REFERENCE MANUAL
III. Regulations and Financial Issues
Introduction
The purpose of this Section is to provide information about
regulatory and financial issues related to the long-term care continuum.
"Contents" lists topics covered in this Section. This is followed by a list of
major questions that will be addressed by the topics in this Section.
The content of this Section will be expanded gradually over time. Highlighted
items are most likely to be linked to more detailed content. Refer back periodically for
issues of interest. The monthly "Tips and Information" columns will address
various items prior to being transferred into this Reference Manual.
Contents
1. Regulation of long-term care
a. Principles of laws and regulations
relevant to the long-term care continuum
b. Federal nursing facility regulations
c. Legal and regulatory principles
related to long-term care
d. Surviving the survey process
e. Physicians and medical director roles
in improving regulatory compliance
2. Financing of long-term care
a. Basic kinds and principles of
reimbursement relevant to long-term care
b. Prospective payment and its
relationship to the care
c. Managed care and its
relationship to the actual care
d. Alternative means of financing
long-term care programs and services
e. Principles for improving
efficiency of care and operations
f. Physician reimbursement
for care
Issues Addressed in This Section
What principles and goals of laws
and regulations are relevant to the long-term care continuum?
What are the specific goals and principles
underlying the federal nursing facility regulations?
What are the important legal and regulatory
principles related to long-term care and how can these be fulfilled?
How can we do well in the survey process?
What role can physicians and medical directors
play in improving regulatory compliance and in the survey process itself?
What are the basic kinds of reimbursement
relevant to long-term care?
What is prospective payment and how does it
relate to the care?
What are basic principles of managed care, and
how does it relate to the actual care?
What are alternative approaches to financing
long-term care programs and services?
How can this organization function more
efficiently while still providing quality care?
What are the issues related to physician
reimbursement for care?
For More Information Contact:
Long-Term Care Information
7801 Ruxwood Road
Baltimore, MD 21204-3540
Tel: 410-825-4728
FAX: 410-825-4728
Internet:
information@ltcinfo.net
