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Practical and compassionate approaches to providing quality care and safeguarding quality of life
The second edition of Managing the Long-Term Care Facility: Practical Approaches to Providing Quality Care updates the first edition's discussion of the operational requirements necessary to manage a skilled nursing facility. This book presents sensitive and empathic regulatory compliant methods for the delivery of care that fosters an empowering environment for all stakeholders. Additional new information includes aging in place, trauma-informed care, ethical dilemmas and collaborative decision-making, workforce culture, and surveys, enforcement actions, and appeals. The pedagogical tools include chapter summaries with quiz questions and case studies. Instructors also have access to PowerPoint slides and test banks.
This book is an excellent resource for students and individuals interested in working in long-term care and other health care industries. The updated best practices for clinical and non-clinical roles within the facility and material on resident advocacy and other important topics provide valuable information for the reader. Working professionals can benefit from the emphasis placed on practical approaches to facilitate person-centered and whole person care and a facility's sustainability.
REBECCA M. PERLEY is an assistant professor in the Health Care Management Department at California State University, Long Beach, USA. Dr. Perley is a licensed nursing home administrator and is committed to improving the quality of care and life of individuals through education, best practices, and a whole person-care approach to the delivery of health care services.
About the Contributors xxv
Foreword xxxiii
Preface xxxvii
Acknowledgments xxxix
About the Companion Website xli
Introduction xliii
Chapter 1 Long-Term Care Continuum 1 Kenneth Merchant, Rebecca M. Perley, Susan M. Duncan, Nancy Wexler, and Michael Carter
Chapter 2 Biological and Psychosocial Aspects of Aging 37 Barbara White and Melvin Hector
Chapter 3 Person-Centered Care 71 Jim Kinsey, Cindy Donovan, and Adrienne Lindsey
Chapter 4 Trauma-Informed Care91 Barbara Ganzel, Nancy Kusmaul, Carla Cheatham, Paige Hector, David D. Clarke, and Rebecca M. Perley
Chapter 5 Resident Advocates and Diversity 47 Ann Wyatt, Robyn Grant, and Rebecca M. Perley
Chapter 6 Physical Environment of Long-Term Care 163 Andrew Lee Alden, Jeffrey W. Anderzhon, and Sarah Moser
Chapter 7 Transitions of Care 191 Paige Hector and Cory W. Woods
Chapter 8 Resident-Centered Clinical Operations 209 Paige Hector and Cory W .Woods
Chapter 9 Ethical Dilemmas and Collaborative Decision-Making 231 David N. Hoffman
Chapter 10 Facility-Centered Clinical Operations 259 Paige Hector and Cory W. Woods
Chapter 11 Technology and Data-Driven Health Care 281 Abby Swanson Kazley
Chapter 12 Resident Assessment Instrument 303 Joel VanEaton and Rebecca M. Perley
Chapter 13 Quality Assurance and Performance Improvement (QAPI) and Quality Assessment and Assurance (QAA) 313 Paige Hector and Alan C. Horowitz
Chapter 14 Surveys, Enforcement Actions, and Appeals 345 Alan C.Horowitz
Chapter 15 Human Resources 367 Sonja M.Talley, Ronke Komolafe, and Rebecca M.Perley
Chapter 16 Workforce Culture 401 JimKinsey, Rebecca M.Perley, and Ann Wyatt
Chapter 17 Marketing and Public Relations 427 Suzanne Richards, Lovella D. Sullivan, and Rebecca M.Perley
Chapter 18 Facility Reimbursement 451 Robert J. Miller
Chapter 19 Financial Operations 477 Robert J. Miller
Chapter 20 Legal Considerations 499
Alain P. Durocher and Deborah K. Cruze
Chapter 21 Compliance and Risk Management 523
David N.Hoffman and RebeccaM.Perley
Chapter 22 Looking Ahead: Domestic and International Policy Implications of Long-Term Care 549 Erlyana Erlyana, Karl Steinberg, Martin Smalbrugge, Alex Bardakh, and Robert J. Miller
Index 581
Andrew Lee Alden, M.Arch., is senior associate and senior project designer with AG Architecture in Wauwatosa, Wisconsin. His commitment to designing for an aging population began early, influenced by his extensive family. With over 25 years in architecture, Alden focuses on creating innovative, resident-centered environments spanning the continuum of care. He supports the future of senior living as an active member of local and national organizations dedicated to improving the lives of older adults. Alden also emphasizes the value of linking research and practice, teaching, conducting post-occupancy evaluations, publishing articles, and presenting at conferences.
Jeffrey W. Anderzhon, FAIA, is principal of Crepidoma Consulting, specializing in environmental designs for the aging. He holds a BArch degree from Illinois Institute of Technology, where he received the Alumni Professional Achievement Award in 2008. Anderzhon is a member of the American Institute of Architects College of Fellows, past chair for Design for Aging Knowledge Community, and coauthor of Design for Aging, Post-occupancy Evaluations and Design for Aging, International Case Studies of Building and Program, along with numerous articles on environments for the elderly. He has served on numerous design juries in the United States as well as internationally and is a board of directors member of the Society for the Advancement of Gerontological Environments Federation.
Alex Bardakh, MPP, CAE, PLC, serves as senior director of advocacy and strategic partnerships at AMDA - Post-Acute and Long-Term Care Medical Association. He spearheads the organization's public policy agenda through congressional advocacy and engagement with federal agencies. Bardakh graduated from University of Maryland, Baltimore County, with a bachelor's in political science and psychology and a master's in public and legal policy. He is a recognized industry thought leader and represents the organization in various coalitions and industry partnerships. With extensive experience in specialty society executive leadership, Bardakh focuses on advocacy and strategic growth. He is a certified association executive (CAE), is certified in nonprofit financial management, and holds a Professional Lobbying Certificate.
Michael Carter, OT, is a retired occupational therapist (OT), having built a career in an inpatient rehabilitation hospital. His OT training encouraged a deep interest in accessible housing to maintain independence. Prior to his OT career, he worked in commercial and residential construction. This background experience allowed him to plan meaningful changes to patients living environment. He also worked with the Center for Universal Design at North Carolina State University to bring an OT perspective to architecture students concerning the diversity of human abilities and disabilities. Carter also worked for the University of Southern California as an online instructor with the executive certificate in home modification program.
Carla Cheatham, Rev., PhD, MA, began in psychosocial services with a master's in psychology, certification in trauma therapy, a doctorate in health and kinesiology, and a master of divinity before working 10 years as a hospice chaplain and grief counselor. Cheatham is a national keynote speaker and consultant focusing on emotionally intelligent and resilient professionals and organizations. She is a member of the National Hospice and Palliative Care Organization's (NHPCO) Trauma-Informed Care Task Force, former chair of NHPCO's ethics advisory council, and assistant professor for University of Maryland's master of science in palliative care. She publishes books and videos about resilience, posttraumatic growth, ethics, grief, healthy leadership, and other emotional competencies for professionals.
David D. Clarke, MD, is president of the Psychophysiologic Disorders Association (EndChronicPain.org), assistant director at the Center for Ethics, and clinical assistant professor of gastroenterology emeritus at Oregon Health & Science University in Portland. He is board certified in gastroenterology and internal medicine and has treated over 7,000 patients whose symptoms were not explained by organ disease or injury but rather by stress or trauma. His book for patients, They Can't Find Anything Wrong!, was praised by a president of the American Psychosomatic Society as "truly remarkable." He has also edited two textbooks on trauma-informed care.
Deborah K. Cruze, JD, MA, currently serves as bioethics director for Kaiser Permanente Riverside Service area. Throughout her 20+ years in bioethics, she has been a frequent presenter and author of topics at the intersection of law and bioethics. Additionally, Cruze has served as adjunct faculty for several colleges and universities, teaching bioethics, law, and business management courses. She holds a bachelor of science in English and political science (summa cum laude) from Northern Arizona University, a juris doctorate from Arizona State University, and master of arts in Bioethics from Midwestern University, where she was awarded the Outstanding Achievement Award in Bioethics. She completed a post-doc clinical ethics fellowship at the University of Texas M.D. Anderson Cancer Center. A member of the Arizona Bar, she previously served the legal profession as assistant attorney general and city court judge.
Cindy Donovan BN, MSHA, served remarkably as the long-time chief executive officer of Loch Lomond Villa in Saint John, New Brunswick (NB). She implemented many positive changes, achieved unprecedented quality improvements, and growth for the organization. Donovan introduced a person-centered care model, which has transformed long-term care in NB. Nurse practitioners now work in NB nursing homes, a provincial Radiography on Wheels brings services to patients, and the program Cycling without Age offers residents trishaw rides throughout communities. She also received the Queens Jubilee Medal and the Planetree Visionary Leadership Award for person-centered care.
Susan M. Duncan, RN, inclusive design specialist, brings more than 40 years of consulting and experience in virtually all facets of accessible and inclusive design. In 1978, she established an interior design consulting firm dedicated to supporting the unique goals and needs of residential, public, and private sector clients. Duncan combined her decades of cross-disability experiences with teaching. She developed and taught a required course on universal design in housing for Seattle Pacific University in Washington. Duncan was an instructor for the online international Executive Certificate in Home Modification program at the University of Southern California Andrus Gerontology Center.
Alain P. Durocher, PhD, has been working full time in medical bioethics since 2010 and taught philosophy, religious studies, and ethics at Dillard University in New Orleans, Louisiana, for eight years. He completed his PhD at the Graduate Theological Union in Berkeley, California, and a master's and two bachelor's degrees from the Université de Montréal, Canada. Durocher is currently the medical bioethics director for Kaiser Permanente, Downey Service Area; codirector of the medical bioethics program for Kaiser Permanente Southern California; and lecturer for the Health Care Management Department at California State University, Long Beach, teaching courses mainly related to health care ethics.
E. Erlyana, MD, PhD, is professor in the Department of Health Care Management at California State University, Long Beach. She worked as a physician for more than seven years before joining the Department in 2009. She received her MD from the University of Atmajaya, Indonesia, and earned her PhD in public administration (with a concentration in health service administration) from the University of Southern California, Los Angeles. Her research interests include access to care for underserved populations, social determinants of health care utilization, disparities in health, and comparative health systems.
Barbara Ganzel, PhD, LCSW, has more than 25 years of experience studying the impact of psychological trauma on brain, body, and behavior as a research neuroscientist, hospice-trained social worker, and trauma therapist. She has been the principal investigator of a neuroimaging research laboratory at Cornell University, director of the Ithaca College Gerontology Institute, and was a founding member of the National Hospice and Palliative Care Organization's (NHPCO) Trauma-Informed Care Workgroup. She has published in Psychological Review, Journal of the American Medical Association, American Journal of Psychiatry, The Gerontologist, NeuroImage, Psychology and Aging, and the Journal of Traumatic Stress, among others.
Robyn Grant, MSW, served as director of public policy and advocacy at the National Consumer Voice for Quality Long-Term Care, where she was responsible for the development and implementation of the public policy agenda. Grant has a master's in social work with a specialization in aging. Before joining Consumer Voice, she was the long-term care policy director at United Senior Action, an Indiana senior advocacy organization, a consultant with the National Long-Term Care Ombudsman Resource Center, and a member of the Consumer Voice Board of Directors. Grant was the Indiana State Long-Term Care Ombudsman for eight...
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