Nursing facility

SNF Skilled nursing facility URI Upper respiratory infection... 

Now in her seventies, Lynn addresses her concerns regarding the lack of safe retirement homes and nursing facilities for elderly people with MCS who are unable to continue living in their own homes. 

Bootman JL, Harrison DL, Cox E (1997) The health care cost of drug-related morbidity and mortality in nursing facilities. Arch Intern Med 157(18) 2089-2096... 

Cooper JW (1999) Adverse drug reaction-related hospitalizations of nursing facility patients a 4-year study. South Med J 92(5) 485-490... 

Some states have recognized the underutilization of pain medications in the treatment of pain associated with chronic and terminal conditions. California, for example, has enacted an "intractable pain treatment" act that reduces the difficulty of renewing prescriptions for opioids. Under the provisions of this act, upon receipt of a copy of the order from the prescriber, eg, by fax, a pharmacist may write a prescription for a Schedule II substance for a patient under hospice care or living in a skilled nursing facility or in cases in which the patient is expected to live less than 6 months, provided that the prescriber countersigns the order (by fax) the word "exemption" with regulatory code number is written on a typical prescription, thus providing easier access for the terminally ill. 

Medicare is an entitlement program and serves all eligible beneficiaries regardless of income or medical history Like Social Securify, Medicare is based on a system of social insurance. Medicare is composed of two programs. Medicare Part A covers inpatient care in hospitals and skilled nursing facilities. It also covers hospice care and some home health care. Part A is financed by a 1.45% payroll fax paid by bofh employees and employers (2.9% for self-employed persons). Currenf employers and employees pay for the health care of current Medicare beneficiaries, wifh the expectation that when they reach age 65 they will receive the same benefits. In the U.S., when people turn 65 years of age, they are automatically eligible for Medicare s Parf A, and they do not have to pay for the hospital insurance if they, or a spouse, paid Medicare taxes when they were working. 

The Fleetwood Project consisted of three phases of research. The first phase quantified the cost of medication-related problems in nursing facilities and estimated the value of consultant pharmacists in these settings. This phase determined that drug regimen review conducted by consultant pharmacists improved patients outcomes by 43% and saved 3.6 billion a year by avoiding medication-related problems. ... 

Khan, A.J., Cotter, S.M., Schulz, B., Hu, Y.L., Roseuberg, J., Robertson, B.H., Fiore, A.E., Bell, B.R. Nosocomial transmission of hepatitis B virus infection among residents with diabetes in a skiUed nursing facility Inf Contr. Hosp. Epidem. 2002 23 313-318... 

The total expenditure for the Medicaid program was 160 billion in 1996. Of the total amount spent in 1996, Medicaid payments for nursing facilities and home health care totaled 40.5 billion for more than 3.6 million recipients. The average cost per recipient in 1996 was 12,300, and almost 45% of the total cost... 

For more than a generation, consultant pharmacists have dedicated themselves to protecting the health of some of our most vulnerable citizens—residents of nursing facilities. Today, the senior care pharmacists ASCP represents are patient advocates for all of our nation s seniors, wherever they reside. 

The ASCP was founded in 1969 to represent the interests of its members and promote safe and effective medication therapy for the residents of nursing facilities—mostly frail elderly patients. The term consultant pharmacists is rooted in federal regulations, which requires a pharmacist to provide drug regimen reviews for nursing facility residents. The organization has grown dramatically over the past quarter century and its membership continues to diversify and expand their services to people who need them the most—America s seniors, wherever they reside (Tables 1 and 2). 

Residency programs last one to two years. The typical training site is a practice setting such as an academic health center, a community pharmacy, a managed care organization, a skilled nursing facility, or a home health care agency. 

Harrison, D.L. Bootman, J.L. Cox, E.R. Cost-effectiveness of consultant pharmacists in managing drug-related morbidity and mortality at nursing facilities. Am. J. Health-Syst. Phaim. 1998, 55 (15), 1588-1594. 

Nursing facilities (skilled/intermediate care) Assisted living facilities/board and care homes Correctional institutions Hospitals (subacute/transitional care)... 

Social Security Act. This section of the legislation covers inpatient hospitalization, critical access hospitals, skilled nursing facilities, hospice care, and limited home healthcare. Critical access hospitals are small facilities that provide limited outpatient care and inpatient services to individuals in rural areas. 

Fonts MM, Hanlon JT, Pieper CF, et al. Identification of elderly nursing facility residents at high risk for drug-related problems. Consult Pharm 1997 12 1103-1111. 

Fig. 12.2 Disposition of patients classified as minor or major strokes by BASIS. In a study of 230 consecutive patients, approximately 25% were classified as major strokes. Highly significant differences in disposition were identified between groups. AH deaths during hospitalization occurred in major stroke patients. Of the major stroke patients who survived, over 70% were discharged to an inpatient rehabilitation facility (IRF) compared to less than 20% of minor stroke patients (p<0.001). Over 75% of minor stroke patients were discharged directly to home compared to less than 20% of major stroke patients (p< 0.001). A similar proportion of both groups were discharged to specialized nursing facilities (SNF). Adapted from Torres-Mozqueda et al. [4]...

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