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Explaining American Standards of Care in Geriatric Settings. S. Jean Szilagyi, RN, MHSA St. Joseph’s College of Maine Alzheimer Europe Conference May 2009. What is Medicare?. Health insurance -for people 65 and older -under 65 with certain disabilities
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Explaining AmericanStandards of CareinGeriatric Settings S. Jean Szilagyi, RN, MHSA St. Joseph’s College of Maine Alzheimer Europe Conference May 2009
What is Medicare? • Health insurance • -for people 65 and older • -under 65 with certain disabilities • -persons at any age with end-stage renal disease, permanent kidney failure requiring dialysis or a kidney transplant.
What is Medicaid? • Federal-state entitlement health care program for low income citizens of the United States • Part of the Title XIX of the Social Security Act of 1965. • Offers federal matching funds to states for costs incurred in paying health care providers.
Skilled Nursing Facility (SNF) • Federal Regulations: • OBRA: Omnibus Budget Reconciliation Act of 1987 State Regulations: Ohio Administrative Code 3701-17
Assisted Living Facility (ALF) • No federal regulations • Varies by name: Rest home, assisted living, boarding home, personal care facility, private homes
Mandatory Standards/Rights/SNF • “Each facility must enable every resident to attain or maintain the highest practicable physical, mental and psychosocial well-being.” • This is a big job…How must they do it?
Resident Rights (SNF) • Freedom from discrimination • Respect • Freedom from Abuse and Neglect • Freedom from Restraints • Information • Money • Privacy • Medical Care • Visitors
Resident Rights (cont’d) • Social Services • Complaints • Protection against Unfair Transfer or Discharge • Family and Friends
WEB SITES/e-mail: • www.cms.hhs.gov • jszilagyi@sjcme.edu • www.alz.org