Medical Ethics Case Study Paper

Creating new support for modernizing multipurpose senior centers including a plan to use the skills and services of older individuals in pain and unpaid

Current numbers show substantial growth from the eighties, and estimates suggest that the demand for long term care among the elderly will more than double in the next thirty years. (Feder, Komisar, and Niefeld) This growth will exacerbate concerns about balancing institutional and noninstitutional care, assuring quality of care, and most importantly adopting and sustaining financing mechanisms that equitably and adequately protect the elderly who need long-term care.

1. Is the profitability or loss of the typical nursing facility in the hands of Medicare and Medicaid system administrators?

What are the Effects of current health care tends on long term care and this facility

The long-term care services delivery system in the United States has changed substantially over the last 30 years . There are approximately 17,000 elderly and disabled persons are receiving care in nursing homes (NNHS, 2004). The number of people using nursing facilities, alternative residential care places, or home care services are projected to increase from 15 million in 2000 to 27 million in 2050 (HHS, 2003). Identifying the best nursing home that would fit their needs can be difficult and time-consuming. Although nursing homes usually provide certain basic care that patients need, some nursing home facilities provides special care for certain types of individuals with special needs. For example, people with dementia, AIDS, ventilator-dependents,

Given the need for quality and modern nursing homes with a well balanced mix of services and amenities in

How cost effective is this considering the different service rates of MDs and NPs? (Assume NPs work 47 weeks per year.)

Any expenditure by or on behalf of a health care facility in excess of $2.5 million which, under generally accepted accounting principles consistently applied, is a capital expenditure, except expenditures for acquisition of

The long-term healthcare system has an infrastructure that is unfriendly and difficulty to navigate. With a growing number of frail older people living in the United States, the pressure to find a more affordable way to care for them will mount. Nearly 12 million people need some form of long-term care (LTC) and half are over age 65 (Wilber, 2014, Class Session 2). As mentioned in the article “Waiting in the Dark with Dad,” a large percentage of American healthcare costs fund medical procedures and medications to keep terminally ill people 65 and older alive (Lopez, 2014, p. 1). Steve Lopez experienced this with his 85-year-old father, Tony, who lived in a nursing home that was a place meant to keep his heart beating, but not actually improve his health and well-being. This is the harsh reality of the long-term care industry that many have faced, including experts in the field such as Dr. Robert Kane, author of It Shouldn’t Be This Way: The Failure of Long-Term Care. Long-term services and supports (LTSS) are supposed to maximize the quality of care and the quality of life for the individual (Kane and West, 2005, p. 169). When that focus is lost, it is the responsibility of healthcare professionals, like myself, to bring that issue back to the forefront of policy making.

Not to mention, if the hospital was to lose too much revenue, it might have enough impact to actually shut the hospital

When faced with the task of finding long term care for a loved one, what is of utmost importance when finding facilities in your area? Is it the amenities? The resources offered? Or the staff members that provide some of the most intimate cares to your loved one? While it might not be the first thing that comes to mind, the nursing staff in long term care facilities create the atmosphere for those who live in it. In fact, the increased turnover rates in long term care facilities has been shown to have a negative impact on the care that your loved one receives. These turnover rates “increase catheter use, restraint use, disruptions in the continuity of care, the probability of medical errors, the risk of developing contractures and pressure

“There is some evidence that the quality of care for nursing home residents has improved, such as the decreased use of physical restraints and psychotropic medications, serious problems continue for many residents, especially those at the end of their lives.” Some of the issues have been corrected, not abusing or neglecting the elderly patients but the services are not handling the most important part of the patients’ lives. They are still having some issues with handling the patients that are at the end of their lives, they need to focus on the end of their lives in dealing with this they need to know how deal with this part with them and the families.

The Institute of Medicine (IOM) has been working toward transforming the American health care system by reporting their research findings and outlining their vision of an improved health care system (IOM 2010). They have collaborated with a variety of health care professionals and developed an ad hoc committee in charge of examining nursing practice with respect to reforming public health care (IOM 2010). This committee has developed four key messages and eight recommendations for nursing’s role in reforming health care, including nurses’ participation with other health care professionals (IOM 2010). These recommendations are in alignment with the IOM’s Core Competencies for all health care professionals, one of which is to work in interdisciplinary teams (Rubenfeld & Scheffer 2015). The IOM recommends that nurses and health professionals work within a team for improved patient outcomes (Rubenfeld & Scheffer 2015). Within the hospital setting, nurses collaborate with a variety of ancillary services and health professionals. Older adults (aged >65 years) in the hospital are in jeopardy of a decline in functional status. They may benefit from the nurse working with interdisciplinary team members. Functional decline in the hospital setting is often not measured, nor are there protocols in place to prevent this risk factor in many hospital facilities (Lyons 2014).

The predominance of residents in nursing homes are long- term, meaning they will never recover enough to be on their own again. For every 100 residents there are 35 that will die in the nursing home and 37 will transfer to a hospital before dying (Day). This does not mean that it was the facilities fault, it just shows that many patients are already reaching their final days when they are placed in a nursing home. People should not expect the nursing homes to revitalize every single resident, considering most are in there for extreme health problems.

Governmental agencies such as JCAHO monitor the care of the patients from a nursing perspective. Quality of care affects the amount of reimbursement for care given to the hospital (Baernholdt, Jennings, Merwin, & Thornlow, 2010). The neighboring community often times depends on the hospital to meet their needs. The amount of people in a certain location may influence when and where the hospital is built. Competition from other nearby hospitals may be another consideration that influences types of care given in the hospital. External forces can add to the strength of the hospital by providing support and monetary compensation. A hospital, however can be weakened when certain rules are not followed, and the hospital receives a fine.