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The subacute care that David has, is set to give him the best chance at recovering as possible. David is a young adult, who was injured in a car accident. He needs a vigorous treatment plan for him to be able to return to his life before the accident. His case is cared for by a psychiatrist, which is a very good idea. When I was in my car accident, my emotional state was terrible. David’s case also has constant monitoring to ensure that he does not regress while doing his treatment plan. The multilevel nursing facility is a great option for David. This is great because as David regains some of the skills like talking, he can advance further to more intense units, and learn how to hold a pencil, and write, and then eventually walk. A car accident affects someone emotionally, and physically. His and Joyce’s care is also very flexible, so it meets the needs of the patients.
The subacute care that Joyce has is deemed appropriate. She doesn’t have a good outlook to getting back to her life before the heart attack. Her care is monitored mostly by nurses to ensure she is not uncomfortable. They still do the daily exercises to ensure that her condition doesn’t deteriorate her, which indicates that they still have hope. “Her breathing is assisted by a mechanical ventilator, and she must be fed and medicated intravenously.” (Pratt, 2016 p.146). Her care also revolves around the nurses knowing how to use each of those machines. Joyce is also under the care of a cardiologist, which is another positive thing, because she is in her semi-comatose state from the heart attack which weakened her heart.
David should be in a multi-level facility. This is because he will continue to progress. He will need to learn to write, hold a pencil, throw a ball, walk… These are all ranging from a variety of things he may not be able to do. They also vary on the level of difficulty. “These facility characteristics are also likely to provide the multilevel facility with the administrative and financial capacity necessary to enter into contracting arrangements.” (Wallace, 1998 p.62). They would enter into an agreement to make sure that David’s plan changes as he progresses, or worsens. This all depends on how his body tolerates al of his therapies.
Joyce should remain where she is, in a single level facility. Her current location has trained nurses to ensure proper treatment with all of the machines that she is using, including the feeding tube, and the ventilator. They do not think that Joyce will make a recovery, and currently just making her comfortable in case she does not wake up from her coma. If Joyce were to wake up, I would assume they would re-evaluate her current medical issues and determine from there where she would go.
Both Joyce and David should remain on different care levels. Both are expected to make different outcomes. Joyce is expected to remain in her center until she passes. David is expected to make a recovery, and be discharged one day. Both patients have a different variety of medical needs. Joyce’s rely mostly on the machines keeping her alive. David is relying mostly on the different amount of therapies.
Currently, there is not only one person paying for the charges associated with David’s rehabilitation, or Joyce’s monitoring. In David’s case he is on an insurance plan with his parents, and Joyce has Medicare. Most payments for long-term care come from Medicaid, Medicare, or private insurance companies. “Medicare and MCOs were not the only reimbursers seeking ways to reduce their costs. Others, such as private insurance companies, spurred on by their corporate customers, were also reacting to major increases in the cost of providing and insuring health care.” (Pratt, 2016 p.132). “The fiscal 2014 federal budget proposal included cuts that would affect the nonprofit acute care hospital sector, with providers bearing approximately $300 million of the approximately $400 billion of proposed Medicare cuts over 10 years.” (Fitch, 2013 p.1). This means that a non-profit hospital does not increase financing. With knowing that the hospital is not increasing the amount of income, it shows that it is mean to be there for a patient’s needs.
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