HEALTH CARE ADMINISTRATION LONG TERM CARE
Healthcare administration long term care
Oneof the most critical facets of long term care in the modern healthcare systems is the role of nursing homes. With the increased numberof aged persons and terminally ill individuals in the society, longterm health care has evolved at a significantly fast rate. Millionsof elderly as well as disabled in individuals in the United Stateslive in thousands of nursing homes. They provide long termresidential care to individuals who have difficulties with dailyactivities. The nursing homes are manned for 24 hours everyday bytrained and skilled nurses and social workers. Although thefacilities receive funded by the public health care program, mainlythe Medicaid, they complement the main health care facilities(Castle, 2010).
Althoughthe elderly and disabled individuals are taken to residential nursingfacilities because of the quality of services offered, which may notbe available in the home based care, the quality of care remains animportant challenge in long term care. At the facility level as wellas regulation level, there are several measures that have been takento increase the quality of care in nursing facilities. The nursingfacilities are beneficiaries of the public funded medical insuranceprograms. Therefore, they must ensure that they meet the qualitystandards set by the Centers for Medical and Medicaid Services. Thesestandards are meant to ensure that individuals residing in nursinghomes receive quality care. The states departments of health areresponsible for oversight and regulation of the facilities’ qualityof services. The quality inspection surveys and certificationdetermine the eligibility of the facility to the public fundedmedical insurance. Additionally, there are federal laws such as theOmnibus Budget Reconciliation Act of 1987 and the new health carereforms by President Obama administration that have a direct andindirect control on the quality of services offered at nursing homes(Castle, 2010).
Inaddition to regulations, there are other initiatives that have beenused to improve the quality of services in nursing homes. The mostimportant initiatives are organizational based. This involves thenursing facility administration providing the necessary facilitiesand resources to promote the quality of services. The nursing homeadministration has the responsibility of ensuring that there areadequate facilities and staff that is necessary to provide therequired services. The facilities in the nursing home should takeinto consideration the needs of the clients. Additional, training andeducating the staff on evidence based practices as well asspecialized training has a huge impact on the quality of services.Education has been identified as the most important component ofquality improvement initiatives in long term care. Other initiativethat promotes quality of services in nursing homes includes increasedadvocacy for governmental, community based and non profitorganizations and promotion of research in long term care (White,2005).
Anotherlong term care facility where improvement of quality is critical isassisted living facilities. These long term care facilities alsohouse people with disabilities and require assistance or supervisionin their daily living activities. Although the services provided inassisted living facilities require specialized and trained nurses andcommunity workers, there do not advanced medical monitoringequipments that are found in nursing homes and other advanced medicalfacilities. It mainly involved assistance with basic household choressuch as laundry, bathing, cooking, eating, toileting and dressing.However, simple medical care services such as medication managementand injection of insulin are offered in assisted living facilities(Namazi & Chafetz, 2010).
Sincesome assisted living facilities are beneficiaries of Medicaidprogram, the responsible government agencies are concerned with thequality of services offered in the facilities. The quality ofservices in these facilities should meet the minimum standards set bythe state departments to qualify for Medicaid eligibility. Theincreased competition and demand for higher quality of services bythe clients has also significantly improved the quality of long termcare in assisted living facilities. Improvement in the quality ofservices in assisted living facilities results into increasedefficiency and sustainable management of the facilities (Namazi &Chafetz, 2010).
Inaddition to government and payer regulations, the National Center forAssisted Living has developed quality improvement programs that areaimed at promoting the quality of care in assisted living facilities.The program entails among others promoting person center based care,ethical and moral standards and practices, financial stewardship andmorality, and continuous improvement. Nonetheless, the administrationof the assisted living facility has the ultimate responsibility ofpromoting quality care. This is done through provision of adequateand well trained staff as well as adequate support facilities (Namazi& Chafetz, 2010).
Longterm care is one of the most important aspects of the modern healthcare systems. The elderly consume over half of the health care systemservices. This is due to the increased demand for long term healthcare services. As a result, health care facilities that specialize onlong term health care services have emerged. This has created highdemand for health care administrators and leaders who can effectivelymanage long term care facilities. Although long term care facilitiesare not complex and large when compared to main stream healthyfacilities such as hospitals, there are special traits as well astraining that are required for a long term care administrator. Due tothe nature of their services, there are numerous ethical issues thatare associated with long term care. These ethical issues are moresensitive compared to other institutions and community basedorganization environment. Additionally, administrators in thesefacilities mainly deal with unique and special cases. Thus, themanagement of facilities as well as staff is significantly differentwhen compared to other institutions and organizations. It is alsoimportant to note that long term care is one of the most regulatedindustries in the United States (Singh, 2014).
Along term care administrator is directly involved in the caringbusiness. Provision of care to the elderly and disabled requires bothskills and passion. As a result, a long term administrator requireshigh level of training preferably a bachelor’s degree, itsequivalent or higher in a discipline related to health careadministration. Majority of long term administrators have basictraining in a health care discipline and advanced leadership andadministration training. Long term care administrators requiretraining in health economics, human resources management, basicaccounting and health information system. In some learninginstitutions, there are programs that enable individuals tospecialize in nursing home and long term care administration. Inaddition to education, experience and in job training is veryessential among long term care administrators. As a result,internship and supervised administration is very essential especiallyamong less experienced administrators. Additionally, to ensure thatthe administrator is acquainted with emerging trends in long termcare management, continuous training through workshops and seminarshave a huge contribution in equipping administrators with criticalskills (Singh, 2014).
Dueto the increased number of elderly individuals in the modern society,there is an increased case of terminal diseases such as Alzheimer’sdiseases has resulted into increased demand for long term services.Due to improved medical technologies as well as the aging of the babyboomers generation, the increased aged population will have animportant impact on the health care system. However, there areseveral ethical issues that will have a direct impact on theoperations of long term care facilities. These ethical issuesrelated to medical ethics as well as general social morality. Thisrequires administrators in these facilities to be able to effectivelydeal with these challenges. This includes adequately training ofstaff as well as implementation of programs that effectively dealswith the ethical issues raised. The most important ethical issuesinclude the loss of privacy and autonomy. Unlike the traditional homesetting, the sick and elderly individuals living in long term carefacilities are likely to lose their privacy. Additionally, long termcare facilities are likely to erode the autonomy of the elderly orsick individual. This has a negative impact on the experiences of theclient. For example, in a long term facility, some of the facilitiesmay be shared and the individual may not have the privacy found inthe traditional homes. Another important ethical issue that is likelyto face administrators in long term care facilities is the quality ofservices provided. In many cases, conflicts between the familymembers and long term care facilities are associated with the qualityof services offered to the clients. Although some of the issuesraised are valid, some of them are as a result of misperception andmisinterpretation of actions or inactions. However, incidences ofneglect, abuse and mistreatment are some of the gravest ethicalissues faced by administrators in long term care facilities (Fleming,2007).
Castle,N. et al (2010). “What Is Nursing Home Quality and How Is ItMeasured?” Gerontologist.50(4): 426–442.
Fleming,D. (2007). “Addressing ethical issues in the nursing home”.Mo Med.104(5), p 387-91.
Namazi,K. & Chafetz, P. (2010). Assistedliving: current issues in facility management and resident care,Westport, Conn.: Auburn House.
Singh,D. A. (2014). Effectivemanagement of long-term care facilities,Sudbury, Mass.: Jones and Bartlett Publishers.
White,H. (2005). “Promoting Quality Care in the Nursing Home”, Annalsof Long-Term Care,13(4), p 26-34.