Your patient states he does not have enough food. What two resources might help?
1. Roadrunner Food Bank of New Mexico
2. New Mexico Association of Food Banks (NMAFB)
3. Food Stamps/SNAP
4. If patient’s household is getting SSI, they can apply for food assistance at the Social Security Office
5. Women, Infants and Children (WIC)
6. Commodity Supplemental Food Program (CSFP)-For low income elderly persons at least 60 years of age
7. Meals On Wheels-home delivery program of medically tailored meals to anyone of any age.
200
The primary decision maker for health care is the
Patient/caregiver/family
200
When must we re-review a patient action plan?
1) with each planned patient contact, 2) with major clinical changes, 3) major social changes, 4) request by another healthcare team member, 5) goal achievement
300
What are the 4 pillars of transitional care?
Medication reconciliation, appointments, red flag knowledge, personal health record/notebook
300
Name 3 potential “red flags” for a patient with heart failure
• Increasing swelling in ankles, feet, fingers, abdomen (tight belt, shoes, rings)
• More than 3 lb weight gain in 1 day, or 5 lbs in 1 wk
• Increasing SOB
• Dry cough
• Harder to breathe lying down
• Chest discomfort
• High heart rate
• Feeling more tired
• Lack of appetite
300
Your patient smokes and is interested in cessation. As her CC, how can you help?
• Ask MCO what smoking cessation resources are covered under their plans.
• NM Quitline: 1-800-QUIT-NOW; http://www.quitnownm.com/
• American Lung Association Resources: Freedom From Smoking® program is widely available throughout the state of New Mexico. Not On Tobacco is offered in select cities. Additional options include Freedom From Smoking® Online, a program available 24/7 at http://www.ffsonline.org and the American Lung Association's Lung HelpLine (800-LUNG-USA). For more information about program locations and schedules, call 505-265-0732 or online at http://www.lung.org
• www.naquitline.org
300
You notice your patient has a COE 066 (Foster Care). What is your first CC action?
Call CYFD, as they are the acting decision-makers for the child. Ask to speak with child's case worker. Treat case worker as you would the child's parent. You are not permitted to share information with the parent, CYFD will communicate with parents as needed.
300
Which PMS clinic is the farthest from the PEC?
Hobbs = 312 Miles (Deming is only 239 miles)
400
Who is most likely to abuse elders?:
• Home care aids
• Family members
• Neighbors
• Friends
Home care aids
400
Your patient was discharged from a behavioral health facility today. What is top on your mind for this person?
7 and 30 day post-hospitalization BH provider app’ts
400
When a CC is assisting a patient with access to eyeglasses or adaptive equipment for their visual impairment, what community resource should be considered?
The Lion’s Club
400
Who has the ultimate responsibility for a patient’s care?
According to the Wickline v State of California court case, the treating physician
400
Of Medicare, Medicaid, and private insurance, which is always the payer of last resort?
Medicaid
500
What % of adults in the US have what is considered, “below health literacy”?
• 14%
• 25%
• 31%
• 65%
31%
500
You call to follow up with your patient who was discharged from a BH facility 4 months ago and last saw his PMS BH provider 1 month ago. You find out that he passed away. As his CC, what do you do now?
Complete a Behavioral Health Critical Incident Report (CIR) within 24 hours of discovering the BH patient death, give to Linda for faxing to the appropriate MCO. Linda will email a copy of the form to the PMS Director of BH
500
For which patients do you create a new NextGen patient file?
For any patient you have interacted with. Interaction includes: left phone message, spoke with caregiver, sent letter, spoke with patient
500
What are the careplan problems that most PMS patients should / do have?
What is 1) ER usage, 2) medication, 3) self-management, 4) preventative measures / GIC, 5) disease specific, 6) community resources
500
Which of the following is NOT a characteristic of pharmacy benefit programs?:
• Provides meds via local pharmacies and mail order
• Includes OTC meds
• Are considered part of a managed care plan
• Often have tiers of meds tied to levels of co-pays