Black Box of Home Care Quality: Hearing Before the Select Committee on Aging, House of Representatives, Ninety-ninth Congress, Second Session, July 29, 1986
U.S. Government Printing Office, 1987 - 232 pages
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additional Administration Aging American appropriate assessment assistance Association beneficiaries benefits bill certification CHAIRMAN client committee concerned condition consumer contract cost Department developed disabled effective elderly ensure established evaluation Federal funding going HCFA health aide hearing home care services home health agencies home health care home health services homemaker hospital important increase independent individual Institute involvement issue less licensed licensure limited long-term mechanisms Medicaid Medicare mode monitoring nursing home older participation patient percent person personnel physical physical therapy physician prepared problems professional quality assurance questions receive recommend record regulations reimbursement REPRESENTATIVE requirements responsibility sanctions served skilled Social Services staff standards statement supervision term Thank therapy treatment visits workers
Page 68 - extended care services" means the following items and services furnished to an inpatient of an extended care facility and (except as provided in paragraphs (3) and (6) ) by such extended care facility — ( 1 ) nursing care provided by or under the supervision of a registered professional nurse; (2...
Page 73 - ... (1) secure and maintain maximum independence and dignity in a home environment for older persons capable of self-care with appropriate supportive services; and "(2) remove individual and social barriers to economic and personal independence for older persons. "DEFINITIONS "SEC. 302. For purposes of this title — "(1) The term 'social services...
Page 48 - The National Homecaring Council also developed, under contract to the US Public Health Service, a model curriculum and teaching guide for the instruction of the homemaker-home health aide in 1978.
Page 68 - Medical supplies (other than drugs and biologicals) and medical appliances. The Medicare law limits payment for home health services to those beneficiaries whose conditions are of such severity that the individuals are under the care of a physician, confined to their...
Page 48 - Few have paid vacations or holidays, and even fewer have paid health insurance coverage. We have not given adequate attention or recognition to the persons who provide this vital service; in fact, in many respects we have exploited them. We have sown seeds for a potential scandal. We have ignored the escalating human needs of paraprofessionals while we have continued to delegate more care to them, and to place more demands on them. In June, 1985, the Rensselaer County (New York) long-term care coordinating...
Page 102 - ... (b) Standard: Clinical record review. At least quarterly, appropriate health professionals, representing at least the scope of the program, review a sample of both active and closed clinical records to assure that established policies are followed in providing services (direct services as well as services under arrangement).
Page 47 - MATERIALS). THE STANDARDS COVER AGENCY STRUCTURE, STAFFING, TRAINING, SUPERVISION, SERVICE, AND COMMUNITY RELATIONS. THE NATIONAL LEAGUE FOR NURSING AND THE JOINT COMMISSION ON ACCREDITATION OF HOSPITALS ALSO ACCREDIT HOME HEALTH PROGRAMS PROVIDED THROUGH SOME COMMUNITY AGENCIES AND HOSPITALS. SUCH ACCREDITATION OR APPROVAL IS ENTIRELY VOLUNTARY, HOWEVER.
Page 55 - ... The issue of standards for paraprofessionals in home care Is not new. To deal with the problem, the National Homecaring Council has promulgated national standards for homemakerhome health aide services, and has administered an accreditation and approval program based on those standards sine* 1962.
Page 63 - Is free from mental and physical abuse, and free from chemical and (except in emergencies) physical restraints except as authorized in writing by a physician for a specified and limited period of time, or when necessary to protect the patient from injury to himself or to others...
Page 102 - If a physician refers a patient under a plan of treatment which cannot be completed until after an evaluation visit, the physician is consulted to approve additions or modifications to the original plan. Orders for therapy services include the specific procedures and modalities to be used and the amount, frequency, and duration. The therapist and other agency personnel participate in developing the plan of treatment.