Long Term Care Services Business Design and Creation

download report

Transcript Long Term Care Services Business Design and Creation

Long Term Care Services
Business Design and Creation
A Vision to Create Innovative Relevant and
Sustainable Industry
at Oakwood University
Status of Current Industry
• On January 1, 2011, baby boomers
began to celebrate their 65th
birthdays and 10,000 people will turn
65 every day for the next 20 years.
• Nationwide numbers total
10,480,000 in the last 2 years 10
months and 13 days.
Alliance for Aging Research. "Alliance for Aging Research Home Page".
Growth of Senior Population
Growth Continued
Status of Senior Health
• The 2002 State of Aging & Health in America, as well as
other sources, indicates older adults use more health
care services than any other age group.
• Today, those aged 65 and older represent 13% of the
population (14.2% in Huntsville, Alabama)
• Seniors account for half of physicians' visits and half of
all hospital stays.
• The average 75-year-old has been diagnosed with
three chronic conditions and uses five prescription
Compounding Crisis
There is a crisis of health status in
the senior population. This
problem is serious but it may be
exceeded by the crisis of capacity
for senior services providers.
Lack of Specialized Care
• There is a gap between aging patients and health care
• Of the 650,000 practicing physicians in the U.S., less
than 9,000 are geriatricians or 2.5 geriatricians per
10,000 elderly patients.
• Sadly, that number is expected to fall to about 6,000
in the near future.
Read more:http://www.super-solutions.com/BabyBoomersTurnGray.asp#ixzz1HcnPCm7FUnder Creative Commons License:Attribution
• The compounding crisis presents unique opportunity
to develop businesses within the LTCS
• The focus of these businesses should be
• Improving health status of seniors
• Maintaining independence of seniors
• Improving the quality of life for seniors
• Delaying institutionalization of seniors
• Accomplishing these goals and outcomes creates
sustainability and market dominance
Overview of the LTCS
Home and Community Based Service
• Community Based Services
• Intended to delay or avoid Long Term Care
• Adult Day Services/Senior Health Maintenance Programs
• Community Based Residential Alternatives
• Home Based Services
• Intended to maintain the person in their home through
provision of supportive non-medical services.
• Collective known as Home and Community Based
Services (HCBS)
Adult Day
• Adult Day Services (ADS) are non-
residential services at a community
based facility providing activities
for elderly and/or disabled individuals.
• Most centers operate 10-12
hours per day and provide meals,
social/recreational outings, and
general supervision.
• Adult daycare centers operate
under a social model and/or a
medical model.
Social model curriculum is designed
to provide social stimulation and
recreation which may improve or
maintain physical and cognitive
function as well as assist in avoiding
Medical model provides same
services as social model but with
clinical oversight and services.
Adult day care centers provide
respite care, enabling caregivers
to work or to have a break from
their care giving responsibilities.
Attendance often prevents rehospitalizations and may delay
admission to residential long
term care.
Daily fees for services are usually
less than a home health visit and
less than half the cost of a typical
nursing facility.
Personal Support Services
• Services provided to assist with activities of daily
living, and related essential household tasks, and
other activities that enable a person to remain in the
home, as an alternative to Nursing Facility care,
including the following:
• Assistance with activities of daily living (e.g., bathing,
grooming, personal hygiene, toileting, feeding, dressing,
ambulation, and med reminders), including errands,
grocery shopping, and health care appointments;
• Assistance with cleaning that is an integral part of
personal care and is essential to the health and welfare of
the enrollee, and
• Assistance with maintenance of a clean and safe
Interaction between LTC , Home Health and
Private Duty Nursing Services
• LTC are non-medical supportive services and can be
stand-alone or used in conjunction with HH and PDN
• Supportive Services are distinguished from medical
services in that supportive services assist with ADLs while
HH and PDN provide skilled/licensable service (e.g. wound
care, catheter care, vent services)
• HH Aide services are most like LTC supportive services
but at a higher cost.
• HH agency may provide a skilled service for 1 hour in the
day and then continue to provide HH Aide services which
look substantially similar to LTC supportive services but at
a much higher cost.
• When the skilled service is no longer medically necessary
the HH Aide may be discontinued.
Financing LTC Services
• Long Term Care Insurance
• Reimbursement model up to policy threshold
• Member purchases services and is reimbursed after the service has been
• Veteran’s Administration
• Full range of benefits accessed the VA clinical assessment and referral
• Medicare
• Limited Benefits
• Medicaid (TennCare)
• Claims based reimbursement model
• Non traditional Medicaid eligibility standards
• Services established based on Medical Need with H&P or other clinical
documentation serving as indicator of ADL deficiency
• Private or Self Pay
Integrating Business Into
• foreFront envisions the
newly developed LTCS
Business Model as fully
integrated into several
academic areas within
the institution
• Students would gain
practical useful real
world experience in one
of the fastest growing
and sustainable business
sectors in the nation.
Examples of Integration
• Social Work
• Performance of Needs
• Communications
• Marketing
• Psychology
• Mental Health
• Counseling
• Business/Finance/Accounting
• Financial Operations of the
• Nursing
• Provision of Direct Care
• Clinical
• Non Clinical
• Allied Health
• Physical Occupational,
and Speech Therapies
Computer Science
• Software
Relationship Model