Course: Managing Long-Term Care Services for Aging Populations

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Session Topic Activites

Models of Long-Term Care Delivery Systems, An Historical Overview

Students will be able to contrast the health care needs of the elderly with those of other population groups. They will be able to compare facility and program types along the continuum of care, including facility-based, home-based, community-based and integrated systems. They will be able to contrast seniors' health care needs and the availability of systems to meet those needs. They will be able to describe the interrelationships among needs assessment, care planning, service delivery and follow-up as related to the health care of the elderly.

Students will become familiar with the evolution of (and differences among) nursing homes, assisted living, congregate housing and independent living. They will be able to explain the role of financing and the marketplace in the development of long-term care delivery systems. They will be able to trace the historical and philosophical underpinnings of seniors housing and care and to describe the management, regulatory and market factors that distinguish independent living, congregate care, assisted living and nursing facility care.


Guest: Chad Boult, Professor and Director, Lipitz Center for Integrated Health Care


The Competitive Environment

Students will understand the importance of applying data to an understanding of supply and demand in the marketplace and will appreciate the cyclical nature of supply. They will be able to identify the critical elements of a project's financial feasibility and how to structure a feasibility statement. They will be able to describe the importance of competitive research in undertaking any seniors housing project. 

Students will understand the basic structure of an effective marketing program for seniors housing, including the critical role of "move-ins." They will be able to describe the importance of positioning (and differentiating) the product in the marketplace. They will be familiar with the various functions and costs associated with an effective marketing and sales program and the criteria for success associated with each.


Guest: Rob Liebreich, Director of Marketing, Brightview Senior Living (The Shelter Group)


Customer Choice and the Marketplace

Students will be able to distinguish among various long-term care products and assess their viability in the marketplace and the underlying reasons for market acceptance or rejection. They will understand the changes in product availability as a function of disposable income, family involvement and customer choice. They will be familiar with databases suggesting both the need for and the availability of various products. They will be able to explain the interrelationships among the various product lines and their impacts one on the other. They will recognize the degree to which family and community involvement are a critical part of a community's ability to survive in the marketplace.

Students will understand the major public financing mechanisms available to the elderly. They will be able to contrast and distinguish the coverage and payment features of third party payers, particularly Medicare and Medicaid. They will understand the basic concepts of managed care and be able to trace the impact of managed care on access, quality and the cost of health services to the elderly. Students will be able to describe ethical dilemmas posed by reimbursement systems for health service providers. They will be able to describe the basic attributes (and impacts on recipients) of various reimbursement methodologies, including cost-based reimbursement, negotiated rates, prospective payment and flat rate methodologies.


Guest: Michael Creedon, Director of Geriatric Health Management, A. T. Still University of Health Sciences


The Customer Focus of Quality Management

Students will demonstrate an understanding of the role of the marketplace in the evolution of long-term care services. They will be able to apply the concept of resident as "customer" and describe the culture necessary to achieve that goal. They will understand the relationship between the increasing ability of seniors to choose and the nature of the service offered. They will be able to draw lessons from the history of nursing homes and apply those lessons to the other modalities of seniors housing and care.

Students will be able to describe the various approaches to quality assessment and management in long-term care settings, including the current regulatory systems in place for nursing facilities. They will be able to articulate the essential nature of quality as value-added service and be able to describe and apply the principals of TQM and CQI. They will be able to describe the importance of a customer focus in the seniors housing environment and be conversant with methods of emphasizing that focus in a seniors housing community.

Maulik Joshi, President and CEO, Delmarva Foundation for Medical Care


The Human Equation of Service Quality and the Critical Role of Strategy

Students will be able to contrast the difficulties long-term care providers face in the areas of employee recruitment and retention with other sectors of health care. They will be able to select among alternative programs available for staff development and training. They will appreciate the importance of staff motivation in reducing employee turnover and will be able to describe inducements complementary to and often substituting for higher compensation. They will become conversant with the seven practices of excellent companies and the importance of patience and persistence over time in developing effective human resource programs.

Students will become conversant with the role of strategy and will understand the difference between strategic thinking and strategic planning. They will appreciate the need to continually evaluate the position of the product in a changing and increasingly competitive environment. Students will also be able to outline the major governance, organizational and administrative issues facing long term care managers and be able to describe major approaches to dealing with them.


Guest: Phyllis Madachy, Administrator, Howard County Office on Aging


Aging, Demography and Seniors' Needs

Students will become knowledgeable of normal age-related social, physiological and psychological changes. Students will understand the important distinctions among disease and chronic illness and debility as these concepts impact the housing and health care needs of the elderly. They will be able to show how changes in functional capacity contribute to health status and identify forces (including advances in health care technology and understanding) that can affect the adjustment of the elderly to the changes of aging and that influence continued independent functioning.

Students will be able to describe the basic demographic data indicating the potential need for social and health care services by various population groups. They will become conversant with a common factual basis on the aging of the American population and be able to present and discuss data on the distribution of basic demographic characteristics and their impact on the seniors housing and care marketplace. They will be familiar with the prevalence of debilitating conditions in the American population and how seniors' communities can address them.


Guest: Linda Fried, Professor and Director, Center on Aging and Health


The Legal and Policy Environments

Students will be able to identify risk management issues and explain the role of appropriate documentation in minimizing risk. They will be conversant with the concept of compliance and the need for compliance planning in long term care facilities. They will be able to outline a basic compliance plan. They will be familiar with the provisions in the law, which serve as a basis for protective services and decision-making. They will be able to deal with the constructive interplay of legal and ethical issues in long-term care.

Students will show an appreciation for the unique regulatory environments within which long-term care services are delivered, including their impact on financing, program operations and life safety. Students will be conversant with the major State and Federal level policy initiatives in the area of care delivery. Students will be able to contrast the various proposals for reform, including issues related both to delivery systems as well as to the financing of long-term care, and how such proposals would impact on their own communities. They will be able to describe the role of interest groups in policy development and be comfortable with their own potential for involvement in the process.


Guest: Paul Gurney, Deputy Secretary, Maryland Department of Health and Mental Hygiene

8   Student Presentations