Shared Flashcard Set

Details

Finance 3
pharmacy related finance (lectures 8)
29
Pharmacology
Graduate
12/07/2009

Additional Pharmacology Flashcards

 


 

Cards

Term
What is long term care?
Definition
It is a variety of services that includes medical and non-medical services for the disabled or chronically ill patients.
Term
Where can long term care be provided?
Definition
home, in community, in assisted living
Term
Long term care can last a few weeks or may go on for a few years. Why might you enter temporary long term care vs ongoing long term care?
Definition
Rehab from a hospital stay or recovery from an illness
Term
What is skilled care?
Definition
- services that can only be given by or under the supervision of a skilled medical professional
Term
What is custodial care?
Definition
- services that can be given safely and reasonably by individuals who are neither skilled nor licensed personnel.
Term
What are assisted living facilities?
Definition

- a generalized care model

- includes a number of services

- aka residential care

- provides a gap between home care and nursing homes

Term
What personal care services are available in assisted living facilities?
Definition

- meals

- housekeeping

- security

- comfort

- transportation

- medication administration assistance

 

Term
Who regulates assisted living facilities and who pays from them?
Definition

- the state regulates it, not federal

- Elderly bear the full cost, medicaid, medicare, and private insurances do not cover the costs.

Term
Do assisted living facilities have a medical director?
Definition

- very few do

- most have outpatient physician or a physician may visit on site

Term
What are some of responsibilites of the AL facilities pharmacy provider?
Definition

- continuity of medication packaging

- provides medication carts, treatment carts

- onsite medication delivery

- consultation services

Term
How can the pharmacy return and credit medications?
Definition
only when packaged as a unit dose
Term
How are medications paid for in an assisted living facilities?
Definition

- 3rd party insurances, or medicare part D

- very few medicaid residents

- the facility bears no responsibility for medication cost

Term
What are the rules and regulations for pharmacy practice in an assisted living facility?
Definition

- no federal rules or regulations

- each state enforces their own rules

- MI has very minimal rules

Term
What is a nursing home facilities?
Definition
- facilities for individuals who require extensive assistance with personal care and health services
Term
What will limit the growth of nursing home admissions?
Definition
Assisted living facilities and home care options
Term
Whats the difference in regulation between non-skilled and skilled nursing facilities?
Definition

Non-skilled: liscensed by only the state

Skilled: liscensed by federal and state

Term
How are skilled nursing homes initial paid for? And then what is it switched to?
Definition

- Medicare Part A

- switched to medicaid or private pay

Term
What is a major problem of resource utilization groups?
Definition

- Medication costs are not factored in

- facilities pay the same for level of care regardless of discrepancies in drug costs

Term
What is the administrator responsible for on the nursing home health team?
Definition

- overall operation of the nursing home

- must have accredited LTC Administration license

Term
What are the medical director responsiblities on the nursing home health team?
Definition

- resident care policies and the coordination of medical care

- must be actively licensed physician

Term
What are the physicians responsibilities in the nursing home health team?
Definition

- responsible for the direct care of residents

- may work with PAs or NPs

- will often have a majority of residents in a facility

Term
What is the director of nursing's responsibility on a nursing home health team?
Definition

- oversight of all nursing services

- must have an RN degree

- must have an RN available 24/7; only RN's can start an IV

Term
What do all pharmacy providers utilize in a nursing home setting? Why?
Definition

- a unit dose system

- provides ability to return to stock

- provides safety and accuracy for nurses administering medications.

Term
What are challenges to pharmacy billing services in LTC?
Definition

- cross over billing

- Medicaid switch to medicare part D

- mulitple formularies

- one payer source changes to multiple

- PA/non-covered drugs

Term

True or False:

There is a federal mandate for monthly medication review by a licensed pharmacist in a nursing home.

Definition
True
Term
Whats included in an analysis performed in monthly MRR?
Definition

- supporting diagnosis for medications

- dosage considerations

- drug interactions

- duplicate therapy

- Adverse drug reviews

- drug food interactions

- untreated conditions

- alternative therapy

- allergy screening

Term
What are other consultant pharmacist services?
Definition

- quality assurance reports and meetings: infection control

- cost containment reporting

- liaison between facility and pharmacy

Term
DUR
Definition

Drug Utilization Review

- review of drug use to determine the appropriateness of the drug therapy.

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