...Ambulatory Surgery Centers: A critical regulatory issue Ambulatory surgery centers are considered medical facilities that are specifically designed to give elective same-day surgeries to ease the high traffic at local hospitals. They do not offer emergency care in this type of facility because it is not considered a hospital. This type of facility means that a patient does not have to be admitted to a hospital and will go home after the procedure is finished. There are many legal issues regarding these types of facilities, and as you will read, they have to do with physician ownership, out of network waivers, and Medicare cases. It takes a lot of effort to run a surgical center and to find out what kind of legal issues can be involved with this type of center. One of the main sources of legal debates that are prevalent in ambulatory surgery centers is when new owners are trying to “buy-out” an owner that is leaving the business. A lot of centers grapple with the understanding of their present contracts concerning buying and with the legal obligation of selling the center for retail value. When a surgery center needs to sell because of finances, the ability to find someone who will give a fair market price can be difficult. Watching and assessing which new owners that will enhance the productivity of the center. Another great debate that involves physician ownership is the newly revised coverage rules and regulations which is a necessity for the early notice of physician...
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...Legal Article Paper-Ambulatory Surgery Centers Themelina Vallas HCS/430-Legal Issues in Health Care:Regulation and Compliance Due: 6/1/15 Teela Carmack Medical facilities called “ambulatory surgery centers”, are that provide same day surgeries for patients that rather do it this way versus going to an actual hospital. This facility is not considered a hospital and therefore does not provide any type of emergency care. In an ambulatory surgery center patients do not need admission, go home right after their procedure and do not stay overnight. Running a surgical center is no easy task, so knowing the laws and regulations are extremely important. There can be many legal issues involved so proper training and education are vital components for the staff and healthcare professionals within those types of facilities. There are many legal issues that mainly involve dealing with physician ownership, network waivers and Medicare cases. Physician ownership seems to be one of the most legally debatable issues having to do with ambulatory centers. This is due to a lot of new owners that come in and buy the business from old owners leaving it. Most owners have to be able to understand their contract with legal obligation for the concerning buyer when selling the center. Selling a surgery center can be difficult especially if it is due to a financial situation. All owners of a business like this must be optimistic about acquiring new business to increase financial compensation and...
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...In the United States of America, there is development of Outpatient surgical care in recent years. The Ambulatory Surgical Centers have separated as specialized branches from major hospitals. In 1983, there were as many as 240 such specialized centers (Winter, 2003) and the number increased to 5,174 in 2008 (Medicare Payment Advisory Commission, 2009). The traditional hospital-based outpatient departments (HOPD’s) are facing challenges and competition from the specialized ambulatory surgical centers (ASC). A description of such development is seen by an example where the patient visits were 20.6 million per year in the year 1996 and it has increased to 31.5 million in the 2006. There is a rapid impact on increase in the number of...
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...Inpatient Hospitalization To Ambulatory Care Services (2010) from the Researchomatic. Retrieved on 09/05 , 2014 noted ambulatory care Sensitive situation are those "for which good outpatient care can possibly avert the need for hospitalization, or for which early intervention can avert difficulties or more critical disease" Although hospitalization rates are leveraged by socioeconomic components for example scarcity . I will discuss and compares inpatients care and ambulatory care on bases of scope and level of service, venues for care deliver, impact o health care finance, and future trends in medicine and care delivery. There are direct personal involvement within the level of services in the practice of ambulatory /outpatient services which detect/ prevent disease such as hypertensions, diabetes , cancer -screening and immunization programs. Since death happened and caused by disease that are contagious , primary prevention lessen the danger of morbidity are enforced by encouraging people to wear seat belt, clean treatment for water/sewage and sanitation inspections in restaurants. One method of ambulatory/outpatient service is that clinician would travel from house to house to skilled practitioners in relatively more complex facilities is a form of medical care. Ambulatory/outpatient can be distinguished in the following categories: Primary care help to control costs, utilization and the rational allocation of resources. and serve as patient...
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...Professional Development Paper Angela Carroll N502-DD1: Health Care Systems Module 3 September 12, 2014 Contributing Factors Related to Failure for Advanced Planning of Long Term Care In today’s society of advancements in medical technology, Americans are living longer which increases the need for long term care. Older adults make up the largest population of those requiring long term care. The current percentage of older adults over the age of 65 is at 12.6% and is expected to increase to 19.3% by 2030. The population of adults over the age of 85 is also expected to increase by the year 2020 (Sultz & Young, 2011). With today’s older adult more than likely being divorced or without children will lead to older adults not having family caregivers. This can also lead to an increase demand of these adults requiring the use of long term care facilities and services. Therefore, one must look at the reasons why older adults and their families overlook the concept of saving for long term care. As a society, what can be done to increase awareness for the need of advance planning? One must understand the definition of long term care. “Long-Term Care involves the need for assistance, including prompting, with activities of daily living” (Calmus, 2013, para. 3). One factor contributing to the lack of advanced planning could be that the majority of long-term care is provided by family members which do not require pay. This can therefore lead to loss of household income because...
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...Inpatient Care & Ambulatory Care I will discuss and compares inpatients care and ambulatory care on bases of scope and level of service, venues for care deliver, impact on health care finance, and future trends in medicine and care delivery. The term inpatient refers to a patient staying overnight in a health care facility, such as a hospital or a nursing care facility.Outpatient refers to services provided while the patient is not lodged in the hospital or some other health care institution.There are direct personal involvement within the level of services in the practice of ambulatory /outpatient services which detect,prevent disease such as hypertensions, diabetes , cancer screening and immunization programs. Since death happened and caused by disease that are contagious , primary prevention lesson the danger of morbidity are enforced by encouraging people to wear seat belt, clean treatment for water/sewage and sanitation inspections in restaurants. One method of ambulatory/outpatient service is that clinician would travel from house to house to skilled practitioners in relatively more complex facilities is a form of medical care. Ambulatory/outpatient can be distinguished in the following categories: Primary care help to control costs, utilization and the rational allocation of resources.and serve as patient advisor , advocate, and system gatekeeper, gives advice regarding to diagnoses, therapies and provides care for chronic conditions. Secondary care on...
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...my research. Next, I will identify the key characteristics of the facility. Then I will explain to why I chose the facility type and then put it all together in my conclusion. The facility I chose to research is the Ambulatory Care Clinic. An ambulatory care clinic has a broad range of medical services available for patients. Having such an advanced technology in today’s healthcare, more doctors and other healthcare providers are having ambulatory care for their patients. Some places that offer the ambulatory care are in doctor offices, hospitals, or in an ambulatory surgery center and some procedures include the following: x-rays, blood tests, minor surgeries, endoscopy, biopsies, childbirth, and many more. The purpose of the ambulatory care clinic is to provide in and out, patient procedures safely and to save time and money for patients. It also prevents from infection to spread with since the patients are not staying overnight with infection can set in. The people that use the ambulatory are patients, staff, families, and the general human population. Both men and women use these services as well and all ages and different diversities. The population in today’s healthcare wants to go to an ambulatory care clinic because of the flexibility hours. The ambulatory care clinics are open more hours to serve multiple patients’ needs properly. They are very cost effective for the patients since they are not staying overnight. I chose this facility because it does provide all the...
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...Facility Planning Shrunda Young-Johnson HCS/446 August 6, 2015 Janice Chilton Facility Planning Houston Texans new ambulatory clinic in Cleveland, Texas will be opening soon. It will feature state of the art surgical center. The Houston Texans Ambulatory Clinic will be have outpatient same day surgery center and imaging center. Our Ambulatory Clinic will have an unveiling in the summer of June 2016. This paper will focus on regulatory requirements and the effects on design and equipment, color selection implication and noise issues, electronic item needs, examination of budget planning and cost estimates, description of stakeholders and implementation plan. Health care organization know the regulatory requirement and their effect on design and equipment, especially for ambulatory clinics. Outpatient clinic have beds that are devoted to “hotel function” the typical nursing units of hospital and the extensive dietetic and housekeeping area that accompanying them (WBDG,2014). The implementation is organized in three steps which are routine, predictive maintenance and preventive. Manager for this ambulatory facility will have contractor and city of Cleveland public health to provide what compliance and regulation on material used for the facility. The color selection is very important in an outpatient ambulatory clinic due to it can create an illusion of a higher ceiling or a wider room or facilitate cueing in way finding orientation. In our health setting, there are...
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...University of Maryland Ambulatory Care Center: Highlighting Issues and Solutions DeVry University HSM 420: Managed Care and Health Insurance \ Introduction The quality of care is measured through the patient receiving the care. The patient measures quality of care through needs and preferences, care given without unnecessary delays and healthcare is not affected by gender, race, age or income. The Surgical Clinic at the University of Maryland strives to meet these goals by providing stellar care in a facility given the Leapfrog award for over a decade. Through observation there were a few areas in which could use improvement. Patients wait times affect how the patient perceives the care given. Another major issue is the need for consistency, reassurance to the patient that although the same physician may not be treating you during each visit the physicians are familiar with your individual case. Patients often find the location of the clinic difficult to find within the hospital which causes frustration upon arrival. The availability of clinics can cause an issue for patients. Description The University of Maryland Medical Center Surgical Clinic is governed by an ambulatory services team with different scopes of practice, including Doctors, Nurses, Administrators and other Clinical staff. The clinic staffs the Practice Manager, three subspecialty Nurses, a Medical Assistant, a Practice Assistant also the Scheduling Coordinator. The University of...
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...Devry Univeristy | Duke University Medical Center | DUKE MEDICAL | | | Duke University Medical Center is ranked number one in North Carolina. Duke is ranked nationwide in 13 adult and 10 pediatric specialties. Duke Consists of 812 bed general medical and surgical facility with 38,205 admittances in the most recent year reported. It accomplished 16,721 yearly inpatient and 20,564 outpatient surgeries. Duke’s emergency room also had 68,646 visits. This hospital was one of 80 facilities that made the classifications in at least one of the 10 specialties investigated for the 2012-13 Best Children's Hospitals. Duke is number one research organization in the world. Major patient care facilities at Duke University Medical Center that are located on their campus include the Duke University Hospital, Duke Clinic, Duke Cancer Center, McGovern-Davison Children's Health Center, Duke Eye Center, Ambulatory Surgery Center, and Center for Living. This makes them a great facility because you do not have to go far for most treatment that you may require. Everything is right there where you need it to be. Duke also makes it easy for you to go right across the street if you have more than one appointment for another medical reason. Duke Medicine offers a whole range of medical and surgical subjects to meet every patient's requirements. Some of the highlights are Cardiology, Neurosciences, Oncology, Ophthalmology, Organ Transplantation, Orthopedics, Pediatrics, Prevention and...
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...program. * Ambulatory Care Accreditation Program – This accreditation program was established in 1975. Organizations accredited by this program are free standing ambulatory care organizations like surgical, medical/dental and diagnostic/therapeutic services in a variety of settings like, ambulatory surgery centers, military clinics, recovery care/short stay, sleep centers, teleradiology, telemedicine diagnostics, etc. Currently there are approximately 1,900 such organizations. In addition there is the Primary Care Home Medical Certification for Joint Commission accredited ambulatory care organizations. This certification focuses on care coordination, access to care, and how effectively a primary care clinician and interdisciplinary team work in partnership with the patient (and where applicable, their family). * Behavioral Healthcare Accreditation Program – This accreditation program began in 1975. Organizations providing services for people with developmental and intellectual disabilities, mental health and chemical dependency. Some of these organizations are: Addictions Center, Crisis Stabilization (24-hour acute care setting), Outdoor Behavioral Services, Outpatient Counseling and Therapeutic Schools (both day and 24- hour). Currently there are over 1,900 behavioral healthcare organizations. * Critical Access Hospital Accreditation Program – This accreditation program was introduced in 2001. Hospitals that have met the requirements stipulated by Center for Medicaid...
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...a model to calculate the ambulatory surgery center’s net cash flows on the basis of estimated utilization, estimated charges, and other relevant data and then take this data and calculate the NPV, IRR, MIRR, and Payback. You must also perform sensitivity and scenario analyses. You should also provide an analysis of risk and the impact of inflation on project profitability. Your completed assignment will be evaluated on the basis of addressing all of the following (in no particular order): 1. The hospital already owns the site for the center, so should any cost be attributed to the land? Explain. 2. What overhead costs should be included in this analysis? 3. How should the cannibalization of inpatient surgeries be handled? 4. a. What is the project's payback? What is the economic interpretation of payback? What type of information do decision makers get from the payback? b. What is the project's net present value (NPV)? Explain the economic rationale behind this profitability measure. c. What is the project's internal rate of return (IRR)? Explain the economic rationale behind IRR. Do the NPV and IRR always lead to the same conclusion about a project's profitability? d. What is the project’s modified internal rate of return (MIRR)? How does MIRR differ from IRR? Which one is a better measure of a project’s true rate of return? 5. To give the board of directors a better feel for the impact of inflation on the outpatient surgery center, prepare a two-variable sensitivity...
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...Funding Health Care Services Ambulatory services are the services offered to patients if they are to be accommodated within the compounds of the healthcare institution under professional nursing care because of the severity of their health or because of the recommendations of patients’ physician or surgeon (Williams, S. & Torrens, P. 2010). The patient is only there for a day and then is discharged for the facility. There are services that be provided in a day starting from registering the patient to providing them with medication. There many different kind of services that falls under ambulatory care such as outpatient clinics, urgent care centers, emergency rooms, ambulatory or same-day surgery centers, diagnostic and imaging centers, primary care centers, community health centers, occupational health centers, mental health clinics, and group practices. There has been an increase in the ambulatory care because it is inexpensive and more appropriate health care setting. It is hard for the health care personnel and patients to adjust because of the changing technology and complex reimbursement systems. There are spending costs involved in health care like money paid to health care providers in hospitals, outpatient centers, Veterans Affairs and other clinics, doctor and dentist practices, physical therapists, nursing homes, home health services and on-site care at places such as schools and work sites. There are few ways to fund ambulatory system like the money tax payers...
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...Root Cause Analysis A.1 Sentinel Event Nightingale Community Hospital identified a recent sentinel event involving the ambulatory surgical center. A sentinel event is defined as an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof (http://www.jointcommission.org/sentinel_event). A three year old female presented to the hospital on September 14th for a planned outpatient procedure. The child was accompanied by her mother. The mother registered the patient with the registrar prior to the procedure. The patient and her mother went to the pre-operative area to complete the informed consent and the necessary physical assessment. The pre-operative nurse obtained the necessary contact information from the mother who notified staff she would be leaving the hospital during the surgery to attend to a sibling matter at home. The mother left her cell phone number as the best contact number to call. This number was entered into the nurse’s personal notebook but was not entered into the patients chart. Post-surgery, the child was taken to the recovery area. The mother had not yet returned to the hospital. During the recovery period the child became more anxious without her mother at bedside. A male presented to the recovery area and identified himself as the child’s father. The patient identified the male as “daddy” and appeared to be comforted by his arrival. The father was provided discharge instructions by the post-operative nurse...
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...services consists of a mix of public and private payment sources. Medicare and Medicaid represent the two major health programs. Funding for Ambulatory Services The use of Ambulatory Care Services is common amongst most people. It has become an important element in the delivery of health care. For many, it has been viewed as the primary source of health care; offering an extensive range of services that don’t require overnight hospitalization. The services offered can be as complex as tests to and therapies or as simple as a minor cut. Traditionally in the U.S., ambulatory care services were provided in the offices of medical practitioners and in the homes of the patients. Presently, these services are performed in outpatient clinics, emergency rooms, and same day surgery centers. Ambulatory care has expanded within the health care system. This is due to the fact that it is less expensive than inpatient stays and less time consuming for patients. In comparison to inpatient patient procedures, outpatient procedures have been estimated to be 30% to 60% less in costs. Funding for Ambulatory care services began when the first surgical care center opened in the 1970’s. The centers became certified by Medicaid, making it more attractive to the public which then allowed the ambulatory services to grow. My recommendation for ambulatory care services is that they should be federally funded. My decision is based on the fact that the use of the government is intended to increase...
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