AMBestadultdaycareWord文档格式.docx

AMBestadultdaycareWord文档格式.docx

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AUTOMOBILELIABILITY

4

Higherifinsuredprovidestransportation.

AUTOMOBILEPHYSICALDAMAGE

--

GENERALLIABILITY

5

PRODUCTLIABILITYANDCOMPLETEDOPERATIONS

Lowerifclientsprovidetheirownfood;

higherforcentersstaffedwithvolunteers.

PROFESSIONALLIABILITY

ENVIRONMENTALIMPAIRMENTLIABILITY

WORKERS'

COMPENSATION

CRIME

2

FIREANDE.C.

3

Higherinolderbuildings.

BUSINESSINTERRUPTION

6

Immediateavailabilityofreplacementspacecritical.

INLANDMARINE

BOILERANDMACHINERY

Low1-3,Medium4-6,High7-9,VeryHigh10

SICCode

SICClassification

8052

IntermediateCare

8059

NursingandPersonalCare,NEC

8322

IndividualandFamilySocialServices

8641

Civic,Social,andFraternalAssociations

ISOCode

ISOClassification

44431

HealthCareFacilities-HomesfortheAged

44437

HealthCareFacilities-HomesforthePhysicallyDisabled/Orphans

61000

BoardingorRoomingHouses

SpecialExposures

Swimmingpools

Inadequatefoodstorage

Clientabuse

Multi-levelfacilities

Prescriptionmedications

RelatedClassifications

DaycareCenters

HospiceFacilities

NursingHomes

OutpatientHealthCareFacilities

SpeechLanguagePathologists

RISKDESCRIPTION

a170r.

Throughoutlife,wearetaskedwiththeresponsibilityofcaringforourfamilies.Aswegetolder,thatresponsibilityoftenincludescaringforaparentorspouse,orfunctionallyorcognitivelyimpairedsiblingsorchildrenwhohavereachedtheageofmajority.Illnessanddisabilitycancauseadifficultsituationtobecomeimpossible;

thestressesofeverydaylife-financialpressure,employedcaregivers,costsoffamilycare-overloadusandmaketheresponsibilityoffamilycareevenmorechallenging.Mostpeoplewhocareforinfirmfamilymembersfeelastrongsenseofobligationanddesiretokeeptheirlovedonesoutofinstitutionsandinahomeenvironment.Manypeopleinthe1990shavefoundthatoneincomeisnotenoughtosupportafamilyandthatasecondincomeisnecessary;

often,thefamilymemberwhowouldbethecaregiverhastofindemploymentoutsidethehome.Justastheneedforchildcaregaverisetothegrowthofdaycarecenterstoprovidecareforthechildrenofworkingparents,theneedforeldercareiscreatingademandforcentersthatcanprovidethesupportiveservicesnecessarytoassistworkingfamiliesinthisendeavor.Additionally,manyelderlypeoplewhoarealonebutotherwisehealthymaysufferfromlonelinessandadesiretosocializewithothers.Adultdaycarecentershavebeendevelopedtofillthisvoid.

Theneedforadultdaycarehasneverbeengreaterandwillcontinuetogrow;

meetingtheneedsoftherapidlygrowingpopulationoftheelderlyhasbecomeapriorityinthe1990s.Twentyyearsago,fewerthan100adultdaycarecentersexisted;

presently,thereareapproximately3,000adultdaycarecentersintheUnitedStatesandmoreareneeded.Thenumberofelderlyparentswithadultchildrenwillnearlydoubleby2030withfamiliesproviding80%oflongtermcare.By2010,oneoutofeverysevenAmericanswillbeover65,andthesegmentofthatseniorcitizenpopulationgrowingthefastestwillbethose85andover,includingover100,000centenarians.

Familiesattempttosolvetheiradultdaycareneedsinmanyways.Somefamiliesarrangetohaveotherfamilymembers,friends,orneighborscareforolderorinfirmrelatives;

however,thistraditionalsourceofcareisbecomingraresincetoday'

seconomyincreasinglypressuresthoseindividualstowork.Somefamilieswillarrangetheirworkhourssothatsomeoneisalwaysathome.Otherfamilieschoosefromavarietyofcommunity-basedarrangements.Somecommonarrangementsinclude:

seniorcenters,adultfostercare,continuingcareretirementcommunities,assistedlivingfacilities,respitecare,andadultdaycare.

Seniorcentersareoftenlocatedinseniorhousing,churchesorsynagogues,veterans'

halls,orschools.Theyareusuallydrop-infacilities,andthosewhoattendorganizetheirowngamesorotherprojects.Hotfoodorsnacksmaybeavailable.

Adultfostercareprovidesaprogramforseniorswhoareexperiencingincreaseddifficultylivingalonesafely.Theseprogramsworkbybringingseniorsintouchwithpersonsinthecommunitywhoarewillingtoopentheirhomesandfunctionascaregivers.Mostcaregiversprovidehousingandappropriatecareandalsoreceivetrainingandorganizationalsupportfromlocalcentersontheaging.Adultfostercareprogramsprovideroomandboardandpersonalcareservicesinaresidentialsettingforindividualswhohavefunctionalimpairmentandrequiresupervisedliving.

ContinuingCareRetirementCommunities（CCRC）createacampus-likeenvironmentwhereresidentsbeginbylivinginanapartment,thenlatermovetoanassisted-livingunitoranursingfacilityastheirabilitytocareforthemselvesdeclines.

Assistedlivingfacilities,atypeofCCRC,offers"

home-like"

residencesthatincludedailymeals,helpwithbathinganddressing,24-hoursupervision,andlimitednursingservices.Assistedlivingarrangementscanbeprovidedinavarietyofsettings,includingfree-standingfacilities;

facilitiesclosetoorintegratedwithskillednursingfacilities;

componentsofcontinuingcareretirementorlifecarecommunities;

orindependenthousingcomplexes.

Respitecareprovideshome-and/orcommunity-basedassistanceforprimarycaregiversofseverelydisabledpersons,andenablesinformalcaregivers（suchasfamilymembers）towork,whileprovidingthemwithrelieffromthestressoffull-timecare.

Adultdaycarerepresentsahybridofhomecareandnursinghomecare.Itoffersclientstheopportunitytosocialize,enjoypeersupport,andreceivehealthandsocialservicesinasafe,familiarenvironment-typically,alocalcommunityfacility.Italsoprovidesrespiteforcaregiversresponsibleforapersonwhocannotbeleftalone,butwhoalsodoesnotrequire24-hournursingcareinaresidentialfacility.Adultdaycareservicesoftenwillincludecareandsupervision;

smallgroupandindividualactivities;

nutritiousmeals;

transportation;

casemanagement;

recreationandexercise;

nursingcare;

education;

familycounseling;

assistancewithactivitiesofdailyliving;

andoccupational,speech,andphysicaltherapies.Generally,clientsareambulatoryormobile（abletomoveindependentlywiththeaidofawheelchair,walker,orcrutches）.Adultdaycarecenterscanbefree-standingoccupanciesortheycanbeaffiliatedwithahospitalornursingfacility.Thisclassificationwillfocusonadultdaycarecentersfortheelderlyoperatingasindependentcentersnotaffiliatedwithotherorganizationsorbusinesses.Theexposuresdiscussedherealsomaybeappliedtotheothertypesofadultdaycarearrangementsaswell.

Adultdaycarecenterscomeintwoforms:

thesocialcentermodelandthemedicalcentermodel.Thesocialcentermodelprimarilyattemptstoalleviatefeelingsoflonelinessandisolationamongolderadults,whilefosteringgroupparticipationandfeelingsofbelonging.Servicesprovidedtraditionallyfocusonrecreationalandgroupactivities.Thesecenterscatertoadultswhosephysicalconditionisstableandwhofunctionindependentlyinactivitiesofdailyliving.Socialdaycarecenterscanbequiteinformal,astherearenoregulationsgoverningthemandnolicensesarerequired.Presently,therearenostaffingrequirements,mandatedactivities,orstaffqualifications.Medicaidusuallydoesnotcoversocialdaycarecenters,althoughsomefundscanbeobtainediftheclientisinvolvedwithaprogramthatcaterstothosewithachronicailment（e.g.,Alzheimer'

sorParkinson'

sdisease）.Inthesecases,amedicalchartisoftenrequiredforclientscoveredunderthisprogram.Someinsurancecompaniesarebeginningtoofferadultdaycarecoverageaspartoftheirnewlong-termcarepolicies;

also,itmaybepossibletonegotiateforcoverageunderolderpolicies.Mostclientsinasocialdaycareprogramarefundedthroughprivatesources,suchasfamilyorindividualincome.Theratesthatcanbechargedforasocialdaycarecenteraretraditionallylowerthanthoseforamedicaldaycarecentersincefewerservicesareprovided.Centerscanbesponsoredbychurches,recreationoradulteducationdepartmentsofthelocalmunicipality,privateorganizations,and/orcorporations.

Themedicalcentermodel,ontheotherhand,provideshealthandrehabilitationservicesinadditiontorecreationalservices.Theintentisrehabilitationormaintenanceofeachperson'

shighestleveloffunctioningandindependence.Medicalmodelfacilitiesaretraditionallystaffedbyhealthcareprofessionalsandcatertothoseindividualsinneedofphysicalassistanceorstructuredenvironments.Asuggestedminimumstaffratioisonestaffmembertoeverysixclients.Fundingformedicaldaycarecentersismorevariedthanthatforsocialmodels;

aclientcanpaywithprivatefundsorthroughfundsavailablefrommedicaldisabilityprograms（e.g.,theCommunityCareProgramfortheElderlyandDisabled,oranAlzheimer'

sgrant）.Medicaidpaymentscanbeappliedincertaininstances.（Medicaidpaysforhealth-careservicesfortheverypoorofanyage.Toqualify,nearlyallofapatient'

sassets