long-term care (LTC)

Epidemiology

• nearly all long-term care entrants are without severe disability* 4 years before & 2 years after entry

* dependence on activities of daily living

• gait speed predicts disability & long-term nursing home placement
  • better predictor than grip strength

Procedure

• long-term care providers contribute to quality assurance & process improvement through input on clinical care processes

Management

• home modification based on interprofessional evaluation (nurse, occupational therapist, person knowledgeble about home modification)
• CAPABLE program provides home visits over the course of 5 months by interprofessional team

Notes

• primarily finded by out-of-pocket payment & Medicaid
• Medicare part A covers $144/day (2016) for days 21-100 of nursing home
• patient is responsible for $185.50 per day for days 21-100 in 2021 but coverage ends at day 100
• Medicaid kicks in when patient spends down assets to a minimum level of worth (varies state by state)

Additional terms

• nursing home