...licensing long-term care facilities to ensure compliance of laws and regulations. Regulatory agencies also receive and investigate complaints that are related to the facility and the services in which the facility provides (Walsh, 2014). All long-term care facilities are expected to abide by these regulations in an effort to ensure long-term care patients proper care, ethical treatment, safe living environments, and health care reimbursement. These agencies expect long-term care facilities to maintain an environment that will emphasize the importance of one’s quality of life and quality of care (Walsh, 2014). This paper will discuss three regulatory agencies including the Centers for Medicare and Medicaid Services, the Department of Licensing and Regulatory Affairs, and the Administration on Aging/Long-Term Care Ombudsmen Program, which have made huge impacts on the way long-term care is delivered in the United States. Centers for Medicare and Medicaid Services The Centers for Medicare and Medicaid Services (CMS) has become a staple among regulating long-term care facility practices. The CMS produces and maintains federal regulations for long-term care facilities that choose to accept residents that rely on Medicare and Medicaid benefits as a form of payment (Long-Term Care Facilities, 1989). Local licensing agencies are responsible for surveying, licensing, and inspecting the long-term care facilities to ensure that they are compliant with the regulations of the CMS...
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...Health Care Fremgen (2009) defines medical laws or actions set by the federal government and the court system that have binding legal force that address legal rights and obligations affecting patients and protecting the individual rights of patients and health care employees. 50 state have statutes for medical practice acts which apply to precisely to the way that medicine is practiced in a particular state. Laws begin as act acts which define the meaning of “practice of medicine” and set the requirements and procedures for licensure. Medical practice acts also establish what can be considered as unprofessional conduct in particular states. Examples of unprofessional conduct include practicing medicine without a license, practicing healthcare or the inability to practice health care while under addiction or mental illness, felony convictions, insufficient record keeping, employing unlicensed persons to practice medicine, and prescribing drugs in excessive amounts. We currently live in a litigious society. Medical providers must balance providing quality and keeping abreast with current health care regulations to protect themselves from health care law suits (Fremgen, 2009). Laws are enforceable rules set by a government authority. An article related to a regulatory issue in health care will be analyzed to reflect how laws affect the regulatory process in health care. The Four Categories of Law Laws fall into different categories which include constitutional law, statutory...
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...Running head: HEALTH CARE LAWS, POLICIES, AND REGULATIONS Health Care Laws, Policies, and Regulations Frank Frimpong Manso HCS 545 July 4, 2016, 2016 Prof Elam Health Care Laws, Policies, and Regulations Health Law, Regulation, and Policy has become the means of health protection and prevention for the American people. The government highly regulates these laws improving the health of the public by developing programs, resources, and tools, aiding in health care access, however, there are also different private bodies involved in regulating the healthcare sector. Health care regulation is focused on three main roles; cost control, quality control, and access expansion and control. This paper will discuss the impact of ACA on health care organizational policies. The Affordable Care Act (ACA) The Affordable Care Act (ACA) is a health care regulation signed into law on the 23rd of March, 2010. The law’s main focus had been to increase the affordability and quality of American health insurance. Its policies were focused on lowering the rates imposed on the uninsured through the expansion of both the private and public insurance covers. It had also aimed to reduce the health care costs incurred by the government along with citizens. Barely seven days after its enforcement had a new health care law come into effect with amendments to the ACA. On March 30, 2010, the president of the United States signed into law the Healthcare and Education Reconciliation Act of 2010. The law had been enacted...
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...titled A good look back over our shoulders Nursing Homes & Long Term Care Management: discussion of the evolution of nursing homes in the United States; what features "shocked" or "surprised" the reader the most during the reading while reading the reader was asked what new information was learned about long term care and facilities in the United States? This assignment also discusses wither regulatory bodies are believed to justified in their formulating so many strict rules and regulations in governing long term care? To close the assignment we answered, how does the past of long term care inform the future of quality assurance in long term care settings? Discuss the evolution of nursing homes in the United States. What features "shocked" or "surprised" you the most? What new information did you learn about long term care and facilities in the United States? Are regulatory bodies justified in their formulating so many strict rules and regulations? How does the past of long term care inform the future of quality assurance in long term care settings? In the twenty-first century, nursing homes have become a standard form of care for the most aged and incapacitated persons. However, historically nursing homes were often thought of dark drab places that Americas would send their elderly when they have determined there was no further use for them in society or when the families have exhausted all means to care for them on their own. They have also been unfortunate victims...
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...Research any four specific regulations related to long-term care and summarize them. 1. OSHA (Occupational Safety and Health Administration): Sets, regulates, and enforces the level of safety and health conditions in work place (Brown, 2017). 2. OBRA (Omnibus Budget Reconciliation Act): Sets the level that every nursing facility must achieve and maintain in the following areas; The rights of the patient, meeting and surpassing adequate levels of care, providing adequate employees to patient ratios, ensuring the patient’s needs are adequately met by the facility, adequate housing environment, regulation of compliance via survey participation, and enforcement of said regulations (Brown, 2017). 3. Equal Employment Opportunity Commission (EEOC):...
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...The Beginning There have been new trends affecting today’s payment methods for long term healthcare services which is making the United States Health Care system ever more complicated. Long term health care today is considered a reimbursement driven industry (Casto, 2006) . The term reimbursement refers to repayment or compensation of health care services (Bowman, 2007). Reimbursement is the process of being repaid for services that have already been given (Casto, 2006). In long term care, services are often provided prior to payment being made. Since patients have already received treatment, the facility, practitioners, and their staff seek reimbursement to cover those expenses such as medications, procedures, and supplies (Bowman, 2007). Generally a physician, health care organization, or practitioner will submit an itemization of services, products, equipment, and supplies that have been rendered (Casto, 2006). This is known as a claim (Casto, 2006). The claim lists the fundamental characteristics of reimbursement such as fees and charges (Casto, 2006). These claims are reimbursed by one of two ways. An institution can be paid by a fixed amount called capitation (Casto, 2006). A capitated amount is what is paid regardless of the number or costs of health care services provided (Bowman, 2007). This often gives providers incentive to lower costs and to focus more on preventive care (Bowman, 2007). Fee for Service is another method of reimbursement. This is paid...
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...Unavailable Health Care: A Nurse’s Problem In the year 2000, it was reported that 44% of residents were abused and 95% were neglected and also witnessed someone else being neglected. According to the National Center on Elder Abuse, elder abuse is common is in community settings such as nursing homes. These numbers are part of many reasons why others do not receive the proper health care that is needed. Not only is it absurd for these statistics to be high, but it also is absurd for these two statistics to be within the healthcare profession. With the baby booming population being at an all-time high, many of them turn to long-term living facilities. Being that nurses are more hands on with patients in any facility, but more importantly, being more involved with older patients in LTCF (long-term care facilities), it is crucial that we examine the reasoning behind these numbers. This is a representation of the lack of passion, integrity, and proper education regarding the profession of nursing. With the exception of not having anyone else to care for them full time, residents have no choice in how much they may depend on a nurse. Due to things such as chronic illnesses, mental disorders, and psychological deformities, the residents of rehabilitation centers and long term care facilities instills trust with the nurses. The humility of the resident leaves their vulnerability levels to be heightened in the nursing and resident relationship. Vulnerability within the resident opens...
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...Examining Government Regulations for the Elderly HSM/210 November 8, 2013 Examining Government Regulations for the Elderly In order for any organization to run properly there must be regulations and laws in place. The Human Services Department of any state must adhere to strict guidelines provided by the federal government because if these rules are not followed there would not be enough resources to help every individual that desperately needs it. Therefore, in order to prevent to rise of elder abuse as our aging population continues to grow by the thousands each day, there must be some changes made to our existing social policies in order for these people to have their needs met. With this said, my target population in week two was the elderly population. With the ever growing number of people reaching retirement age each year since 2011 when the generation known as the Baby Boomers started to retire at the rate of almost 10,000 per day, many of these elderly people must rely on the services provided by their local human services organizations. In the state of Missouri alone, where I live, Missouri’s elderly population, which is defined by those age 65 and older, is expected to rise significantly over the next several years, from less than 15 percent of the state population in the year 2000 to over 20 percent of the population by the year 2030 (Missouri Senior Report, 2013). However, the needs of the elderly population vary greatly because the youngest...
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...challenge in long-term care in regards to ergonomics is the human factor. Since humans are the main facilitators of providing care to the residents of long-term care facilities. The way they accomplish their jobs is a very important entity to the success of these facilities. This main challenge is manual lifting and of moving patients which can lead to other problems including lumbar problems and musculoskeletal disease. Over the years these injuries have cost healthcare industry billions per year in worker’s compensation claims and high turnovers of caregivers leaving the profession and finding jobs elsewhere causing a shortage. It have also caused the quality of care to decrease as caregivers are given these burdensome tasks to perform you find residents waiting for a long time without assistance, causing injuries to both residents and employees. With high turnover ratios, the word will spread about the facility not being adequately staffed at all times, therefore limiting the amount of patients transferring or enrolling into a facility. This could then raise the cost of care at that given facility to accommodate the charges accrued to operate the facility. This could also ultimately cause the facility to be placed out of compliance with the state and being forced to meet state guidelines and adhere to state regulations or be forced to shut down the facility; hence forcing all patients into other facilities that might not offer adequate care. The governance of long term- care facilities...
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...geographic borders as long as the laws do not obstruct the rights of individuals guaranteed by the constitution. The federal government regulates health matters through the powers granted to the federal government in the federal constitution. This allows the federal government to create benefit programs and to indirectly regulate local activities that it would not have the authority to regulate directly. For example, the federal government created the Medicare program to pay for health care for the elderly and disabled, and Medicaid to pay for health care for the poor. Health care institutions that receive federal money in payment for services to Medicare and Medicaid recipients have to abide by federal regulations in order to keep receiving federal funds. According to Pozgar (2012), “a tort law is a civil wrong, other than a breach of contract, committed against a person or property for which a court provides a remedy in the form of an action for damages”. Within the general field of health care there is a good deal of discussion of tort law and health care because tort actions comprise what are more commonly known as medical malpractice or medical negligence actions. A medical malpractice or medical negligence suit can be raised against a physician or health care provider accused of having violated some standard of care that is recognized in the medical industry. A standard of care is simply a minimum threshold level of expertise that the health care provider is expected...
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...LONG TERM INVESTMENT DECISION BY A COMPANY The producers of low calorie microwavable food have been expecting a change in price and they want to choose the price strategy which would make their product less elastic and responsive to changes in the prices, then the company should make careful analysis of the entire market situation. The company should look for the substitute goods in the market and their pricing strategy. Higher the number of substitutes are available, higher will be the chance of rise in elasticity of our low calorie microwavable food. The buyers should not have many options to buy from the market. However, if there are only few substitutes available, then the producers may keep the price high in the market of their product. It is also determined by the market power of the producer. Market power is determined by the elasticity of demand of the product. The firm can set higher mark-up over their marginal cost if they know that customers will not shift to another product in case of price increase. Hence, the firm or the producer should consider the cross price elasticity of demand of their product. Another factor to be considered while setting up prices of their product in the market is that of government policies in the economy. Fiscal policy would determine the taxes and other components of aggregate demand. If the firms have set higher taxes, then people would have less disposable income available with them and they would like to spend less on such less calorie...
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...Horner; Tobia; Wood | Motor Vehicle Personal Injury Protection Insurance: Revises conditions for completing long-form traffic crash report; provides that certain entities exempt from licensure as health care clinic must nonetheless be licensed in order to receive reimbursement for provision of PIP benefits; requires that application for licensure, or exemption from licensure, as health care clinic include statement regarding insurance fraud; specifies additional unfair claim settlement practice; authorizes Division of Insurance Fraud of DFS to establish direct-support organization for purpose of prosecuting, investigating, & preventing motor vehicle insurance fraud; specifies effects of Florida Motor Vehicle No-Fault Law. | Effective Date: July 1, 2012 | Last Event: Chapter No. 2012-197; companion bill(s) passed, see CS/CS/HB 1101 (Ch. 2012-151) on Sunday, May 06, 2012 8:42 PM | Date Available for Final Passage: Tuesday, March 13, 2012 6:19 PMhttp://www.myfloridahouse.gov/Sections/Bills/billsdetail.aspx?BillId=47180 | 1. State the administrative agency which controls the regulation. Explain why this agency and your proposed regulation interest you (briefly). Will this proposed regulation affect you or the business in which you are working? If so, how? Submit a copy of the proposed regulation along with your responses to these five questions. The proposed regulation can be submitted as either a separate Word document (.doc) or Adobe file (.pdf). This means you will submit...
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...throughout industries, and yet, it may be particularly crucial for health care companies. Adjustments in law, such as the Patient Protection and Affordable Care Act (ACA), have reshaped the economics and regulations that surround these companies and the industry as a whole. In order to implement the changes these laws require, health care companies have to evaluate their efficiency of care, and how that may affect their profit margins and sustainability over time. Risk and quality management strategies are popular in most industries, and perhaps especially so in health care companies. Patients filing lawsuits for malpractice, over-occupied beds and other limitations force these corporations and organizations to have real-time accountability for their workers, and a means for determining their patients’ level of satisfaction. As the factors, laws and issues fluctuate within the health care industry, risk and quality management analyses have to become that much more nuanced. Baxter Medical is one of the foremost leaders within the health care industry, producing pharmaceuticals and various medical products for patients and health care organizations. Since their pharmaceutical division represents a significant portion of their sales, and core competencies, they need to be particularly vigilant in keeping up with risk and quality management strategies. Combatting financial issues and keeping abreast with regulation developments requires a close relationship between risk and quality...
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...populations. The Medicaid program was introduced into law in nineteen sixty five, which is known as the Social Security Amendments Act. Before this law was passed, health care services for the under privileged were provided through several programs sponsored by the state and local governments, charities and community hospitals (Briggs, 2013). In the first program medical providers received payments, for medical services from the state on behalf of individuals who were receiving public assistance. The medical assistance program for the aged was created in nineteen sixty. This program was designed to help elderly individuals who didn’t qualify for public assistance, but was in need of assistance with medical expenses. The Medicaid program provides three types of medical protection coverage which include health insurance for low income families with children, and individuals with disabilities. Also offers long-term care for older American’s along with individuals who are considered disabled. The last coverage that was offered was a supplemental coverage for low-income Medicare beneficiaries whose services were not covered under their current plan like outpatient treatments, and prescription drugs (Briggs, 2013). Medicaid is a joint federal and state program. Every state establishes its own eligibility requirements, payments, benefits packages, and program administration under board federal guidelines. Hopefully with the Affordable Care Act of 2010 going into effect more American’s...
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...Long Term Care: A Directional Strategies Report for Interim Healthcare, Inc. Group 6: Jessica Aho, Roger Brenz, Dale Bunton, Kadigah Chess MHA5010 Strategic Health Care Planning Instructor: Matthew Brooks Abstract This document will explore the directional strategies of Interim HealthCare Inc., a long term care facility located in Sunrise, Florida. Our team will analyze the existing stated directional strategies (mission, vision, values, and ethics statement) given by Interim HealthCare and then will offer suggestions of improvement to ensure a foundation necessary for the current strategies of the organization. Long Term Care: A Directional Strategies Report for Interim Healthcare, Inc. Introduction Interim HealthCare, based in Sunrise, Florida, was founded in 1966 and is currently the nation’s oldest proprietary national organization. There are over 300 independently own franchises which employ more than 75,000 health care workers that services approximately 50,000 people daily. Interim HealthCare offers both home care and home health care services to a variety of settings including hospitals, nursing homes, physician offices, prisons, schools, and clinics. In addition, Interim HealthCare also offers hospice services for terminally ill patients in their last months of life to provide the highest degree of comfort and dignity possible using state-of-the-art symptom management for quality care. With the growing need for qualified supplemental health care staff...
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