...KOT1 TASK 2 Discuss with Mrs. Zwick’s daughter, based on coverage requirements, which of Mrs. Zwick’s costs will be fully or partially covered. Mrs. Zwick’s has Medicare A, Medicare B, and Medicare D. According to Medicare’s coverage guidelines, her stay in the hospital and the skilled nursing home stay will be covered by Medicare Part A. The walker that she needs will also be covered by Medicare Part A. All of the doctor’s visits in the hospital and the skilled nursing home will be covered by Medicare Part B. All test done in the nursing home or hospital such as lab test, X-rays, etc. will be covered by Medicare Part B. Any physical therapy needed in the skilled nursing home for rehabilitation will be covered by Medicare Part B. All the medications that Mrs. Zwick is going home on and when hospitalized will be covered by Medicare Part D. The urinary tract infection treatment will not be covered by Medicare. It is considered a hospital acquired infection. Hospital acquired infections in Medicare’s eyes are preventable. B. Explain how Medicare policies would affect reimbursement for the additional care Mrs. Zwick needed when she developed a hospital-acquired infection. Discuss the ethical implications of Mrs. Zwick’s incurring costs related to her hospital-acquired condition. The only thing that will not be covered by Medicare is the treatment of her hospital acquired infection. It is considered a preventable condition, so Medicare refuses to pay for...
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...KOT TASK 2 Running head: KOT TASK 2 1 KOT TASK 2 MISTY PLATT WESTERN GOVERNORS Organizational Systems & Quality Leadership KOT1 Mentor: Dr. Vanessa Lee March 25, 2013 KOT TASK 2 KOT TASK 2 SCENERIO #1 The problem that Mrs. Zwick is facing is a problem that many Americans face each year with their healthcare. The immune-compromised patients and elderly patients are victims of 2 hospital acquired infections, all of which can be prevented by following procedures for infection control prevention such as proper hand-washing technique. While being a patient in a skilled nursing home due to mild stroke complications, Mrs. Zwick was diagnosed with a urinary tract infection that was deemed to be a hospital-acquired infection due to non-compliant care with her urinary catheter. Due to this unforeseen infection, Mrs. Zwick’s hospital stay was extended to a total of forty days instead of the expected twenty-one days. Naturally, Mrs. Zwick’s daughter becomes disturbed and concerned as she manages her mother’s medical bills and consults with the nurse and admits that she is unsure of how Medicare will handle the benefits in this situation. In this position, it is the nurse’s obligation to educate Mrs.Zwick and her daughter as well in regards to what they should expect after being discharged from the facility. Medicare Part A, will provide medical coverage for Mrs. Zwick’s hospital and skilled nursing care stays which will also include her laboratory tests, physician consults...
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...Organizational Systems and Quality Leadership[->0] Nursing Leadership Jean Marion WGU For every patient, there is a team of healthcare professionals collaborating to determine the best plan of care for that patient. As a part of that team, nurses have a great opportunity to advocate for the patients and have a positive impact on patient care outcomes. By being a good leader, the nurse can make the patients needs knows, demonstrate exceptional patient care, and motivate and inspire the team to do the same. There are strategies that nurses on an interdisciplinary team use to enable them to exert leadership without occupying a formal leadership position. One strategy is to be a good role model. If the nurse is professional, kind, respectful, honest, and trustworthy, others are more likely to be the same while working with her. If someone in the group is always "goofing off," and being disrespectful, it can disrupt the entire group. The role model nurse will always do what’s in the best interest of the patient. They come to work on time and as scheduled. They are knowledgeable, and participate in continuing education. The other members of the team will respect a good role model and come to her with questions or when needing advice. A good role model will not put others down, or make them feel stupid; she will educate, and mentor. These qualities will make others look to her for leadership. A second strategy is to take responsibility for problems....
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...Healthcare Utilization and Finance WGU Organizational Systems &Quality Leadership KOT1 Lynnell Fulkerson Healthcare Utilization and Finance Medicare A1. Medicare Part A Medicare Part A covers medically necessary services and supplies including hospitalization and skilled nursing facility (SNF) care. Mrs. Zwick spent five inpatient days in the hospital and 40 days in a SNF. Medicare Part A will cover 100% of the first 60 days of Mrs. Zwick’s hospital stay after she pays the $1,184 deductible. Because Mrs. Zwick spent at least three days as an inpatient in the hospital, and assuming that the skilled nursing facility Mrs. Zwick is admitted to is Medicare certified, Medicare Part A will pay for 100% of her first 20 days in SNF (2013 Medicare Costs, 2012). Medicare Part A also covers days 21- 100 in a SNF with a $148 per day co-pay, however, Mrs. Zwick had a hospital-acquired infection (HAI) of the urinary tract and was unable to participate in rehabilitation for 7 days. Medicare will not cover the costs of those 7 days in the SNF because in 2009 the Centers for Medicare & Medicaid Services (CMS) stopped paying for preventable conditions including hospital-acquired urinary tract infections (Paddock, 2007). The skilled nursing facility will not be reimbursed for the cost of care and services for that time. The additional time in the SNF, 13 days, will be covered by Medicare Part A except for the $148 daily...
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