Compliances: The First Noncompliance Act

Committing medical coding fraud or abuse is extremely detrimental to the healthcare industry. They both lead to higher healthcare costs and an increase in the cost needed for medical coverage. In addition, the increasing discovers of these acts are putting a very negative light on healthcare workers, including those who are not committing either act. With the medical world being so complex we often instill and great amount of trust in the persons taking care of medical billing and coding, this trust also makes committing fraud and abuse easier for dishonest people to take advantage of.

The plaintiff in Ard v. East Jefferson General Hospital, stated on 20 May, she had rang the nurses station to inform the nursing staff that her husband was experiencing symptoms of nausea, pain, and shortness of breathe. After ringing the call button for several times her spouse received his medication. Mrs. Ard noticed that her husband continued to have difficulty breathing and ringing from side to side, the patient spouse rang the nursing station for approximately an hour and twenty-five minutes until the defendant (Ms. Florscheim) enter the room and initiated a code blue, which Mr. Ard didn’t recover. The expert witness testified that the defendant failed to provide the standard of care concerning the decease and should have read the physician’s progress notes stating patient is high risk upon assessment and observation. The defendant testified she checked on the patient but no documentation was noted. The defendant expert witness disagrees with breech of duty, which upon cross-examination the expert witness agrees with the breech of duty. The district judge, upon judgment, the defendant failed to provide the standard of care (Pozgar, 2012, p. 215-216) and award the plaintiff for damages from $50,000 to $150,000 (Pozgar, 2012, p. 242).

This duty was then breached. Either care was not administered, or it was ministered improperly. The quality of the care is established through the testimony of expert testimony from other doctors.

B) According to the “ Journal of Medical Ethics” it may not be that simple to assist with

The Enforcement Act of 1871 (Civil Rights Act of 1871) it ties into why the Title 42 U.S.C Section 1983 was preformed, it was also known as the Ku Klux Klan Act. The purpose of the 42 U.S.C Section 1983 was to provide a civil remedy against abuse and cruel punishment they were receiving from the Ku Klux Klan on the southern states. The laws protected all the citizens of the U.S. Regardless of the color of their skin. Deliberate indifference is the prevailing standard for establishing a variety of civil rights claims in the jail or prison context. At first these rights were only implied for for people with medical care, then was required for all people. The Farmer vs. Brennan case was argued from January 12, 1994 until June 6, 1994, about petitioners

‘The providers had failed in its legal duty to notify the Care Quality Commission of serious incidents including injuries to patients or occasions when they had gone missing.’

Sule stated that, “The Patient Bill of Right adopted by American Hospitals Association states that ‘a patient possesses the right to be informed of the medical consequences of his or her actions and decisions and refuse treatment to the extent permitted by the law’. However, this is true only if the patient is in position to understand the consequences of his treatment. Incompetent, senile patients neither have the correct judgment regarding which treatment is appropriate for them, nor are they in a state of understanding the implications of their treatment. In such case, their willingness to grant or deny consent cannot dictate the course of treatment.” Problem with the Act is being able to find that the patient component enough to make such a call. Another issue that Sule stated was on confidentiality and autonomy. According to Sule, “This is another ethical issue erupting from the conflict of patient's rights and professional ethics in nursing job and profession. The Patient Bill of Right makes it mandatory for the medical practitioners to reveal the form and extent of the ailment along with the course of treatment to be undertaken by the practitioners. However, this law of autonomy clashes with the nursing ethic that the professional should maintain high degree of confidentiality regarding the patient's health and treatment.” This can cause conflicting issues in the NP’s

There has been recent changes in the felon disenfranchisement laws which can be credited to the President Obama’s administration. Starting with the passing of the Fair Sentencing Act in 2010 which reduces the sentence gap between cocaine and crack cocaine. Fast forwarding in 2015 a bipartisan criminal justice reform bill passed called the Sentencing Reform And Correction Acts Of 2015. This law reduce mandatory minimum sentence for non-violent offenders, the bill also made sure that the Fair Sentencing Act Of 2010 was made to retroactive for prior offenders who were sentence before the law passed. The newly passed bill Provide intensive recidivism programs for incarcerated prisoners to earn credit to be released early into a residential halfway

In Joint Commission, the stated out the standards needed for an organization to be compliance with patient care and safety criterion for accreditation. In Nightingale Community Hospital, some of this policies and procedures are not rightly observed in all the units, example is the policy that clearly stated that verbal orders has to be verified within 48 hours is not being practiced in many units. Above all, the second quarter compliance was steady and of all quarters rated the best, but the compliance result for the third quarter were quite poor. Most of the policy needs revision and the standard needs improvement in other for the hospital to be in compliance. One of the policies that need to be implemented is the form the nurse that collects the order, the form has to signed, dated and placed outside of the patient's chart, bringing it to the knowledge of the physician that an action is requested from him in regards to the patient.

As a result, nurses were running behind trying to get their regular and stat blood work, assessments, vitals and charting done on time. Hence, it was unfair to the patient as well as a nurse taking care of the patient. If he was given lorazepam as ordered, he would not have gone to DT and this would not have created any unnecessary stress on the nurses, doctors and patient care techs. This clinical case is related to the emancipatory knowledge. Emancipatory knowing is the ability to identify social and political problems of injustice and adds all the elements of experience and context to change a situation (Chinn, 2010, p. 63). As soon as charge nurse noticed that the patient had a change of status and tachycardia, she looked at the doctor’s note, assessment data and MAR to figure out what was wrong with this picture and what needs to change. Also, she found out that the nurse who had this patient during the day had all higher acuity level patient along with 1 code patient. In addition to this, patient was assigned to the room far from nurses’ station. Also, charge nurse immediately called hospitalists as soon as patient had a change of

a. The LPN was engaged in caring for the emergency transport patient along with the RN and was also in the process of discharging the other two patients. 3. Why did the LPN not notify the RN of the alarm and reading? a. With the information provided, it appears that the LPN was distracted as well as did not follow her scope of practice.

In the health care system there are many laws and regulations that are put into place to protect the patients that use the health care system as well as the facilities and insurance companies. Unfortunately in some cases physicians, facilities and employees break these laws and cause a critical problem in the system. In the case of Park Ridge Hospital and Adventist Health Systems, Park Ridge Hospital was found guilty of insurance fraud and over charging patients. These fraudulent charges and procedures not only cost the patients money but also have a huge impact on health care all together.

Patient compliance is a complex ethical dilemma that has plagued health care for years. The issue of patient noncompliance needs to be addressed in the context of the changing reimbursement landscape. According to Chesanow (2014) compliance and issues surrounding compliance have been extensively studied. I find it interesting to note that despite the abundance of studies, non-compliance has grown significantly over the years.

The Civil Rights Act of 1964 has helped in the transition to bring it to a state of equilibrium. However this created a significant amount of hostility in the workplace. The friends of the white males who were passed over for position began to despise the minority or woman who was hired. The little things that could legally be done in retaliation were done. The weapons used to discourage the instigators of change were things like additional work forcing the new employee to work nights and weekends or being looked over for public praise. Over time, the petty knee jerk reactions began to dissipate. However the distain for the invaders had not gone away it has only changed it outward appearance. The use of education verses experience has created a legal loophole allowing companies to hire who they want and reject other qualified employee who simply have not been given the opportunity to prove themselves.

Combat compliance is framed as an analytic puzzle related to the variability of behavior, or responses of combatants, both individuals and as a collective, to the realities and risks of warfare. The underlying assumption here is that there is an intrinsic risk of death in any scenario of combat (Magagna, 2016). The enemy is always rationally assumed to have an interest in your death. What follows is that obeying of commands presents itself as an implicit acceptance of such risks. The puzzle here is figuring out how and why vastly differing reactions occur. At some points soldiers show limited levels of compliance, sometimes even ending up in mutiny, while in other cases units show extremely high levels of compliance, exhibiting tenacity under conditions of overwhelming odds (Magagna, 2016). This essay attempts to explain the factors that give rise to the variability of combat compliance. What is important, as alluded to earlier, is to be able to provide a generalizable argument that is applicable across time and space. The essay will first lay out of varying levels of combat compliance to discuss the characteristics and consequences of variability. Secondly, it will explore and contrast the factors of automaticity as a function of training and institutional design and the factor of the combat contract as a rational cost benefit analysis of material and moral incentives, in an attempt to critically analyze their merits in accounting for the variability of combat compliance.