This assignment will explore compliance issues with federal and state laws and regulations governing healthcare organizations, such as the Anti-Kickback Law, the False Claims Act, the Stark Law, credentialing, medical errors, and patient safety. It is important to understand healthcare compliance for the benefit of improving patient care. It is also important to promote adherence to applicable laws, payer healthcare requirements, and to protect the organization against fraud, waste, abuse, and other potential liabilities.
Instructions
Write a 2–3 page paper in which you:
Summarize one statute, one regulation, and one guidance document that impose compliance obligations on healthcare organizations.
Explain what healthcare organizations must do to comply with legal requirements.
Describe the standards for corporate compliance programs set forth in the OIG Compliance Guidance and the Federal Sentencing Guidelines.
In addition to the textbook, provide two sources to support your writing. Choose sources that are credible, relevant, and valid. Cite each source listed on your source page at least one time within your assignment. For help with research, writing, and citation, access the library, or review library guides.
Explain why New Employee Orientation and Training is an important aspect of Health and Safety Performance Management
No more than 3 pages, calibre font 11, single space
Marks will be deducted for grammar, lack of content, esthetics, – meaning a professionally done paper
Tom is a new employee at XYZ Company Ltd which just started operating 3 months ago. The company provides administrative support to several construction contractors. On his first day Tom inquired about when he would receive his New Employee Orientation and OHS Training. His supervisor chuckled and explained to Tom that there was no need since he would be working in an office environment and was coming in with over 15 years’ experience as an Administrative Assistant. Tom was surprised at first but thought it was for the best since there was already a stack of documents for him to process waiting for him at his new desk.
All hospitals serve patients, employ physicians and nurses, and adhere to the rules and regulations defined by the legal framework for clinical services. Although nonprofit and for-profit hospitals are fundamentally similar, there are significant cultural and operational differences, such as the purpose or mission for running the hospital, strategic approaches to scale, financial strategies, and operational discipline. The culture at for-profit hospitals is business driven, and at nonprofit hospitals, it is service driven. For balanced healthcare services, both are important.
This assignment will help you explore for-profit and nonprofit hospitals, including their purpose, strategy, and services. You will identify one for-profit hospital and one nonprofit hospital in the United States. You will conduct research and compare these identified for-profit and nonprofit hospitals to analyze the strategic similarities and differences between these two categories of hospitals. This assignment will prepare you for Project Two by helping you develop skills to analyze hospitals’ financial needs and their impact on health policies and laws.
Prompt
To complete this assignment, you will create an analysis report that includes a comparison table for for-profit and nonprofit hospitals. You will research for-profit and nonprofit hospitals, collect information about their financial strategies and malpractice guidelines, and then compare these two categories and analyze their similarities and differences. Then you will summarize your analysis findings. Last, you will recommend an appropriate justification for the need for both for-profit and nonprofit hospitals in the U.S. healthcare system.
You are required to cite a minimum of three sources overall to support your claims. However, your submission must cite at least two outside sources from your own research. You may cite no more than one source from the module resources in your submission. For additional help with completing this assignment, refer to the Shapiro Library Guide: Nursing – Graduate item in the Start Here module. You may also use the Online Writing Center, located in the Academic Support module.
Business Objective: Describe the business objectives or purposes of for-profit and nonprofit hospitals, including their general mission and vision. Consider the following in your response:
What are the core objectives of for-profit and nonprofit hospitals, and how do these influence their financial needs?
What are the key differences in the mission and vision of for-profit and nonprofit hospitals?
Financial Strategy: Analyze the financial strategies of selected hospitals, explaining if their financial needs are key influencers for their business objective. Consider the following in your response:
How does tax status impact for-profit and nonprofit hospitals?
Are the financial needs of for-profit hospitals and nonprofit hospitals different?
Provision of Uncompensated Care: Describe the concept of provision of uncompensated care. Consider the following in your response:
What is uncompensated care?
Is there any difference in the provision of uncompensated care in for-profit and nonprofit hospitals?
Liability for Malpractice: Analyze liability guidelines for malpractice and its financial impact on for-profit and nonprofit hospitals. Consider the following in your response:
Are liabilities different for for-profit and nonprofit hospitals?
What is sovereign immunity law, and how does it impact liability limits for malpractice in for-profit and nonprofit hospitals?
Recommendation: Using your analysis findings to support your claim, share your recommendation about the need for both for-profit and nonprofit hospitals in the United States. Consider the following in your response:
What are the key strategic differences between for-profit and nonprofit hospitals?
How do the financial needs or objectives of for-profit and nonprofit hospitals impact the policies and laws?
Is there a need for both for-profit and nonprofit hospitals in the U.S. healthcare system? Share your recommendation with appropriate justification.
Guidelines for Submission
Your submission should be a 3- to 5-page Word document, including your completed comparison table from the provided template. You must also include an APA-style title page. Use 12-point Times New Roman font, double spacing, and 1-inch margins. Sources should be cited according to APA style.
Requirements: I would say at least 3 pages long and then add the comparison table
Not sure if it went through or not but this table needs to be filled in as well.
Synthesize Elements of Forming a Community Health Partnership
This assignment requires your synthesis and reflection of the elements needed to form your proposal for a community health partnership. Such partnerships are mandated by the ACA for nonprofit hospitals and offer benefits to both partners.
Your proposal will contain an overview of the benefits; and, using your weekly resources and assignments, you will identify the steps needed to form a partnership of this type.
You will summarize the predicted ROI for this nonprofit hospital/community health partnership from a holistic perspective in narrative form rather than a financial accounting perspective.
Lastly, you will incorporate your summary of how the 13 health leadership competencies are applied in each step and weigh the value of the abilities in each for health administrators. (collaboration, information seeking, analytical thinking, strategic orientation, accountability, performance measurement, project management, community orientation, professionalism, financial skills, innovative thinking, team leadership, and process management/organizational design)
Length: Minimum of 10 pages, not including title and reference pages
References: Include a minimum of 7 scholarly resources
Your paper should demonstrate thoughtful consideration of the ideas and concepts presented in the course and provide new thoughts and insights relating directly to this topic. Your response should reflect scholarly writing and current APA standards.
Requirements: 10 pages or more/use references & competencies (in bold) listed.
Doug and his wife Maria have three adult children, all of whom are married with young children of their own. Doug works as a regional sales representative for a chemical company that produces plastics, chemicals, and agricultural products. He has been in the position for 15 years, having moved into this job after leaving a different company doing similar work. The job requires him to travel to give demonstrations of the products across a six-state region. This requires him to fly and drive in unfamiliar areas. Maria works as a junior high school principal. Doug and Maria are financially set for retirement at age 65. Overall, they are in good health. At the age of 60, Doug received a diagnosis of Parkinson’s Disease (PD).
Early phase
In the year before his diagnosis, Doug had three minor car accidents while he was traveling in unfamiliar territory. Maria was suspicious that the accidents were related to his PD and, after consulting with the neurologist and Doug, they decided he should no longer travel alone out of his immediate area. After a few months of traveling with a colleague, he reluctantly stepped down to a district sales representative position to stay closer to home. Within the next year, Doug started experiencing exacerbated (worsened) symptoms related to fine motor coordination, changes in speech, as well as anger, anxiety, and depression. The neurologist placed Doug on short-term disability at the age of 61. After six months on short-term disability, the law mandates that the individual must apply for Social Security Disability. Therefore, due to Doug’s health continuing to decline and his inability to return to work, Maria had to file for long-term disability for Doug. At first, Maria attempted to work with Doug to complete the disability paperwork. Doug was easily frustrated with formulating the responses to the questions on the forms; he did not know how to answer the questions nor where to find the information within their household records, so Maria hired a lawyer to complete the paperwork.
Three months after submitting the application, Doug was approved for Social Security Disability Income (SSDI). This was a significant drop in income. Doug’s employment income was twice that of Maria’s; he was bringing home $7500 per month. His SSDI income is $2788 per month. Since Doug left his full-time job, he was no longer eligible for health benefits from his employer. He is not eligible for Medicare under the disability guidelines until two years after payments begin. Maria completed the paperwork to add him to the health insurance through her job, which doubled her monthly contribution to health insurance. The decrease in household income required them to utilize their retirement funds earlier than planned. In addition, Maria knows, as the disease progresses, she may have to make decisions about her own full-time work as a principal, which will further strain their financial situation.
Middle phase
Doug and Maria enjoyed playing Scrabble with their friends Susan and Bob, who lived nearby. The two couples would get together every Saturday for some friendly competition along with dessert and lively discussion. A year after his diagnosis, Doug was exhibiting stooped posture and changes in his speech, which made it difficult to understand what he said. These were clear signs the disease was progressing. In some aspects of his life, he appeared to function well enough, such as easily performing most activities of daily living, but it became clear he struggled with activities in the game of Scrabble. For example, he was having a difficult time creating words from the tiles he chose, where to place them on the board, and he could no longer add up his points correctly. In addition, Doug was embarrassed because he continually knocked tiles out of place on the board, struggled to communicate clearly and interact with friends in a social situation. Doug felt a great deal of shame due to the changes and told Maria that he no longer wanted to participate in the weekly game night. This meant that Doug and Maria had less interaction in their own community and became more socially isolated, which is not uncommon for families with a chronically ill member.
Late phase
Doug was in charge of managing his own medications, which he needs four times a day. One day, about four years after his diagnosis, Maria was away from home at noon when Doug called her to ask what he was supposed to do with the noon pills. “I’m supposed to throw them out, right?” That was an early sign of dementia. It was a signal for Maria that Doug could no longer control his own medications and that he probably shouldn’t be left alone for very long. The incident marked the start of a steep decline in Doug’s cognitive and emotional abilities, and the couple’s relationship changed from one of partners to one of patient and caregiver. Maria relied on their children and other family members to help with Doug’s care, and she began looking for support groups to help her figure out how to handle the deteriorating situation. Even though she had a rotation of helpers, most of the work of Doug’s care was Maria’s responsibility.
Doug’s condition progressed to the point of needing full-time care in a skilled nursing facility a little more than a year later, after he lost the ability to stand up, even with help. He always needed two people to help him, and that just wasn’t possible at home. In addition to the tremendous emotional stress on the family, moving Doug to a skilled nursing facility further increased the financial burden. Maria made the decision to sell the house and move to a small apartment by herself. She had to spend the proceeds from their home to pay for Doug’s nursing home care before Medicaid would help pay for his care, due to the Medicaid eligibility spend-down requirements. Doug passed away five months after moving to the skilled nursing facility. Maria was still paying for his care out of the proceeds from the sale of their home, so she never received Medicaid assistance for Doug’s care.
Address the following within the required template
Briefly define Parkinson’s Disease.
What physical changes occur related to the onset of the disease?
What are the possible psychological changes with PD?
What system(s) are affected?
What are the treatments and therapies?
The case study shared details that indicate Doug is no longer able to identify and resolve problems.
Identify two examples in the study that indicate Doug is losing this ability.
Provide two other examples that may arise as the disease progresses that are related to identifying and resolving problems.
Discuss possible feelings and stressors Doug may be experiencing as the disease progresses and he must rely on caregivers more.
Refer to the required reading list for the topics related to this assignment for ideas.
Discuss the effects of the diagnosis of PD and its progression can have on a spouse and family (micro-level).
Refer to the chapter and required readings regarding caregiving and caregiver burden (e.g., employment, psychological effects, financial stressors, role in the marriage, etc.).
Locate two services in your own community that offer assistance to people with PD and their caregivers (meso-level).
Describe the services available, cost, and eligibility requirements.
In your opinion, are Doug and Maria eligible for the services? Explain your answer based on your findings and the knowledge of Doug and Maria.
At the macro-level, research the state and federal programs, legislation and initiatives that affect chronic illnesses. Discuss the pros and cons of two of the following items as they affect patients and caregivers.
Legislation and lobbying efforts (e.g., changes to the Affordable Care Act [ACA], stem-cell research, etc.)
Requirements to qualify for Social Security Disability Income (SSDI)
Requirements to take advantage of the Family and Medical Leave Act (FMLA)
Requirements to qualify for Medicaid/Medicare.
What are the requirements of these programs in terms of paying for skilled nursing for Doug? Do Doug and Maria qualify for assistance through these programs? Why or why not?
Americans with Disabilities Act (ADA).
A program, legislation, or initiative of your finding.
Use a minimum of three scholarly sources. List references in APA format within the response box on the template.
