...Quality: An Analysis of Minimum Direct Care Staffing Requirements for Nursing Homes John R. Bowblis Objective. To study the impact of minimum direct care staffing (MDCS) requirements on nurse staffing levels, nurse skill mix, and quality. Data Sources. U.S. nursing home facility data from the Online Survey Certification and Reporting (OSCAR) System merged with MDCS requirements. Study Design. Facility-level outcomes of nurse staffing levels, nurse skill mix, and quality measures are regressed on the level of nurse staffing required by MDCS requirements in the prior year and other controls using fixed effect panel regression. Quality measures are care practices, resident outcomes, and regulatory deficiencies. Data Extraction Method. Analysis used all OSCAR surveys from 1999 to 2004, resulting in 17,552 unique facilities with a total of 94,371 survey observations. Principle Findings. The effect of MDCS requirements varied with reliance of the nursing home on Medicaid. Higher MDCS requirements increase nurse staffing levels, while their effect on nurse skill mix depends on the reliance of the nursing home on Medicaid. MDCS have mixed effects on care practices but are generally associated with improved resident outcomes and meeting regulatory standards. Conclusions. MDCS requirements change staffing levels and skill mix, improve certain aspects of quality, but can also lead to use of care practices associated with lower quality. Key Words. Minimum direct care staffing ratios, quality, nursing homes ...
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...Assignment 1.2: Strategic Questions & Health Care Segments Name: Michael Greene |Seven Strategic Questions | | |Yes or No. Your answer reflects |For “yes” answers, please provide a specific example. | | |your organization’s perspective. | | |1. |Yes |My current organization is a contracted service, therefore, the external environment | | | |influences capital allocation and decision making severely in the manner of labor and | | | |supplies, in particularly. | |2. |Yes |If any of our clients do not like a particular manager, no matter how good we think they| | | |are, my organization must respond to the needs of the ones we service. | |3. |Yes |Unpleasant surprises for my organization typically tends to be in the form of a | | | |cancellation notice. | |4. |Yes |My organization’s...
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...Westmount Nursing Home and Cogeneration sale Town Hall Meeting Supervisor Doug Beaty Supervisor Peter McDevitt Supervisor Mark Westcott 5/1/2014 Opening Remarks We believe the public should have the opportunity to weigh in There are major financial challenges facing the county. Where possible favor privatizing County functions including Westmount. We don t understand why other county run facilities running similar deficits aren t looked at with the same steely gaze taken to Westmount. The Cogeneration plant has hindered the county s ability to attract buyers for Westmount. One potential buyer was not willing to pick up the future co-gen payments to Siemens and dropped out. We want people to know the truth about the Cogeneration plant. Finding a caring operator is every bit as important as the initial sale price. We do not support how this sale process has been handled and the deal terms with the one remaining buyer. We re here tonight to tell you why. Doug Beaty, Peter McDevitt and Mark Westcott Agenda Overall Economics o The State of the Nursing home industry o Westmount Nursing Home o Cogeneration plant Cogen Impact: o How the deal was originally structured o The financial impact to Westmount o The impact on the current sale. Alternatives We will propose other options. Conclusion - what is this really all about? Town Hall meeting Presentation first, questions and comments after. Supervisor Beaty or Westcott will recognize each ...
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...Running head: INDEPENDENT PRACTICE FOR NURSE PRACTITIONERS Analysis of independent practice for Nurse Practitioners in Pennsylvania Jamie Novitski Misericordia University Analysis of the policies of independent practice for Nurse practitioners in Pennsylvania This paper will analyze the policies throughout the United States of independent nurse practitioners. The paper will include the following topics: proposed solutions, background information, political setting and structures involved, stakeholders, value assessment, resources needed to reach intended goals, and power bases involved. Identification and Analysis of the policy Currently in the state of Pennsylvania, nurse practitioners...
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...The corporate entity named Kindred Healthcare was birthed out of the bankruptcy of a company called Vencor. Vencor specialized in nursing homes and became very successful before it plunged into fraud and bankruptcy. Today Kindred boast operating; “hospitals, nursing centers, home health, hospice and non-medical home care locations and a contract rehabilitation services business across the United States” (2014). According to Kindred’s website Kindred has ~ “102,600 employees, 2,787 locations in 47 states, 97 transitional care hospitals, 16 inpatient rehabilitation hospitals, 90 nursing centers, 21 sub-acute units, 664 Kindred at Home-home health, hospice and non-medical home care sites of service, 100 inpatient rehabilitation units (hospital-based) and...
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...Company Introduction: Assured & Associates offers a unique combination of premier home health care and community-based social services to the Atlanta, GA metro area. Market research indicates that there is a significant need for quality home health care and social services within this region and we believe that by employing competent and well-educated staff and providing them with organized and responsive management, we can become the home health care/social service agency of choice in Orlando, FL. Assured & Associates will be created as a Limited Liability Company based in Orange County. owned by its principal investors and principal operators. The initial office will be established in quality office space at 1800 Pembrook Drive in Orlando, FL which is the heart of Orlando. Pembrook Commons is located close to a hospital facility, which will serve as referral bases for our agency. Consumers of our services will be those individuals and families in need of home health care and/or social services. These patients are usually referred by other health care professionals such as physicians, attorneys, insurance companies and health care facilities. Our agency has already developed an excellent reputation with many of these professionals, through the work of our Registered Nurse, who has been providing home health care services for the past twenty years. Our agency must be licensed by the State of Florida and our services reimbursed by Medicare, Medicaid and other private...
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...The Footprint of a Nursing Home Leader Many of us promised our parents that we wouldn't ever put them in a nursing home. Reality is that more than 3 million Americans rely on services provided by nursing homes at some point during a year and 1.4 million of these reside in the Nation’s 15,800 nursing homes on any given day (Bonner, 2013). In my position as Vice President of Operations with a publically traded healthcare company, I support twelve nursing homes. One such nursing home is a 194-bed for-profit Center that provides post-acute, rehabilitative, skilled nursing, and short and long-term care services. This Center is located in Texas approximately 5 miles from the border of Mexico. In an effort to support the Centers’ mission to “Make a Difference – Every Day, Every Time,” there are six key objectives vital to success: 1. Culture: Maintain a productive and positive employee environment. 2. Care: Provide quality care so residents may achieve their optimum level of functioning thus living an improved quality of life. 3. Census: Anticipate community health needs and develop business partnerships that help improve market share. 4. Cash: Ensure timely and effective collections. 5. Cost: Control operation costs. 6. Compliance: Comply with regulatory requirements. Strong leadership is essential for this Center to successfully reach its key objectives. While the leadership at this Center has a history of consistently attaining key objectives...
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...The Impact of the Aging Population on the Health Workforce in the United States: Summary of Key Findings March 2006 This study was funded by the National Center for Health Workforce Analysis Bureau of Health Professions Health Resources and Services Administration Prepared by Center for Health Workforce Studies School of Public Health, University at Albany 7 University Place Rensselaer, NY 12144-3458 Impact of the Aging Population on the Health Workforce in the United States The expected growth of the older adult population1 in the U.S. over the next 50 years will have an unprecedented impact on the U.S. health care system, especially in terms of supply of and demand for health care workers. The supply of health care workers may decrease as they age and large numbers retire and/or reduce their working hours. At the same time, older adults consume a disproportionately large share of American health care services, so demand for health services will grow. The aging of the population will also affect the nature of the skills and services the health care workforce must be equipped to provide, and the settings in which this care is provided. The so-called “baby boom” generation (people born between 1946 and 1964) is already having an effect on the health care system and it is expected to grow as the century progresses. The number of Americans age 65 and older (35 million in 2000) will rise by more than 19 million to 54 million by 2020. From 2000 to 2050, the number of...
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...National Health Reform - Decreased Cost in Medicare and Medicaid: How Does it Impacts Nursing Home Care in New York State by Vina Aileen Bonner HCA 621 Utica College Fixing medical care and health insurance in the United States has been a public policy concern for about a century. Presidents such as Theodore Roosevelt, Harry S. Truman, John F. Kennedy, Richard Nixon, Jimmy Carter and Bill Clinton focused on the National Health Reform, but only President Barack Obama achieved the health care reform. Health care costs are increasing while the access to health care is declining. The occupationally based health insurance system is greatly stressed. Medicare and Medicaid are consuming more of the federal budget. According to the White House’s budget for U.S. Department of Health and Human Services (HHS), President Obama’s proposal would save nearly $360 billion in Medicare and Medicaid over the next 10 years: $56 billion would come through Medicaid reforms. Medicare is a federal health insurance program providing health care benefits to all Americans age 65 and over. Medicare is a significant part of the reason the national debt is soaring out of control. It is an open-ended program for provided for millions of senior citizens and people with disabilities. Medicare is growing faster than Social Security and more expensive in the next 25 years. Nationally, health care experts believe that as much as third of all health care spending – about $800 billion in...
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...Introduction SAMPLE CASE ‐ Instructor has added comments in brackets[] Good Hands Healthcare (GHH), a nursing home provider and a major player in the American healthcare industry, is at a crossroads: the company has been facing financial trouble in recent years and the board must decide whether the current founder and CEO, George Jackson, is fit to revive the company and what can be done to turn the precarious situation around. External Analysis Environmental and industry opportunities for GHH include: • The increasing need for eldercare services due to increasing life expectancies and aging baby boomers • Rapid expansion and increasing consumer preference for assisted living and home health care Environmental and industry threats to GHH include: • Highly regulated and fragmented industry (difficulty in gaining significant market share) • Reduced nursing home use (due to growing availability of alternatives such as home‐delivered eldercare) • Pressure from the government and general public to increase quality of care while reducing expenses • Reduced federal funding and healthcare reform measures (changing regulations and reimbursement cuts) • Increased number of lawsuits and patient care liability costs (leading to reduced liability ...
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...Healthcare Ecosystems LTT2 The challenges which are met in today’s healthcare are vast. It would seem that there are obvious reasons for the incorporation of health informatics to justify apparent flaws in the government programs such as Medicaid, TRICARE and Federal Employees Health Benefits Program are three legislative policies which impede its progress. With most disciplines there exists certain parameters which provide the basic focus for which the disciplines fashion themselves around. In all there are seven elements in the public health sector; http://www.cdc.gov/mmwr/preview/mmwrhtml/su6103a5.htm, and in this scope exist, planning and systems design, data collection, data management and collation analysis, interpretation, dissemination, and finally the application to public health programs. Like most new technologies; robust changes to processes can be delivered, but are met with opposition. Health information technology can defeat a lot of the lethargic processes comprised in healthcare management, but arguably by some as the use of terms such as unintended consequences can slow growth to the field and prospects of health information exchange http://www.amia.org/amia2012/panels. It is believed that while the Electronic Health Record would be composed and stored within secured database systems that there is huge risk which exist; patient privacy, as mandated by the Health Insurance and Portability and Accountability Act (HIPPA). The opposition that...
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...Principles of Healthcare Reimbursement Anne B. Casto, RHIA, CCS Elizabeth Layman, PhD, RHIA, CCS, FAHIMA Copyright ©2006 by the American Health Information Management Association. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, photocopying, recording, or otherwise, without the prior written permission of the publisher. ISBN 1-58426-070-X AHIMA Product No. AB202006 Ken Zielske, Director of Publications Susan Hull, MPH, RHIA, CCS, CCS-P, Technical Reviewer Marcia Loellbach, MS, Project Editor Elizabeth Lund, Assistant Editor Melissa Ulbricht, Editorial/Production Coordinator All information contained within this book, including Web sites and regulatory information, was current and valid as of the date of publication. However, Web page addresses and the information on them may change or disappear at any time and for any number of reasons. The user is encouraged to perform his or her own general Web searches to locate any site addresses listed here that are no longer valid. AHIMA strives to recognize the value of people from every racial and ethnic background as well as all genders, age groups, and sexual orientations by building its membership and leadership resources to reflect the rich diversity of the American population. AHIMA encourages the celebration and promotion of human diversity through education, mentoring, recognition, leadership, and other programs. American...
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...The challenges which are met in today’s healthcare are vast. It would seem that there are obvious reasons for the incorporation of health informatics to justify apparent flaws in the government programs such as Medicaid, TRICARE and Federal Employees Health Benefits Program are three legislative policies which impede its progress. With most disciplines there exists certain parameters which provide the basic focus for which the disciplines fashion themselves around. In all there are seven elements in the public health sector; http://www.cdc.gov/mmwr/preview/mmwrhtml/su6103a5.htm, and in this scope exist, planning and systems design, data collection, data management and collation analysis, interpretation, dissemination, and finally the application to public health programs. Like most new technologies; robust changes to processes can be delivered, but are met with opposition. Health information technology can defeat a lot of the lethargic processes comprised in healthcare management, but arguably by some as the use of terms such as unintended consequences can slow growth to the field and prospects of health information exchange http://www.amia.org/amia2012/panels. It is believed that while the Electronic Health Record would be composed and stored within secured database systems that there is huge risk which exist; patient privacy, as mandated by the Health Insurance and Portability and Accountability Act (HIPPA). The opposition that some have towards health informatics...
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...PREVENTING CATHETER ASSOCIATED URINARY TRACT INFECTION Elizabeth Quartey Abstract According to the CDC estimates in 2002 there were 1.7 million Healthcare-Associated Infections (HAI), and 99,000 HAI- associated deaths in the hospital. The report stated that the four largest categories of HAI, responsible for more than 80% of all reported HAI, are central line-associated bloodstream infections (CLABSI, 14%), ventilator-associated pneumonia (VAP, 15%), surgical site infections (SSI, 22%), and catheter-associated urinary tract infections (CAUTI, 32%). HAI are a great financial costs to health care facilities. The Centers for disease Control and Prevention (CDC) estimates the medical cost of HAI in the U.S. hospitals as $6.65 billion in 2007, and that number has increased to almost $10 billion a year currently. Statement and Significance of the Problem One in 20 patients who are admitted to a hospital will be a victim to an infectious agent they are exposed to during their hospitalization according to the Centers for Disease Control (CDC) (Goodman, Brenda, 201, Hospital-Acquired Infections cost $10 Billion a year). The five most common infections are surgical site infections, infections associated with the use of devices like central lines, catheters, ventilators and clostridium dificile are costing the health care System in the USA almost $10 billion a year to treat. In the article Vitamin D has the potential to reduce the risk of Hospital-Acquired...
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... A. Organization Self Assessment Tool (See Appendix 1 A) 1. Description of practice setting The work environment for the practice of nursing has been known as one of the most demanding throughout all areas of nursing. In general, nurses provide the vast majority of patient- care in hospitals, nursing homes, ambulatory care sites, and other health care settings. Penant Hospital is 200- bed hospital located close to the inner city. We serve mainly people from low socio-economic backgrounds, average age 65years. There is a large migrant population in the area, with demography of blacks, whites and Hispanics. Penant hospital was established almost fifty years ago and is part of a large corporation. We are Joint Commission accredited and have over 400 medical staff. Our dedication to providing quality, compassionate, cost effective healthcare that is responsive to the needs of our patients, physicians and community is firmly established in our mission. We provide many services to our community. These services encompass emergency care, breast care, inpatient hospice care, behavioral health, laboratory services, wound care, orthopedics as well as pain management. Penant Hospital has an administrative team which comprises of Chief Executive Officer (CEO), Chief Medical Officer(CMO), Chief Nursing Officer(CNO), Chief Financial Officer (CFO) , Chief Organizational Officer (COO) and Director of Risk Management. Their job expectations and responsibilities include...
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