Medicare is a big issue for the older adult who depends on this medical insurance to pay for his or her hospital bills, medications, and rehabilitation. When talking to your older client about what Medicare will pay for and what it will not, what do you tell your client that Medicare will not cover the cost of?
Semiprivate room
Hospice care
Custodial care
Skilled care
The Correct Answer is C
A. Semiprivate room.
Explanation: Medicare can cover the cost of a semiprivate room during a qualifying hospital stay or skilled nursing facility stay.
B. Hospice care.
Explanation: Medicare provides coverage for hospice care for individuals with a terminal illness and a life expectancy of six months or less.
C. Custodial care.
Explanation: Custodial care, which involves assistance with activities of daily living (ADLs) such as bathing, dressing, and feeding, is generally not covered by Medicare. Medicare primarily covers medically necessary and skilled care, such as hospital stays, certain nursing home stays, hospice care, and some home health care services. Custodial care, which focuses on assistance with routine personal care, is considered non-medical and is typically not covered by Medicare.
D. Skilled care.
Explanation: Medicare covers skilled care, including services provided by healthcare professionals such as nurses and therapists, when deemed medically necessary. Skilled care is typically required to improve or maintain a person's condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D","E"]
Explanation
A. Optimize physical health
Explanation: A person-centered community focuses on promoting and optimizing the physical health of its residents. This may include access to healthcare services, wellness programs, and activities that support overall well-being.
B. Provide financial assistance
Explanation: While financial considerations can impact an individual's overall well-being, providing financial assistance is not a standard component of a person-centered community. The focus is more on holistic care, social engagement, independence, and addressing basic needs. Financial assistance is often managed through external programs or services.
C. Provide social engagement
Explanation: Social engagement is a crucial component of person-centered care. Communities that prioritize person-centered care create environments that foster social interaction, community involvement, and meaningful connections among residents.
D. Maximize independence
Explanation: Person-centered communities aim to maximize the independence of their residents. This involves tailoring care and support to the individual's needs while empowering them to maintain autonomy and control over their daily lives.
E. Address basic needs
Explanation: Addressing basic needs is fundamental in a person-centered community. This includes ensuring that residents have access to essential necessities such as food, shelter, and personal care to create a supportive and dignified living environment.
Correct Answer is D
Explanation
A. HIPAA (Health Insurance Portability and Accountability Act)
Explanation: HIPAA, enacted in 1996, focuses on protecting the privacy and security of individuals' health information. While it is essential in healthcare, it is not directly connected to the nursing home reform mandated by the 1987 law.
B. OASIS (Outcome and Assessment Information Set)
Explanation: OASIS is a set of standardized assessments used in home health care, primarily for Medicare-certified home health agencies. It is not directly connected to the nursing home reform mandated by the 1987 law.
C. Fulmer SPICES
Explanation: Fulmer SPICES is a tool used for assessing common geriatric syndromes, but it is not specifically associated with the nursing home reform mandated by the 1987 law.
D. Resident Assessment Instrument (RAI).
Explanation: The Resident Assessment Instrument (RAI) is associated with nursing home reform mandated by the Omnibus Budget Reconciliation Act (OBRA) of 1987. OBRA '87 established regulations and standards for nursing homes, including requirements for comprehensive assessments, care planning, and quality of care. The RAI, specifically the Minimum Data Set (MDS), is a standardized assessment tool used to evaluate the health status and needs of nursing home residents, ensuring a consistent and comprehensive approach to resident assessment and care planning.
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