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The Evolution of Nursing Homes in America

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Module 1 - Case
Introduction to Quality Assurance in Long Term Care
Assignment Overview

Up to this point, you have learned a bit about rules and regulations that govern the operation of long term care facilities. Some in the long term care industry have half-heartedly joked that "long term care is more heavily regulated than the nuclear power industry." Whereas this may be an exaggeration, it speaks to the fact that long term care facilities are VERY heavily regulated.

In order to appreciate the current regulatory environment in which long term care facilities must operate, we need to understand the history of long term care in America. In order to answer the question "why do we have so many rules and regulations in long term care," we need to go back in time and witness the evolution of long term care in this country.

Zinn, L. (1999). A good look back over our shoulders. Nursing Homes & Long Term Care Management, 48(12), 20-54. Retrieved from Proquest.

Although the article is dated 1999, it is an exceptionally well done article that chronicles the evolution of long term care in America.
Case Assignment Task

In this first case assignment, you are asked to read the background material as well as any other articles that you research and prepare a 4-5 page paper that addresses the following:

Discuss the evolution of nursing homes in the United States.
What features "shocked" or "surprised" you the most?
What new information did you learn about long term care and facilities in the United States?
Are regulatory bodies justified in their formulating so many strict rules and regulations?
How does the past of long term care inform the future of quality assurance in long term care settings?

Assignment Expectations

Your references and citations should be consistent with a particular formatting style, such as APA.
Your response should be based on this article. You can pull in outside material if you wish to substantiate a point, but that material should be scholarly, such as peer-reviewed articles, white papers, technical papers, etc... Do not include information from non-scholarly materials such as Wikis, encyclopedias, www.freearticles.com (or similar websites).
Your response should incorporate the objectives of the module with the requirements of this assignment.

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Solution Preview

In providing guidance for this posting, the evolution of nursing homes in the United States has been a somewhat slow process, due to the fact that it seems that many individuals within the medical community as well as within society at large had not placed a great emphasis upon the expeditious improvement of nursing home conditions. Nursing homes began as what was referred to as alms houses in early America, which were little more than places in which the elderly were provided room and board, and food. The first nursing homes with adequate nursing care and sanitary conditions were established by church organizations, and later, non-profit and for-profit organizations established nursing homes with trained nursing staff ...

Solution Summary

This solution describes key aspects of the evolution of nursing homes in America.

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The U.S. Health Care System

Develop a brochure:

I work for the Dept of Labor in Washington, DC in the Health Care industry division. I have been given the task of designing an informational brochure or fact sheet which will provide high school students with a broad, general knowledge base about the US Health Care system. It will become part of a series of brochures entitled "Introduction to US Industry". Each brochure in the series will touch on a different major US industry and will be used as a supplementary instruction tool for General Business classes in high schools across the country.

The brochure must fill both sides of a standard 8" x 11" sheet of paper. I can either set up the printing: (1. portrait style so that the finished product is in "fact sheet" format, or (2. landscape style so that it can be folded into a 3-panel brochure. I have to give the fact sheet or brochure the title, "Introduction to the US Health Care Industry".

I must cover the following components in my brochure, keeping in mind that the target audience (high school students) may know nothing concerning the subject I am writing about:

1.) A summary of the evolution of the US health care system from its roots until today.
2.) A description of major characteristics of the US health care system as a whole, also making note of its four subsystems.
3.) A listing and brief explanation of major types of health care professionals.
4.) A listing and brief explanation of these major types of health care settings or structures: (a. outpatient care, (b. hospitals, (c. managed care, and (d. long term care.
5.) An explanation of 2-3 challenges and/or opportunities the health care industry is facing in its environment today. You may wish to select from: conflicting self-interests of multiple players, imperfect market conditions, maintaining the public trust, changes in Medicare reimbursement, emerging medical technology, dealing with regulations and / or accreditation, or other topics from our learning in this course that you believe are crucial.
6.) A generalization of the impact of government legislation or health policy on the health care system.

This is a no-nonsense government style publication, so only the facts are needed. The brochure should be neat and well organized, but artwork and graphics will not be considered in the grading. You may, however, feel free to use various fonts and print sizes / styles, bullets, etc., to add emphasis, clarity, or variety to the appearance of your brochure.

Below is a sample outline that can be used to begin constructing this project and setting up the subheadings for the required six components of the fact sheet or brochure:

The US Health Care System
1.) History
2.) Characteristics
3.) Professionals
4.) Settings
5.) Opportunities / Challenges
6.) Health Policy

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