...Bryant/Smith Case 42: Hopsital Charges GM 533 Keller Graduate School of Management Date: 02/14/2010 EXECUTIVE SUMMARY The research is done to find the solutions for some of questions like; the relationship between the doctors and their charges, the type of insurance having its effects on its customers and if there is any relationship between charges, payor and physicians. The data that is used in this research analysis to find the proper equation model for the relationship between payor, physicians and charges and number of days stay at the hospital, is from the Bryant/Smith Case 42 Hospital Charges (Appendix 1). As described in the case, the hospital’s revenues are determined largely by the patients’ insurance coverage. The data being used are for normal delivery of babies. The null hypothesis test states that there is no relation between the patients with managed care insurance and patients with commercial insurance. This means there is no difference between the patients with either insurance. The alternate hypothesis states that patients with managed care insurance are paying more than patients with commercial insurance. The 95% confidence level was chosen to calculate hypothesis test, and regression analysis. Based on the hypothesis test, that was conducted to compare the difference between the two different insurances, it is concluded that patients with managed care insurance are paying more charges than the patients with commercial insurance. Hypothesis test...
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...JONA Volume 42, Number 10, pp 461-466 Copyright B 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins THE JOURNAL OF NURSING ADMINISTRATION Nurturing Charge Nurses for Future Leadership Roles Patricia A. Patrician, PhD, RN, FAAN Douglas Oliver, DNP, RN, ACNS-BC, NE-BC Rebecca S. Miltner, PhD, RNC-OB, NEA-BC Charge nurses are untapped leadership resources that can be groomed for future advanced leadership positions in healthcare organizations. The purpose of this study was to understand the development needs for the charge nurse role. This study demonstrates they receive little or no training for assuming positions of leadership and offers suggestions for enhancement of preparation. There is growing evidence of an impending crisis in chief nursing officer (CNO) retention.1 Seventy percent of CNOs report they will change jobs or retire in the future.2 The critical need for succession planning in nursing leadership has been demonstrated, yet two-thirds of CNOs reported that they do not have succession plans in place.3 Proactive planning is clearly needed to prepare the next generation of nursing leaders.4 The 1st step in succession planning is to identify nurses to mentor and develop. Commonly, nurses in management roles are likely candidates for development; however, many organizations do not consider charge nurses candidates for advancement based on the perception of the role as more of a task master than leader.5 Martha Dawson, DNP, RN, FACHE Kathleen A. Ladner,...
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...Lacey Tucker PA203 Unit 3 Medical expenses/billing report Professor Olson August 17, 2014 Medical Service | ChargedTo HMO | Agreedto | % Diff. | $ Diff. | Typical Cost | % Diff. | $ Diff. | | | | | | | | | Office Visit | $ 60.00 | $ 45.00 | 25% | $ 15.00 | $ 47.50 | 20.83% | $ 12.50 | Pain Medication | $120.00 | $100. | 17% | $20 | $85.75 | 28.54% | $34.25 | Plastic Surgery | $15,000 | $15,000 | 0% | $0 | $14,000 | 6.7% | $1000.00 | Physical Therapy | $75.00(per visit) | $55.00 | 27% | $20. | $50.00 | 33.3% | $25.00 | Chiropractor | $ 100.00(Per visit) | $ 70.00 | 30% | $ 30.00 | $ 57.00 | 43% | $ 43.00 | Total Overages Date | Charge Type | Amount Overcharged | | | | 03/01/2002 | Office Visit | $ 15.00 | 03/15/2002 | Office Visit | $ 15.00 | 04/01/2002 | Office Visit | $ 15.00 | 04/15/2002 | Office Visit | $ 15.00 | 05/01/2002 | Office Visit | $ 15.00 | 05/15/2002 | Office Visit | $ 15.00 | 03/01/2002 | Pain Medication | $ 20.00 | 04/01/2002 | Pain Medication | $ 20.00 | 05/01/2002 | Pain Medication | $ 20.00 | 06/01/2002 | Pain Medication | $ 20.00 | 03/01/2002 | Physical Therapy | $ 20.00 | 03/08/2002 | Physical Therapy | $ 20.00 | 03/15/2002 | Physical Therapy | $ 20.00 | 03/22/2002 | Physical Therapy | $20.00 | 03/29/2002 | Physical Therapy | $ 20.00 | 04/07/2002 | Physical Therapy | $ 20.00 | 04/15/2002 | Physical Therapy | $20.00 | 04/22/2002 | Physical Therapy | $ 20.00 | 04/29/2002 | Physical...
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...Attributable Hospital Cost and Length of Stay Associated with Health Care-Associated Infections Caused by Antibiotic-Resistant Gram-Negative Bacteria Patrick D. Mauldin, Cassandra D. Salgado, Ida Solhøj Hansen, Darshana T. Durup and John A. Bosso Antimicrob. Agents Chemother. 2010, 54(1):109. DOI: 10.1128/AAC.01041-09. Published Ahead of Print 19 October 2009. Downloaded from http://aac.asm.org/ on January 1, 2012 by guest Updated information and services can be found at: http://aac.asm.org/content/54/1/109 These include: REFERENCES This article cites 43 articles, 12 of which can be accessed free at: http://aac.asm.org/content/54/1/109#ref-list-1 Receive: RSS Feeds, eTOCs, free email alerts (when new articles cite this article), more» CONTENT ALERTS Information about commercial reprint orders: http://aac.asm.org/site/misc/reprints.xhtml To subscribe to to another ASM Journal go to: http://journals.asm.org/site/subscriptions/ ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Jan. 2010, p. 109–115 0066-4804/10/$12.00 doi:10.1128/AAC.01041-09 Copyright © 2010, American Society for Microbiology. All Rights Reserved. Vol. 54, No. 1 Attributable Hospital Cost and Length of Stay Associated with Health Care-Associated Infections Caused by Antibiotic-Resistant Gram-Negative Bacteria Patrick D. Mauldin,1,2 Cassandra D. Salgado,3 Ida Solhøj Hansen,1 Darshana T. Durup,1 and John A. Bosso1,3* Department of Clinical Pharmacy and Outcome Sciences, South Carolina College of Pharmacy...
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...the patient to sort inpatient hospital admission into one of originally 467 groups. The number grew to about 538 clinically related groups where it classifies similar consumption of hospital resources and the length of stay. This system was adopted by Medicare in 1983 to reimburse hospitals for inpatient admissions. Some hospitals are excluded from this form of reimbursement such as psychiatric hospitals, rehab facilities, long term and cancer hospitals. The CMS administers the DRG system and issues all the guidelines for it. DRG’s are updated on October 1st every year. This includes base rates, wage directories, establishment of new DRG’s and elimination of others. On October 1st, 2007, CMS established a new set of codes known as Medicare Severity Diagnosis Related Groups (MS-DRGs). These codes are more specific and take into account the severity of a patient’s illness and the resources used. As a result, a more suitable reimbursement is issued. There is about 750 MS-DRGs and 538 DRGs. The payment method used by Medicare for hospitals is known as DRG weight of one. Payments are made per admission where the hospital and payor agree on a base rate that is multiplied by DRG weight to determine reimbursement. Length of stay don’t factor in unless there is an outlier case. The Ambulatory Payment Classification (APC) system uses Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) to classify outpatient hospital admissions into clinically related...
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...CENTERS FOR MEDICARE & MEDICAID SERVICES Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare This official government guide has important information about: • What is a Medicare Supplement Insurance (Medigap) policy • What Medigap policies cover • Your rights to buy a Medigap policy • How to buy a Medigap policy This guide can help if you’re thinking about buying a Medigap policy or already have one. 2013 Developed jointly by the Centers for Medicare & Medicaid Services (CMS) and the National Association of Insurance Commissioners (NAIC) How to use this guide There are 2 ways to find the information you need: 1. The “Table of Contents” on pages 3–4 can help you find the sections you need. 2. The “List of Topics” on pages 53–56 lists topics in this guide and the page number of where to find them. Who should read this guide? This guide helps people with Medicare understand “Medicare Supplement Insurance” policies (also called Medigap). A Medigap policy is a type of private insurance that helps you pay for some of the costs that Original Medicare doesn’t cover. Table of Contents Section 1: Medicare Basics 3 5 A brief look at Medicare. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 What is Medicare? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 The different parts of Medicare . . . . . . . . . . . . . . . . . ...
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...Community Hospital is expecting an audit from the Joint Commission in 13 months, and the areas of Information Management, Medication Management, Communication, and Infection Control all need to be addressed before the visit. The purpose of this executive summary is to review and outline the current state of compliance at Nightingale Community Hospital in a specific priority focus area discussed below. Information Management is one of the areas of focus for the Joint Commission visit, and it is being explored in depth in this summary. Here are the Joint Commission Standards in regards to the area of Information Management: IM.02.02.01 : The hospital effectively manages the collection of health information. A: Compliance Status Under the standard IM.02.02.01 in The Joint Commission Edition, there are three elements of performance. One of these states “The hospital follows its list of prohibited abbreviations, acronyms, symbols, and dose designations” (The Joint Commission EDition). While most of these elements of performance are being followed, Nightingale Community Hospital is at 99.6% compliance for unacceptable abbreviations, and needs to strive to reach 100%. From December to January, items that are on the list of unacceptable abbreviations were brought down to 0% in many cases, such as...
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...MD, Siraj Bechich, MD, ´ndez, MD, and Franscesc Rosell, MD, PhD Anna Schembari, PhD, Francesc Ferna OBJECTIVE: The objective of the study was to evaluate the effectiveness of a single home-based educational intervention for patients admitted with heart failure. METHODS: There were 106 patients: 42 in the intervention group and 64 in the control group. Patients were randomly assigned to receive an intervention by nursing staff 1 week after discharge. Primary end points were readmissions, emergency department visits, deaths, costs, and quality of life. RESULTS: During the 24-month follow-up, there were fewer mean emergency department visits in the intervention group than in the control group (.68 vs 2.00; P = .000), fewer unplanned readmissions S14 www.heartandlung.org NOVEMBER/DECEMBER 2010 HEART & LUNG Aguado et al Educational intervention in heart failure patients readmissions, emergency department visits, and deaths. The impact on healthcare costs and quality of life measures is also assessed. MATERIALS AND METHODS Design We previously5 described a randomized clinical trial performed at the Sagrat Cor University Hospital (a 400-bed urban teaching hospital). The trial included patients admitted to the internal medicine and cardiology services between July 2001 and October 2003 with systolic HF according to the Framingham criteria. All patients were in New York Heart Association (NYHA) functional class II to IV and had left ventricular ejection fraction...
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...Recommendations for Leadership Development 11 References 13 Organization Overview CHRISTUS Santa Rosa is a well-known hospital system located in San Antonio, TX. Their key mission is about taking care, in all senses of the phrase, of people. I have selected Claudia Trevino, manager of the Revenue Integrity department, to analyze for the purposes of this document. I chose this leader because she constantly demonstrates strong leadership skills as well as compassion, a very important value to our hospital. I hope, by the end of this, that I will be able to understand, on a deeper level, what it means to truly serve the community, to be a great leader, and how to successfully maintain the work-life balance. Organization Description Since its early beginnings in 1869, founded by the Sisters of Charity of the Incarnate Word, CHRISTUS Santa Rosa has made it their mission "to extend the healing ministry of Jesus Christ," and do so by offering their medical services to communities all over the city. The Sisters, from Galveston, heeded the call from the Catholic bishop of Texas to care for the multitude of sick, infirm, and orphaned in the Texas frontier during a cholera epidemic in San Antonio. When the sisters arrived in San Antonio, the population was only 12,000 and there was no public hospital - until the sisters founded CHRISTUS Santa Rosa Hospital ("About Us", 2015). Santa Rosa...
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...Herzog Memorial Hospital Case Study Group Member: Arifa Akhter Nitol: 260532844 Daniela Campo: 260462469 ShiPeng Chen: 260526665 Zhenzhou Wu: 260496298 Zhenxuan Zhou: 260510679 Question 1 Pareto diagram of the positive comments for all ten categories Question 2 Pareto diagram of the negative comments for all ten categories Question 3 The patients’ comments support the score of HCAHPS. Out of 75 negative comments, 33 of them address the issue of noisiness while only 1 out of 17 positive comments support the statement that area around the room is quiet at night. Therefore, it is evident that the HCAHPS claim on why Herzog Memorial Hospital has low satisfaction is valid. Question 4 1. Facilities: includes all issues caused by: •Room-sharing: Unsatisfied roommates/ Noises of roommates •Design of the room 2. Noise at Night: All noise at night regardless sources of noises. 3. Air Conditioning System: includes all issues caused by uncomfortable room temperature. 4. Dirtiness: includes all issues related to dirtiness that are not caused by water. 5. Labor Issues: includes all issues caused by labor. (E.g. speak too loudly) 6. All Other Issues 7. Water Issues: issues caused by high iron content water Affinity Chart: Numbers are row numbers in Excel Question 5 Category | Frequency | Cumulative Frequency | Cumulative Percentage | Facilities | 42 | 42 | 44% | Noise at Night | 16 | 58 | 60% | Air Conditioning System | 12 | 70 | 73% | Dirtiness...
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...Winterbourne View hospital abuse From Wikipedia, the free encyclopedia The Winterbourne View hospital abuse occurred at Winterbourne View, a private hospital at Hambrook[->0], South Gloucestershire[->1], England, owned and operated by Castlebeck.[1][->2][2]A Panorama[->3] investigation broadcast on television in 2011, exposed the physical[->4] and psychological abuse[->5] suffered by people with learning disabilities[->6] and challenging behaviour[->7] at the hospital.[3] Local social services and the English national regulator (Care Quality Commission[->8]) had received various warnings but the mistreatment continued. One senior nurse[->9] reported his concerns to the management[->10] at Winterbourne View and to CQC, but his complaint was not taken up.[4] The public funded hospital has been shut down as a result of the abuse that took place.[5] Contents [hide[->11]] 1 Abuse[->12] 2 Reaction[->13] 3 Systemic failings[->14] 4 Investigations[->15] 5 Convictions[->16] 6 See also[->17] 7 References[->18] 8 External links[->19] Abuse[edit[->20]] The undercover footage showed staff repeatedly assaulting and harshly restraining patients under chairs. Staff gave patients cold punishment showers, left one outside in near zero temperatures, and poured mouthwash into another's eyes. They pulled patients' hair and forced medication into patients' mouths. Victims were shown screaming and shaking, and one patient...
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...Life Insurance Proposal In the Philippines, insurance products are being offered through Sun Life of Canada (Philippines), Inc., a member of the Sun Life Financial group of companies. In this proposal, you and your refer to the policy owner while we, us, our and the Company refer to Sun Life of Canada (Philippines), Inc. Proposal Information On the life of : Joseph Ryan Lansangan Basic Plan Sun MaxiLink Prime - Non-Smoker Ps Age Last Birthday : 28 (Male) Currency : Philippine Peso Benefit Amount Regular Premium 1,000,000.00 Ps Ps Ps Ps Ps Ps Ps Ps Ps 52,500.00 1,260.00 1,430.00 5,860.00 61,050.00 0.00 61,050.00 15,262.50 0.00 Additional Benefits Total Disability Benefit (Waiver of Premium) - TDB Accidental Death Benefit - ADB Hospital Income Benefit - HIB Class: Standard Ps 1,000,000.00 Ps 2,000.00 /day Total Annual Regular Premium Annual Excess Premium (to be Billed Regularly) Total Annual Premium (to be Billed Regularly) Total Quarterly Premium to be Billed Excess Premium (One-time) Sun MaxiLink Prime is a variable life insurance product until age 88 payable for 10 years*. The living benefit is equal to the fund value, which is partially or fully withdrawable from the policy's share in the separate account(s). The death benefit is the higher of the sum of 200% of the face amount and the fund value or the minimum death benefit. The minimum death benefit is equal to 500% of the regular premium plus 125% of each paid excess premium, if any, less 125% of each partial...
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...Individual Deployed to Entity | Technology > Delivery > GDN for Technology > APAC Delivery Centers > India Delivery Center > H&PS > HPS-HC > Others > HPS-HC-01 | | | | | | | | | | | Specialty | Proficiency | Functional/Technical Specialty | Technical > Packaged Software & Apps > Industry Applications-PRD > Products Industry Applications | Not Assessed | Industry Specialty | Industry > No Industry Specialty | Not Assessed | | | | | | | | | | Office Phone: | Email Address: jithin.ram.nambiar@accenture.com | | | | | | | Profile Summary | | | I hold a B-Tech degree in Electronics and Communication Engineering from Amrita University. I have 42 Months experience in Healthcare IT. Previously worked as an Implementation Consultant with Allscripts and was involved in the implementation and support of the Sunrise Acute care and Ambulatory products. Before joining Allscripts I worked with a Domestic Healthcare Company as Business Analyst and was involved in the implementation of HIS and LIS at various client locations across India. | | | | | | Job Experience | | | Non-Accenture | Client/Company : Allscripts | Project : Eclipsys Sunrise Product Implementation | Project Duration : Jan. 2011 - Nov. 2011 | Standard Role : Business Analyst | | Project & Role Description | | Worked with Allscripts in...
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...Case Summary The patient, a 23-year-old male (date of birth September 30, 1994), presented to the facility’s Emergency Department on February 27, 2018, with a history of schizophrenia, seizure disorder, polysubstance abuse (ETOH, marijuana, heroin and BZDs), opiate intoxication, depression and suicidality. The patient was admitted to the Medical Center on February 27, 2018. The following diagnoses were submitted: Admitting Diagnosis of altered mental status; Principal Diagnosis of seizure disorder; Secondary Diagnoses: enterocolitis due to Clostridium difficile; suicidal ideation; sedative hypnotic or anxiolytic dependence with withdrawal; opioid dependence with withdrawal; other psychoactive substance use unspecified with mood disorder;...
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...HOW TO USE CLASSICAL MANAGEMENT APPROACH IN UTILIZING ACCIDENT &EMERGENCY DEPA RMENT? BY ZAHRA AHMED EBRAHIM Master in Business Administration General Management Organization and Business Management Open Asia e University 2011 Introduction Background of the Study A number of approaches to the structure and management of organizations developed during the late 1800s and early 1900s .The early philosophies are traditionally labelled classical theory while the later approaches include systems theory and contingency theory. The classical approach to organization focuses efficiency through design. Eleanor and Phillip (2009) kept four elements to build classical theory: division and specialization of labour, chain of command, organizational structure, and span of control. The first element emphasised about dividing the work reduces the number of task that lead to proficiency and specialization. The second element is the chain of command which is meant the hierarchy of authority and responsibility within the organization. However, the collaboration between staff and there managers improve the efficiency and productivity of the unit. Moreover, the third element is organizational structure that describes the arrangement of the work group. The design of the Organization is intended to faster the organization survival and success. Finally, the span of control addresses the pragmatic concern of how many employees a manager can effectively supervise. The later approaches...
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