Legal Aspects of U. S. Health Care System Administration Lillie Cox Dr. A. M. Miller HSA 515 Health Care Policy, Law, and Ethics October 31, 2014 Legal Aspects of U. S. Health Care System Administration In the United States health care administration, there are lots of health laws, such as federal, state and local. The administrator will need to know these laws, because they will be interacting with top professionals at all levels. The health administrator is new to Well Care Hospital, and the hospital for the past six months has been under scrutiny for breach of medical compliance. It is important that the top administrator be concerned about the importance of his or her conduct within …show more content…
In the administration of medical services in the United States law and regulation now control much of professional life. (p. 586) Well Care Hospital professional’s duty is to be committed to the care of all patients and make improvements within the life of the patient. According to the National Ethics Committee of the Veterans Health Administration (2003), “Professionals are required to make a fiduciary commitment to place their clients’ interests ahead of their own. Patients should be able to trust that their interests and welfare will be place above those of the health care profession” (p.2) Negligence happens when a “person’s actions fall below a certain level of care. Negligence can involve doing something carelessly or failing to do something that should have been done.” (Fremgen, 2009, p. 35). In order to prove negligence the plaintiff must present the following elements: 1) duty to care, 2) breach of duty to care, 3) injury and 4) causation (Pozgar, 2012, p. 33). Duty to care is the first element which deals with the care that the defendant (physician) owes the plaintiff (the patient). If there are an emergency, the physician is obligated to treat the patient, but they are not obligated to treat everyone. If the
Negligence is the failure to do something. Many medical cases are filed as medical malpractice suits, “medical malpractice is professional misconduct. Malpractice differs from negligence because it is performed by a license medical professional” (Flight 2). The case of Horton V. Niagara Falls Memorial Medical Center can be used as a primary example where negligence, “failure to take reasonable precautions to protect others from the risk of harm” (Flight 33), is visible.
Administrative law usually deals with the in house laws such as HIPPA, HITECH, and other ethical laws. When working as a medical biller and coder you should follow all of the laws and regulations that deal with how you do your job. HIPPA is an example of administrative law. You as a biller or coder should never release any personal or medical information pertaining to a patient; always keep it safe from others that do not have authorization to the information. If you should disclose any of this information, than you could be reprimanded, fired from your job or even fined for the breach of information.
Healthcare professionals have an ethical obligation to respect patient’s wishes. Consequently, many legal and ethical dilemmas arise in healthcare in response to clinical decisions related to the needs, beliefs, and preferences of patients and families. Other dilemmas result over concerns about the integrity, competence, or actions of other healthcare professionals. Preserving human dignity, relieving suffering, equality, integrity, and accountability are essential nursing values (Kangasniemi, Pakkanen, & Korhonen, 2015). Nurse leaders have an
In this paper I will be discussing how as a new office manager what factor pertaining to health care information need to be considered. Some of these factors are legislation, organization structure and flow of information, billing, accrediting bodies, standards, monitoring and assessing practice to HIPAA.
They need to know the fundamental lawful and moral doctrines that will manipulate the hospital atmosphere; the lawful affiliation of the patient and the health organization (Niles, 2014). The demands of the health care administrator include “The basics concepts of law, both civil and criminal healthcare law, tort reform, employment-related legislation, safety in the workplace, the legal relationship between the provider and the patient” (Niles, 2014, p. 285). Accreditation and Legal process put much demand on the health care administrator because the health care administrator needs to understand the translate law; criminal and civil and what it means in the workplace (Niles, 2014). When making decisions the health care administrator needs to work in compliance with mandates or else any violation could result in a lawsuit or loss of accreditation (Niles, 2014). When it comes to the Joint
“Running a health care organization is a team sport. It is very important that all members of the team-whether on the medical staff, in management or on the board-understand the role of governance and what constitutes effective governance” (Arnwine, 2002). Running a hospital is a difficult task. Several factors need to be seriously thought of and considered in every decision and undertaking. Unfortunately, all the three important factors in governing a hospital is not always in harmony. As likened to a team sport, if the three major components are not working with each other as a team, there will be tension and a great divide will be experienced. And often times, the patients will be in the middle and will be greatly impacted. This writer believes that there are several factors that contribute to the tension that usually exists among the medical staff, the board and administration. One factor is the disconnect, where each entity is not seeing each other eye to eye and their visions may be different from each other. Another factor may be the lack of communication in order to bridge the gap and to build a respectful and a relationship wherein there is trust for each end every member of the group. Often times, the medical staff is concerned with ensuring that patients are cared for in a manner that their practice is protected as well as the patients are getting the appropriate care. On the other hand, the board of trustees may be focused in ensuring that that
Our textbook, highlighted that as health care administration we need to direct our attention to the legal environment as part of our responsibilities. Market forces in health care continue to change, as do legal and regulatory forces. Health care organizations need to stay attentive in assessing, as well as following, new regulations and rules in addition to federal and state laws. The complexity of the health care regulatory environment is not likely to decrease soon; hence the need for administrators to keep current on ever changing
The core values of a healthcare administrator are communication and relationship management, leadership, professionalism, knowledge of healthcare and business skills (HealthcareAdministration.com, 2012). As mention earlier, a healthcare administrator must to able to communicate clearly and respectfully with patients, customers, industry leaders, partners, department heads and hospital workers. They must be able to create meaningful relations with peers, and be able to promote constructive interaction between individuals and groups in all situations. A healthcare administrator must have the ability to create a shared vision for and inspire their team. They must be able to create and implement a strong organizational plan for the facility they
Working as a health care administrator requires tremendous responsibilities and faces unprecedented obstacles throughout the career years. Health care industries are more likely to get involved with lawsuit and courts than any other industries. There is a tendency that people do get nervous and anxious when confronted with unexpected federal government agency. First and foremost, it is imperative to keep the atmosphere calm and cooperate with the agency smoothly. A Subpoena Duces Tecum has been ordered which is a writing to inform a person or a representative to attend at the court to bring documentation. Also in a meanwhile it is important to get a legal advice and assistance from law firms. So that a framework can be built on how to proceed
In the health care system, a multitude of errors occurs on a daily basis. Doctors, nurses, orderly’s, etc., everyone in health care settings has responsibilities that warrant careful attention. This was exhibited in the case study titled ‘An Extended Stay’. In this case study, we are introduced to a middle-aged man in his 60s named Mr. Stanley Londborg. He presented with several health conditions, including a seizure disorder, hypertension (also known as high blood pressure), and Chronic Obstructive Pulmonary Disease (COPD). Londborg was no stranger to the hospital and was known fairly well by faculty members. Londborg paid a visit to the Emergency Room at the hospital complaining of wheezing and breathing complications. The physician that examined Mr. Londborg yielded his symptoms as an acute worsening of
People see hospitals as a place where one goes for healing and medical care, but hospitals are businesses that healthcare administrators have the responsibility of maintaining. Healthcare administrators’ responsibilities include many aspects related to patient care. Some of those aspects are social and public policy and the technical management of healthcare delivery in hospitals. Unfortunately, healthcare administrators are faced with many challenges as well. One of the growing challenges that healthcare administrators are facing is the shortage of healthcare professionals.
The doctor had a duty to treat the patient. This legal duty is established if the healthcare provider agrees to treat the patient. This must be established, as a doctor providing emergency care in a public place may not be guilty of malpractice.
Health care administration is a very important and crucial role in today’s healthcare system. With an ever-changing national health care system, the role of a Health care Administrator or Healthcare Executive more than ever is needed. Healthcare facilities, organizations, and or offices rely on health care administrators to plan, direct and coordinate all medical health services (United States Department of Labor , 2014). Some areas where one might find administrators are managing entire medical facilities, specialized clinical departments, or a medical practice for a group of physicians (United States Department of Labor , 2014). The need for high-quality health care administers is more now than ever with the fast-changing health care laws.
Healthcare management is a great, complex, and dynamic field. Like any business, healthcare requires exceptional administration to keeps its operations effective and smooth. Notably, the healthcare field is constantly growing, calling for the expertise of skilled administrators with the capacity to manage hospitals. Since my childhood, I have enjoyed solving problems, helping people, caring about the community and individuals, and having an excellent compensation and growth opportunities.
Administrative staff remains at the top- level of the organizational structure, formulated of individual’s that have ownership (stakeholders) with the functions of operations in the healthcare facility. These important individuals are accountable for the enforcement on policies and regulations, with ensuring the implementation for public