Recall from ASSIGNMENT 1 that you were conducting an indepth study of one aspect of long-term care. PLEASE RECALL thst this assignment requires you to incorporate feedback/changes from assignment 1. Building from ASSIGNMENT 1, you will complete ASSIGNMENT 2 by preparing an additional FULL 5 page paper in which you address the following: a. Requirements for administration b. Types of direct care staff employed (as well as their training, education, and licensure/certification requirements). c. Discuss staffing retirements (are specific patient/client to staff ratios required in the regulations?) 2. Discuss marketing as it relates to your selected settinh. 3. Provide an overview of how services are paid for in the setting that you are exploring. 4. Describe the agency/organzation responsible for surveying the care quality of your facility. 5. Discuss how you would implement a continuous quality improvement (CQI) program in your facility to address any care issues. What methods would you use and why? Conclude paper with a summary. USE 4-6 Academic sources cite references Doubled spaced with 1 inch margins 12 point Times new roman in-text citations, icluding page numbers to avoid plagiarism

Skilled nursing facilities
Institutional affiliation

Skilled nursing facilities
Having looked at skilled nursing facilities as my nursing care setting of choice, in this paper I will provide an in depth analysis of a skilled nursing facility. Skilled nursing facilities are institutions where round the clock care is offered by experts’ medical specialists such as the physicians, therapists, nurses among other medical experts. is best chronic health situations such as intravenous therapy, routine injections among others form the conditions that should be addressed in a skilled nursing facility.
Requirements for administration
Before admission to a skilled nursing facility a preadmission evaluation of the patient is usually conducted. The evaluation encompasses;
Looking at the patients current condition
Base level functionality of the patient
The medical history
The exact that medical condition that has contributed to the need for admission in a skilled nursing facility.
The base level functionality depicts to whether the patient can undertake any tasks on his or her own. Notably skilled nursing facilities should be confused for nursing homes and therefore this is why the patient has to meet the requirements or admission. If the patient needs regular technical care then it is presumed that the patient meets admission criteria. At the same time based on the medical history I is possible to ascertain the number and severity of conditions and ailments that the patients has suffered before. If the ailments have incapacitated the patient, then the patient can be admitted in a skilled nursing facility where he or she will receive technical and immediate care.
The kind of medical staff employed in skilled nursing care facilities
As noted earlier, a skilled nursing facility is most suitable for severe and demanding medical situations that may include; intravenous therapy and routine injections. Therefore some of the direct care staff employed in skilled nursing facilities include; cardiologists, therapists, psychotherapists, nurses, clinical officers and physicians. The role of registered nurses in skilled nursing facilities is to assess the needs of the patients on around the clock basis and give the report to the various specialists. Notably these nurses can only be employed if they are registered by the relevant nursing bodies. Specialists such as cardiologists are occasional medics who only attend to the wards when the patient requires attention. These specialists rely on the report given by the nurses. Most importantly, the federal laws stipulate that the all the skilled nursing facilities should be adequately staffed. All the facilities should have sufficient medical practitioners that ensure that all the residents are given adequate care. It should be understood that the purposes of placing patients to skilled nursing facilities is to prolong the lives of the patients since they are already incapacitated and there health is at stake.
Staffing retirements
As stipulated earlier all the medical practitioners employed n a skilled nursing facility are registered by the relevant authorities. Though most skilled nursing facilities are private ventures the employees must be deployed in collaboration with the federal government. The nurses for instance, are expected to work for a minimum of eight hours a day. The same case applies to the other employees. This means that the employees are employed on payable and pensionable terms. A medical officer usually retires at the age of sixty. Upon retirement, the employees are obliged to receive all the benefits enjoyed while still employed. It is worth noting that an employee can seek an early retirement under clearly stipulated conditions. It should be understood that the trauma that these employees undergo in their daily endeavors force them to seek an early retirement.
Marketing of skilled nursing facilities is usually done through the government websites. The health care ministry is obliged to provide information about all the medical facilities including the skilled nursing facilities. Individual skilled nursing facilities cannot market their premises n their behalf. This kind of restriction is purposefully meant to prevent the public from acquiring misleading information is usually the norm with the private sector. Moreover any advertisements made by the business should be countersigned by the directors in the federal government.
Payment services
Payment in skilled nursing facilities is made through the health insurance. In an event where the patient is registered under any health insurance the patient is supposed to commit at least half of the amount of money supposed to be paid for the entire duration that the patient is to be admitted to the facility. It is however worth noting that lack of insurance means that the patient will have to incur huge sums of money that would have been catered for by the insurance cover.
Quite often patients who do not have an insurance cover have been forced to seek alternative medical solutions since the costs of placing an individual in a skilled nursing facility is highly expensive and unaffordable to less fortunate.
The surveying agencies
It is constitutionally mandated that all the healthcare institutions work under a strict supervision of the oversight authorities. Within the context of skilled nursing facilities the federal health care and the Medicare program are the two agencies bestowed with the responsibility to oversee and supervise the management and the operations of the skilled nursing facilities. The inspection is done two times every year. All the skilled nursing facilities are also expected to publish their reports for public consumption in their websites and also in print media. After the assessment a report is usually issued and as such the skilled nursing facilities need avail the information in report to all the stakeholders especially the members of public. The intent of these agencies is to ensure that the patients receive quality specialized services and that they ear value for their money sine skilled nursing facilities are highly expensive. The oversight is meant to ensure that the recipients of longer term case receive quality services and care from their specialists. Since it is also a recent institution in long term health care that emanated from nursing homes, oversight assures the public that skilled nursing facilities are accredited and perform their duties within the stipulations of the relevant federal and national health laws and policies.
The agency surveys are then published in the relevant documents where the member of public can access the information. The intent of checking the operations of skilled nursing facilities is to ensure that the members of public access the right information than will guide then when deciding on which facility to place their relatives or even recommend the people in their social circle.
How would implement a continuous quality improvement program in skilled nursing care facilities
The purpose of a continuous quality improvement program is to ensure that the medical needs of the patents are fully met. The skilled nursing facility is intended to promote abrupt recovery and medical safety. A continuous quality improvement plan would encompass the following methods;
• Prescription medication
Prescription medication is based on the already diagnosed ailments. Immediately after admission, the patient is examined on all the possible illnesses. This should take the first few days of the patient’s stay in the facility. Medical prescription is done by different specialist that examined the patient. Based on the prescription the medics are supposed to monitor regulation the response of the patients to the medication being administered.
• Physical therapy evaluation
Physical therapy evaluation is an examination that encompasses the assessment of all the boy parts including areas that the patient has not complained about before or even after admission. Here the medic uses their experience and knowledge to predict the possible health conditions that may be instigated by the current ailments. This process is intended to detect and prevent any other illness that may compromise the recovery journey of the patient.
• Face to face with the patient
Face to face meeting with the patient after every 60 minutes is paramount in ascertaining the patient’s thoughts, feelings and attitudes towards his or her condition. This evaluation is meant to give the patient an opportunity to communicate with the health officer and explain to him about the recovery journey and whether. If the patient is optimistic that he or she will heal then the medic is able to confirm that the recovery journey is successfully and that the health goals are always being fulfilled.

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White, C. (2005). Medicare’s Prospective Payment System for Skilled Nursing Facilities: Effects on Staffing and Quality of Care. Inquiry, 42(4), 351-366. Retrieved from
Weiss, J., Caruso, J., Scala-Foley, M., Archer, D., & Reinhard, S. (2004). Making Sense of Medicare: Medicare Skilled Nursing Facility Benefits. The American Journal of Nursing, 104(8), 65-67. Retrieved from
“Outbreaks of Human Metapneumovirus in Two Skilled Nursing Facilities — West Virginia and Idaho, 2011–2012.” Morbidity and Mortality Weekly Report, vol. 62, no. 46, 2013, pp. 909–913. JSTOR, JSTOR,

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