommodate changing magnitude of the day-to-day needs of long-term care consumers.Support your responses with examples.Cite any sources in APA format. Submission Details

Address whether or not the patient is attempting to compensate for a medical issue and thus creating a deficiency or excess in his or her diet

Resources: Flaherty, E., & Resnick, B. (Eds.). (2014). Geriatric nursing review syllabus: A core curriculum in advanced practice geriatric nursing (4th ed.). New York, NY: American Geriatrics Society. Geriatric patients have many nutritional and hydration concerns that impact their health and ability to acquire sufficient nutrients. Advanced practice nurses evaluating these patients must be able to account for all barriers that prevent elders from obtaining adequate nutrition, including medical conditions, transportation, finances, physiologic changes, and functional abilities. When evaluating patients, it is important to consider how they eat, what their diet consists of, and whether they have any special dietary needs that are not being met. Assessment tools, such as the Lawton Instrumental Activities of Daily Living (IADL) Scale, are an integral part of this evaluation process as they help providers identify potential obstacles for patients. In this Discussion, you assess a patient at your current practicum site and consider strategies for improving any nutrition or hydration issues.To prepare:Review this week’s media presentation, as well as Chapters 28 and 29 of the Flaherty and Resnick text.Assess a patient using tools for inpatient and long-term patient care, such as the Lawton IADL Scale.Note: You should coordinate this opportunity with the Preceptor at your practicum site.Consider whether nutrition and/or hydration might be impacted by the patient’s functional abilities. Reflect on whether the patient is able to go out and get food to eat, cook meals, safely use the stove, etc.Consider the patient’s diet and whether they have any special dietary needs due to medical conditions, such as congestive heart failure, end-stage kidney disease, diabetes, oral health issues, etc. Reflect on whether or not the patient is attempting to compensate for a medical issue and thus creating a deficiency or excess in his or her diet.Based on your patient assessment, think about strategies for improving any nutrition issues that might have presented (e.g., nutritional supplements, community resources such as Meals on Wheels, referral to a nutritionist or dietician, etc.).By Day 3Post a description of the patient assessment you performed using a tool for inpatient and long-term patient care, such as the Lawton IADL Scale. Explain whether nutrition and/or hydration might be impacted by the patient’s functional abilities. Then, describe the patient’s diet and whether he or she has any special dietary needs due to medical conditions. Address whether or not the patient is attempting to compensate for a medical issue and thus creating a deficiency or excess in his or her diet. Finally, explain strategies for improving any nutrition issues that might present during the patient assessment. **Please use at least to references and site within the paper in apa format

Elementor #8857



Identify the populations served and any issues of population vulnerability.

 
Review emerging standards of culturally competent care. Here are possible resources to use:
DHHS Office of Minority Health
National Center for Cultural Competence
AHRQ
Annie E. Casey Foundation
question; Write a 2,800- to 3,500-word paper that explores the following topics in your workplace or a setting that you select for this discussion:
Define culturally competent care appropriate for your own workplace, based on your perusal of the assigned readings.

Identify the populations served and any issues of population vulnerability.

Comment on standards of cultural competence that appear to be met and any that are not met.
Identify how delivery of nursing care could be affected where standards are being met and where they are not being met.