...people who enter a nursing home will stay there five years or more. (www.medicare.gov/LongTermCare/Static/Home.asp) Long-term care financing is a growing concern over recent years. The number of elderly Americans in proportion to the total population is rapidly increasing. Individuals need to plan well in advance in order to cover the burden that it places on individuals, families, and society. The average annual cost of nursing-home care in the US was $74,000 in 2005 and is projected to rise to $175,000 by 2020. This amount would decimate the assets of all but the wealthiest. (Weisser, 112) The federal and state governments along with the private sector are struggling to define the roles of delivering care to the elderly. Medicaid, Medicare, and Private long-Term Care Insurance are current ways to finance our elderly care. While there are a variety of ways to pay for long-term care, it is important to think ahead about how you will fund the...
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...facilities rely on JCAHO accreditation procedures to indicate to the public that their particular institution meets quality standards”(JCAHO). JCAHO and its policies have taken on a real importance in the medical field, despite the lack of official government sanction. The Joint Commission is an independent, private sector in the United States that administers accreditation programs for hospitals and other healthcare-related organizations. The Commission develops performance standards that address crucial elements of operation, such as patient care, medication safety, and infection control and consumer rights. Most state governments require that healthcare organizations be accredited by the Commission as a condition for licensing and Medicaid reimbursement. JCAHO evaluates and accredits approximately 18,000 health care organizations, including hospitals; ambulatory surgery centers (ASCs), health care networks, and clinical laboratories. The Joint Commission was founded in 1951 as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Joint Commission Resources (JCR), a global affiliate group, oversees the Joint Commission International (JCI). In this essay I will continue to use the monopolistically...
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...Regulatory Agency Regulatory agencies ensure health care practitioners and facilities promote safety, legal compliance, and quality patient services. If health care were not regulated of if accreditation were not required patients would not have a sense of comfort and safety. The regulatory agency the Joint Commission on the Accreditation of Healthcare Organizations commonly known as JCAHO, which “conducts periodic on-site surveys to verify that an accredited organization substantially complies with Joint Commission standards and continuously makes efforts to improve the care and services it provides” (The Joint Commission, 2010, p. 3). The JCAHO ensures that health care providers and facilities are maintaining the required standards of care in place by the regulatory agency. JCAHO is constantly improving the quality and safety of care provided in any health care facility. History of the Joint Commission of Health Care Organizations In 1910, Ernest A. Codman, M.D., found that many health care practitioners were practicing medicine that was outside their scope of training. It was then that he “proposed the end result system of hospital standardization. Codman thought that if hospitals were to track every patient and the patient were treated long enough it could be determined whether the treatment was effective and use the results to improve care” (2010, A Circular Century, p. 26). In 1913, the American College of Surgeons (ACS) was established and by 1917, the...
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...Administrative Ethic Paper 1 Cecile Delos Santos HCS/335 April 29, 2013 Susan Morgan Administrative Ethic Paper 2 The thought of abuse in elderly are very disturbing but it does happen. They are very vulnerable and dependent on other people to function in everyday life. Resident abuse in nursing homes facility or home care facility is a problem all over the world, but has become less of a concern in America, because the Department of Health Services become very strict on rules and regulation for nursing home and home care. This is for the protection of elderly and to provide the best care for them and have a quality of living. Nursing homes provide best patient care and services for elder patients and well being of these residents are provided. Most of the workers in the nursing home are caring, compassionate and conscientious and help their patients in their everyday life from bathing, eating, activities, and total patient care if needed. However, some time in other facility, staff, fellow residents or sometimes visitors to the facility may be guilty of abusing patients in some point, this will cost a lot because it is a federal felony to abuse a patient and may cause jail time and penalty. Different Types of Elder Abuse: •Physical Abuse: The most common type of abuse in elderly. This is a type of abuse that the caregiver force the senior citizen to do something that the caregiver wants him...
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...Annual reports are given as comprehensive as possible, reporting a company's prior years activity. Shareholders and other interested parties are given information concerning the company’s financial performance. These reports must be filed with the company’s registry and may be required to be publicized, it depends on the area. More regular reports are required of those companies listed on the stock exchange. Most reports contain: Chairperson's report, CEO's report, Auditor's report on corporate governance, Mission statement, corporate governance statement of compliance, Statement of directors' responsibilities, Invitation to the company's AGM and financial statement information. [pic] Lincare Holdings Inc. was founded in 1972 and is headquartered in Clearwater, Florida. Providers of oxygen and other respiratory therapy services to home health care market in the Lincare Holdings Inc. also supplies home medical equipment ( hospital beds, wheelchairs and other supplies) that present helpful to consumers. State-of-the-art oxygen system producers from 1965. Known for making 24-hour, seven-days-a-week reliability, professional service representatives, and staff, Lincare provides: Oxygen Therapy, Respiratory Services, Infusion Therapy, CPAP, Ventilators, NVS, Enteral Therapy, Pediatric Respiratory Services, Patient Education & Rehabilitation. Individualized services to the prescribed need of each patient. Sanitarily providing respiratory equipment with monitors to...
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...services (DHS) to any organization that the physician or a member of his/her immediate family has a financial relationship. Exceptions to the law exist and will be examined in later sections of this reflection. Originally the Stark Law (Stark I) only applied to referrals of Medicare Beneficiaries, but Section 1877 of the Social Security Act (the Act) (42 U.S.C. 1395nn), also known as the physician self-referral law, or Stark Law, intends to prevent the misappropriation of or over utilization of healthcare that could result from incentivized diagnostic ordering protocols that may be a direct result of financial relationships that could influence healthcare decisions. The law is named for its author, United State Congressman Pete Stark, a Democrat from California, who authored and supported the creation of this piece of legislation. The law’s purpose is to prohibit a physician from referring a patient for designated health services (DHS) to any organization that the physician or a member of his/her immediate family has a financial relationship. Exceptions to the law exist and will be examined in later sections of this reflection. Originally the Stark Law (Stark I) only applied to referrals of Medicare...
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...The necessity for long-term care is increasing which will require additional training and education for health care personnel, family members, and patients. Family members can have peace of mind knowing their family member will gain confidence in learning how to become accustomed to his or her new life while maintaining a quality continuum of care during and after treatment for physical, mental, or age associated illnesses. Long-term care is also known as personal assistant services and is defined as an individual who requires health care assistance for more than 90 days. Personal assistants provided to a patient help them with the activities of daily living (ADL) as well as instrumental activities of daily living (IADL). These activities may include personal care services like bathing, doing household chores, and other activities to help the patient remain independent while still residing in or near his or her home while maintaining the quality of care the person is accustomed to if there are no medical hindrances preventing it. Long-term care also includes community services, such as meals, adult day service programs, and transportation services (Austin & Wetle, "The long term care continuum, Who needs long-term care?," 2012). Residential facilities, such as skilled nursing facilities and assisted living facilities, also provide long-term care services along with housing ("National Clearinghouse For Long Term Care Information,” n.d.). Continuum of care services are...
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...Evidence Based Nursing Practice: Pressure Ulcers Jane Smith Research and Scholarship for Evidence-Based Practice March 10, 2010 Evidence-Based Nursing Practice: Pressure Ulcers The primary goals for conducting nursing research are to generate new knowledge to promote positive outcomes for patients, enhance quality and cost-effectiveness of care, improve the healthcare delivery system, and validate the credibility of the nursing profession through evidence-based practice (Schmidt & Brown, 2012). The purpose of this paper is to explore the practice-related problem of pressure ulcers and the importance of the problem in the nursing profession. Practice Setting Problem Pressure ulcers are a serious concern in caring for adults in all types of settings (Stotts & Gunningberg, 2007). I have personally observed and cared for numerous patients with debilitating, painful decubitus wounds to their bodies both in long-term care and acute care settings. I will never forget a patient that I took care of at a long-term care facility; even after pain medications she would plead that she would rather die than have me change her pressure ulcer dressing. It is heartbreaking to know that the majority of these pressure ulcers could have been prevented had the correct measures taken place. It is essential for all healthcare providers to examine and explore the evidence based guidelines and information regarding pressure ulcers...
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...medicare.gov, Medicare insurance coverage is governed by federal and state laws, and the decision of whether a service is covered, or not, is made by Medicare. Moreover, insurance coverage/decisions are handled by local companies that process Medicare claims. These companies will make the decisions of whether procedures, and/or interventions recommended, are medically necessary, and whether that particular service is covered in their area (Medicare.gov). Scenario# 1 A1. Medicare Part A Explaining insurance coverage to Mrs. Zwick, and her daughter, must be done in a simple and informative manner, keeping in mind that insurance coverage is a complex process that often varies. However, below are some pointers to be addressed during the Mrs. Zwick’s discussion. Medicare Part A, A.K.A. hospital insurance, insures hospital services days (inpatient care, general nursing care, meals, medications, semi-private/private room if medically necessary, and supplies), and up to 100 days of coverage in a Skilled Nursing Facility (SNF). To qualify for Medicare Part A coverage, the physician orders must include the amount of midnights (count) needed to treat the illness and/or injury. Patients must stay in the hospital for over 72 hours (admitted for inpatient medical care). Hospital stay less than 72 hour, will be considered as outpatient care, and a disqualifier for coverage. At discharge, the primary care physician (PCP) must write an order for SNF services. The Medicare Part A coverage...
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...Generally, a nursing home is a residential facility offering daily living assistance to individuals who are physically or mentally unable to live independently. Residents are provided rooms, meals, assistance with daily living, and in most cases, some medical treatment. The U.S. nursing homes and long-term care facilities industry includes about 80,000 establishments (single-location companies and branches of multi-location companies) with combined annual revenue of about $210 billion. The severe shortage of nursing assistants, home health and home care aides, and other paraprofessional workers is the primary trend influencing the current wave of concern about the long-term care workforce. National data on turnover rates show wide variation, depending on the source of the data: One source suggests that turnover rates average about 45 percent for nursing homes and about 10 percent for home health programs, while other data place average annual nursing home turnover at over 100 percent per year. High rates of staff vacancies and turnover have negative effects on providers, consumers, and workers: The cost to providers of replacing workers is high; quality of care may suffer; and workers in understaffed environments may suffer higher rates of injury. The future availability of front-line workers does not look promising. There will be an unprecedented increase in the size of the elderly population as the “baby boom” generation ages. This is why questions such as, nursing-home growth...
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...The Joint Commission HCS/430 October 20, 2014 Kelly Gantt The Joint Commission The Joint Commission is independent, not for profit organization that has been around since 1951. According to the Joint Commission (2014), “The Joint Commission accredits and certifies more than 20,500 health care organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards” (para. 1). The Joint Commission’s mission is “to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value” (The Joint Commission, 2014, para. 1). The Joint Commission’s vision is “all people always experience the safest, highest quality, best-value health care across all settings” (The Joint Commission, 2014, para. 2). The Joint Commission evaluates and accredits health care organizations and programs in America and around the world. This organization is the United States (U.S.) oldest and largest accrediting body for health care. For a health care organization to become accredited through the Joint Commission they must have an on-site evaluation every three years and laboratories every two years (The Joint Commission, 2014). Joint Commission International (JCI) was founded in 1994 and...
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...One of the things we will be talking about in the medical section is elderly women and Medicare. The passage of Medicare did not occur until 1966, which marked a key milestone in women’s economic security. It was also a huge influence to decreasing income equality between genders. Alina Salganicoff’s journal article “Women and Medicare: An Unfinished Agenda” written by mentions that “Today, Medicare serves 24 million women ages 65 and older, representing 56 percent of older adults enrolled in the program, and provides them with financial protection at a time in their lives when they have the greatest need for medical care and often the fewest family and economic resources” (43). This shows that almost 60% of women are covered by Medicare....
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...STARK LAW HCA322 HEALTH CARE ETHICS AND MEDICAL LAW 10/26/15 What is Stark Law? According to starklaw.org, “Stark law, actually three separate provisions, governs physician self- referral for Medicare and Medicaid patients. The law is named for United States Congressman Pete Stark who sponsored the initial bill.” Dr. S and Dr. V were accused of violating the law after they sub leased a nuclear imaging camera from the local hospital so that they would not have to refer patients, and could perform the examinations on site. Qui tam action was brought by four other physicians who believe that the sublease violated the Stark Acts. This essay will further explore Stark Law, and decide whether or not Dr. S and Dr. V are guilty of committing a crime. Dr. S and Dr. V Found Guilty? “Faced with increasing evidence that health care practitioners were referring patients to other businesses owned or co-owned by the referring physician or a close family member, Representative Fortney Stark introduced a bill that would make these "self-referrals" illegal,” (Bustillos, D). To prevent physicians from creating a system in which they exploit patients for their own personal financial gain, Stark Law was put into effect. This law is very important because even though the medical community is a business, the quality care of patients should always be the top priority. Anytime large quantities of money can be accumulated it creates a corrupt system in which the financial aspect of the business...
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...States doesn’t have universal health care, we refer to the Medicare and Medicaid system. Medicare is referred to as “the universal health insurance for elderly people” (Barr, 2011, pg.132). Medicare is a federal program that helps all people 65 years or older pay for healthcare. Those who qualify for Social Security benefits are automatically eligible for Medicare (Barr, 2011). When Medicare was passed in 1965, only 56 percent of elderly people have hospital insurance. It was a strong national consensus that none of the elderly in United States should face financial ruins because serious illnesses were seen as a threat to financial security of seniors (Barr, 2011). Due to that reason, Medicare was created to ensure financial stability. Not only does Medicare cover people 65 years and older, but it also covers individuals with certain disabilities, and individuals with End-Stage Renal Disease that requires dialysis or transplant (Medicare.gov). Unlike Medicare, Medicaid was not created as a program for all people who fall below that poverty line. It only covers certain subgroups of poor people (Barr, 2011). Medicaid provides medical benefits to groups of low-income people, some who may have no medical insurance or inadequate medical insurance, health care to children, pregnant women, parents, senior, and individuals with disabilities (Medicaid.gov). Medicare is made up of four different parts: part A, B, C, and D. Medicare part A is a service plan for hospital care. All people eligible...
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...Medicare Summary Medicare, America’s biggest health protection plan currently covers more than 50 million people nationwide. Medicare can be summaries into 2 major categories, Traditional and Advantage. Both of them have 4 subcategories known as Part A, B, C, and D. Each of them represents a specialty insurance plan; Hospital, Medical/Health, Advantage Plans, and Prescriptions. The Centers for Medicare and Medicaid are responsible for the program operations. Medicare has changed over the years including the legislation law of reform H.R. 3590, Patient Long Protection and Affordable Care Act signed into law in 2010. And then there was H.R. 4872, the Health Care and Education Reconciliation Act. This legislation brings changes and impacts for how the Part D Medicare plans are to enroll and advertise beneficiaries. The legislation protect and strengthen all recipients of Medicare while expanding provisions for low income recipient groups by increasing original Part D provisions. These changes have powerful impact on Part D of the Medicare operations and dynamics that include specialty prescription coverage and benefit design (American Health and Drug Benefits, 2012). There is a plethora of obstacles ahead for the Medicare program; even though the U. S. government’s plan for modification has brought benefits to many, especially for (Over 65) seniors and physically disabled Americans covered by the plan. Revenues are decreasing and the cost of health care is steadily climbing,...
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