Compare and contrast the licensure, certification, and accreditation requirements of the services of the long term care continuum.

COMPARISON AND CONTRAST OF THE LICENSURE , CERTIFICATION

AND ACCREDITATION REQUIREMENTS OF THE SERVICES OF

LONG-TERM CARE CONTIINUUM

Hospitals

Without certification by the federal government , a hospital cannot receive payment for services provided to Medicare or Medicaid beneficiaries . The Joint Commission on Accreditation of Health Care Organizations (JCAHO ) determines that hospitals accredited by this body meet or exceed JCAHO standards and that they also meet federal certification standards

To be certified and accredited according to JCAHO standards , a hospital must invite agents of the Center of Medicare and Medicaid

Services (CMS ) for inspection of its facilities . Before the hospital is granted certification , the working condition of these facilities must meet federal standards . Such facilities as may be subjected to inspection include rural health centers , end stage renal disease facilities , ambulatory signal centers , and facilities for persons with developmental disabilities

Nursing Homes

A second very important segment of the continuum of long term care is nursing homes . A facility must meet Medicare requirements to qualify for reimbursement . Nursing homes are highly regulated at both federal and state levels . To be reimbursed by Medicare or Medicaid , a nursing home must be certified

Certification : To be certified by JCAHO , nursing homes must meet the two basic stipulations of the Omnibus Budget Reconciliation Act of 1987 (OBRA , 1987 . These stipulations are that

There shall be no compromise on the quality of staff employed in nursing homes

All the medical , dietary , pharmaceutical , psychological , physical and mental-ill-health services , must meet definite standards

Besides , an on-site inspection is carried out on the site of the nursing homes , to ascertain the quality of

Residential care processes

Staff /resident interaction

environmental condition

The inspection is to determine whether individual resident meets are met , whether the interaction between staff and resident is satisfactory with respect to the purpose of an ideal nursing home , and whether environmental sanitation and health standards are complied with regarding cleanliness , safe storage and preparation of food , protection from physical and mental abuse , and adequate care practices

Licensure : The licensing requirements of nursing home are established by the congress . In general , to be issued a license , a nursing home must be staffed with sufficient and qualified personnel and must meet the physical plant standards of the federal safety codes

Home Health Agencies

Licensure : Most states license Medicare certified home health agencies as a health care provide . This is done under the jurisdiction of the states health department

Certification : Home health care agencies must be certified in to obtain Medicare reimbursement . The major licensing requirement for home health agencies is that

Agencies shall be governed by a governing authority , shall maintain an active professional advisory committee , and shall be directed by an administrator and operate any services offered in compliance with these regulations

This governing authority must have full legal authority and responsibility for the operation of the agency which shall adopt bylaws and rules that are periodically reviewed ' The professional body , on the other hand , must be appointed by the governing authority and must consist of...