PubMed · 10290197
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S W Haley. Alternative staffing patterns.. https://pubmed.ncbi.nlm.nih.gov/10290197/
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During these times of escalating health care costs and increased demand for critical care beds, hospitals are often unable to provide the intensive level of nursing care that is required. One large urban trauma center found that 36% of the surgical intensive care unit patients required a level of nursing care intermediate between the intensive care unit and the general ward. A multidisciplinary team met to plan and develop a surgical/trauma intermediate care unit to provide this level of care. Goals, objectives, specific admission, discharge criteria, and administrative responsibility were determined. An educational program was developed based on a needs assessment of the staff. During the implementation phase and throughout the unit's operation, advanced practice nurses performed an integral role as resource personnel. The purpose of this paper is to describe the multidisciplinary process used in the development of a new unit and to highlight the advanced practice role in this activity.
This rule corrects an oversight by setting forth time limits for new issues that may be considered by an Administrative Law Judge (ALJ) during a hearing afforded a Medicaid skilled nursing facility (SNF) or intermediate care facility (ICF) because the Secretary proposes to cancel its approval under section 1910(c)(1) of the Social Security Act (the Act). This amendment is necessary because current rules do not take account of the fact that hearings under section 1910(c) of the Act (unlike Medicare hearings) may take place before the cancellation is put into effect. The purpose is to establish time limits appropriate to section 1910(c) situations.
Long-term care services used by Medicaid residents were analyzed to assess whether intermediate care facilities were used as substitutes for skilled nursing facilities, or whether intermediate care facilities and skilled nursing facilities complemented each other on the continuum of care.