1. Question : (TCO 4) Your hospital has just been told that all of your cardiovascular surgeons are transferring their practice to a competitive hospital beginning next year. How would this affect a forecast of volume?
Student Answer: First and foremost, if a hospital is suddenly lost all of its cardiovascular surgeons...heads will roll. However, if there are a major lost of service such as the cardiovascular surgeon...there will be a decrease in the volume due to the lost of services. Thus when the hospital have a reduce in the total volume it will also have a reduce in total cost. If the hospital is operating under statistics budget...in the long run, through the development or discontinuation of certain programs volume may be
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OCE designed to processes claims for all outpatient institutional providers including hospitals that are subject to the Outpatient Prospective Payment System (OPPS) as well as hospitals that are NOT (Non-OPPS). Each OCE results in one of six different dispositions. The dispositions help to ensure that all fiscal intermediaries are following similar procedures. There are four claim-level dispositions: Rejection, Claim must be corrected and resubmitted; denial, claim cannot be resubmitted but can be appealed; return to provider, problems must be corrected and claim resubmitted; and suspension, claim requires further information before it can be processed. There are two line item–level dispositions: rejection, claim is processed but line item is rejected and can be resubmitted later; and denial, claim is processed but line item is rejected and cannot be resubmitted. (Essentials of Health Care Finance, 7th Edition. Jones & Bartlett Publishers p. 26).
4. Question : (TCO 1) How could a hospital legally avoid being covered by the Emergency Medical Treatment and Labor Act (EMTALA)?
Student Answer: The Emergency Medical Treatment and Active Labor Act (EMTALA) passed in 1986 and it requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. It further stated Participating
In 1986, the Emergency Medical Treatment and Labor Act (EMTALA) was enacted. The federal government enacted the law to provide everyone with access to emergency medical care, even for those unable to pay. EMTALA declared that any individual who enters a “qualifying hospital” is entitled to an “appropriate” medical examination to determine if an “emergency medical condition” is present. The individual cannot be “transferred” until the “emergency medical condition” is “stabilized.” Only if the individual cannot be “stabilized,” an “appropriate transfer” may be performed. Hospitals must accept
One of our branch goals for DBR 2017 deliveries is to maintain procedures inventory and perform annual audit. I wanted you to review procedures of the desk that you are working on. You are required to perform this task quarterly. Below are dates that our procedures are assigned to your names.
The entire hospital holds a total of 90 beds, 5 operating rooms, 6 examination rooms, and a laboratory. Despite the size of the hospital, they average 150 operations per week and 7000 to 7500 operations annually. Also, it is important to note that there are only 12 full-time surgeons and 7 assistant part-time surgeons that handle all operations in 5 day a week period. The last thing to take into consideration is that each patient stays 3 days out of a week starting the day they arrive. Although Shouldice’s operations seems to be functioning just fine, there is a debate of effectiveness of whether or not they are fully utilizing their full potential in relation to surgeries performed and beds being
Today, MSC visited Maria at her residence for a face to face visit. When MSC walked in Maria was having a snack at the table. Maria waved and greeted her staff. MSC said, Hello, How are you?" She stated that she needs to talk to MSC in private after she finishes her food. MSC spoke wither Medical Direct Care Counselor Marie Rose. She stated that Maria has been doing good. He is cooperative at times, but requires redirection. Maria stated that she is medically stable and her behavior has improved over the past few months. She is communicates her wants and needs effectively. Maris continues to go to all of her medical appointments and enjoys attending program. Maria goes on all community inclusions and makes suggestions on places she would like to go. She struggles with balancing money, staff continues to assist her in budgeting.
A medical office needs to be compliant with employment laws; this will ensure they do not have lawsuits that could patiently put a company out of business. This also helps the offices run smoothly and free from errors. There are several employment laws a few of them are the American with Disabilities Act (ADA), the Employee Retirement Income Security Act (ERISA) and the Health Insurance Portability and Accountability Act (HIPAA). The American with Disabilities (ADA) is when an employer is to provide reasonable accommodation to an employee with a known mental or physical limitation, or a qualified individual with a
The Emergency Medical Treatment and Active Labor Act (EMTALA) was enacted in 1986 as a part of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985. EMTALA was enacted to prevent hospitals with Emergency Departments from refusing to treat or transferring patients with emergency medical conditions (EMC) due to an inability to pay for their services. This act also applies to satellite locations whom advertise titles such as “Immediate Care” or “Urgent Care,” and all other facilities where one-third of their patient intake are walk-ins. Several rules and regulations to this act have been established and it has become a very serious piece of legislation and health
ting a safety net to ensure that care that falls below the standard can be identified and improved or relevant held responsible. It also creates a responsibility (both personal and institutional) to ensure that care providers can be held responsible for their care and therefore creating incentive to provide good care.
In the following table, describe each of your choices and explain their functions and roles within the health care field. Your responses should total at least 50–75 words for each choice.
SUPPORTING INFECTION AND PREVENTION AND CONTROL ON SOCIAL CARE ASSESSMENT CRITERIA 1. Explain how infection prevention policies and guidelines can be applied in own working settings Infection prevention policies and guidelines can be applied by • Providing information that is recent on how to prevent infections. Training staff regularly and making regular supervision relating to health and infection. • Providing the right equipment at all time for staff and service users can go a long way to prevent infection. Also making sure the proper sterilizing of scissors, urine bottles……… • Proper disposal of material used for service users.
Another issue is immigrants using emergency care instead of preventative care. The Federal Emergency Medical Treatment & Active Labor Act (EMTALA) states that hospitals with emergency rooms
As you begin to get older your muscles within your digestive tract can start to become really weak and would possibly start giving you the risk of having a lot of constipation. Also as you get older your heart is beginning to get less efficient and would not be able to pump the blood around your body like what it used to have done. Also the other things that could happen to your organs as you begin to get older are
One in particular states, “The hospital is professionally and ethically responsible for providing care, treatment, and services within its capability and law and regulations (Showalter,2013).” Patients may not always have the funds to be treated when their insurance coverage is not available. It would be up to the facility to decide how they are going to continue care in these situations. They have policies on the destruction of medical records. Another policy includes they must comply with the standards of emergency care. Also, that patients have access to interpreter services to include the most common languages used in the healthcare facility. These standards of care are updated all of the time by healthcare experts, nurses, staff, to ensure the most updated
The ethical right for individuals to have access to health care already has a form of legal binding within the United States as seen in the Emergency Medical Treatment and Active Labor Act. “In 1986, Congress passed the Emergency Medical Treatment and Active Labor Act (EMTALA), which forbids Medicare-participating hospitals from “dumping” patients out of emergency departments” (Pozgar, 2010, p. 221). The act provides that:
Their existing system and reputation have already set them apart as a market leader and has proven to be a profitable setup. However, there is still an unmet demand. Option 1 to add 50% more beds may not be beneficial if we don't also increase operation. Increasing the number of bed by 50% would not be advisable unless they would add more surgeons and operating rooms because the existing operating
In the care home for adults there are different principle in health and social care practise which we applies irrespective of gender, race, disability, age, sexual orientation, religion, belief.