SUMMARY OF LOAN REQUEST AND BORROWER RELATIONSHIP: Lead bank has requested if our bank would be interested in lending $20 million out of the $175 million revolving credit line for Almost Family. Our bank currently has a deposit and cash management relationship with Almost Family and is in the geographical distance of the company, BUSINESS / INDUSTRY ANALYSIS: Business Evaluation: . Almost Family is an industry leader in the home health care industry. Strength’s of Almost Family include its personal and management, experience (time established in this industry), and its financial strength (see attached spreadsheet with financial statements and ratios). The company has two divisions, home health care and healthcare innovations. The home health care division has two reportable divisions, visiting nurse services (VN) and personal care services (PC). Healthcare innovations also have a reportable division. The VN helps provide skilled medical services in patients’ homes to reduce prolonged stays in hospitals and nursing homes. A large amount of revenue derived from this program (96%) is from Medicare with private insurance and Medicaid making up the rest. PC services are also provided in patients’ homes but theses services are more toward custodial than skilled nature. PC revenues are derived on an hourly basis with Medicaid picking up 84% of the tab. The Healthcare innovations division was created separately to report on developmental activities outside the home health
This paper will explain the components of the Home Health Care delivery system of continuum. The reader will be able to understand some of the services provided by the home health care system and how they fit into the continuum of care. It will give details on how the entity does or does not contribute to the overall management of healthcare resources.
The home health industry is highly fragmented. In fact, only 5% of home health care providers generate over $5 million in Medicare revenue (Harris Williams and Company, 2015). Amedisys’ economies of scale undoubtedly helps ensure operational efficiency, which will assist with maintaining long-term profitability. In addition, their relatively large employee population enables Amedisys to offer employees competitive wages and full benefits. This assists with attracting and retaining top talent.
Samantha stated that initially many people asked her if she chose to be a family nurse practitioner to be a “mini physician” (S. Hage De Reyes, personal communication, June 22, 2016). In her perspective, it has been an issue to show others in health care professions that nurses just want to expand their knowledge. She “fights battles every day” for her patients because of the holes in our health care system (S. Hage De Reyes, personal communication, June 22, 2016). In her experience, she has seen many individuals without insurance. She has learned that being a family nurse practitioner is being an advocate for the patient and helping them get the resources that they need. Family nurse practitioners help provide care in a more affordable way. In Samantha’s opinion, family nurse practitioners are the answer to creating access to care for the large uninsured population and those that are newly insured under the Affordable Care Act, and I could not agree
Overview of the Patient Centered Medical Home project piloted by Geisinger Health System in Danville, Pennsylvania
Patient-Centered Medical Homes (PCMH) are growing in popularity as the right thing to do improve patient care. PCMH are growing in popularity, as there is early evidence of their effectiveness (Egge, M. 2012). The PCMH concept has been widely promoted as a way to enhance primary care and deliver better care to patients with chronic conditions. This model of care has stimulated the attention of payers, Medicaid policy makers, physicians, and patient advocates, as it has the potential to address several of the limitations of the current healthcare system (Wang, J. et al 2014). Currently, primary care in the United States is focused on acute and episodic illness, it inadvertently limits comprehensive, coordinated, preventive and chronic care (Bleser, W. et al 2014). The PCMH address these limitations through organizing patient care, emphasizing team work, and coordinating data tracking (Bleser, W. et al 2014). A PCMH and HMO have some similarities but are markedly different.
The role of nurse practitioner is valuable when discussing collaborative care. There are so many levels of care, so many health entities, and so many insurer criteria involved that it is instrumental to have a role that can work towards help bring all aspects together. In addition to diagnosing, treating, and managing care, the role of the nurse practitioner is to manage simple and episodic acute health issues along with chronic disease (Sangster-Gormley, Martin-Misener, & Burge, 2013). It is important to note that although this is a function of this role, nurse practitioners also practice from a holistic point of view which allows them to help manage patient conditions or wellness in a more complete fashion. This includes helping patients have access to care beyond primary and secondary care settings. This encourages nurse practitioners to work alongside other health care and allied health professions, and families to create an individualized plan for every patient (van
Documentation and communication are constant challenges that healthcare providers face when seeking continuity of care for their patients. Every time a patient moves from a hospital to a nursing home, or from a skilled nursing facility to home health or hospice, the staff that cares for the patient is at risk for a gap in patient care and communication. Home health and hospice agencies rely heavily on Medicaid and other insurance for reimbursements in order to continue to provide care for their patients and keep the doors to their agencies open. Thorough and timely documentation is the key to ensuring proper reimbursement for nursing services and other therapies provided from insurance agencies. This same
With the passing of the Affordable Care Act in 2010 approximately 32 million more people will be insured throughout the United States. The need for healthcare workers and providers will be in drastic demand to provide care to these insured Americans. The 2010 IOM report details out how the advanced practice nurse can be a valuable asset in primary, chronic and transitional care and their skill set should be used to promote better healthcare across the nation (IOM, 2010). This impact of this report should help progress advanced practice nurse’s ability to practice without individual state regulation and be governed under one body to server in and outside of the hospital setting
One of the aims of the Patient Protection and Affordable Care Act (ACA) of 2010 is improved integration and coordination of services for primary patient care. The patient-centered medical home (PCMH) is one of the approaches by which improvements can be established. The patient-centered medical home model is particularly well-suited for people who have chronic illness. The design of the patient-centered medical home model departs substantively from traditional reimbursement policies, in that, the ACA provides for incentives and resources to enable care coordinators to be directly recognized and compensated for their care coordination work. Care coordinators are most often registered nurses who through their work that aligns with ACA engage in quality improvement work, cost-effectiveness measures, and patient advocacy. To bring the ACA model to a human scale, the authors present a case study of a care coordinator at a patient-centered medical home in rural Maine. The table provided below provides a basic textual analysis of the study as it is published in the professional nursing journal.
Nursing has evolved in many ways over the years, in particular is the Florence Nightingale foundation of caring for the whole family and not just the patient. The following case study of Omid 's story: The Power of Family-Centered Care highlights the positive and negative aspects of their family’s healthcare experiences , and models of family nursing and concepts of family-centred care. By comparing the theories and models to what is currently put into practice by today’s nurses and healthcare providers a better outcome for this family is idealized.
Competition in the home health field is intense, particularly in rural areas, where the need for services is in more demand. Because services are expensive to provide, it is critical for agencies to generate a volume of visits sufficient to cover fixed expenses plus make a small profit. Competition is primarily between another company Care One, Inc., a multicounty operation that has been established in the area for well over 10 years. AHHS surpassed them in total number of visits after its second year of operation and has been progressively growing. Many of the physicians in the area, however, continue to use Care One, and Care One receives more referrals from the local hospitals than AHHS. Currently AHHS has 32 employees, including 15 registered nurses, 8 nursing aides, 1 physical therapist, I speech language therapist, and 7 administrative staff.
Initiatives like AAI are very important to means to providing accessible health care for the elderly. No center is within an hour’s distance from an elderly Arkansans’ resident. Teamwork is the key. Physicians, nurses, social workers, and other health professionals all work together as a team for the benefit of their patients. Advanced degreed nurses act as associate directors. The initiative is successful. Decrease in rates of emergency room use and hospitalization and an increased rate in elderly patient gaining health care knowledge are a few of the unpublished claims. Despite its successes, the initiative faces a few challenges. For example, funding is
The information contained in this report was gathered in a private nursing home over 2 weeks that for the sake of this essay, be called “facility x”
Mr. Paul Mackay, a sole proprietor, has approached the Commercial Bank of Ontario in order to obtain an additional $194,000 bank loan and a $26,000 line of credit. Paul owns and operates a general merchandising retailer in Riverdale, Ontario named Lawsons’. The bank loan is needed for Mr. Mackay to reduce his trade debt that has a sheer 13.5 per cent interest penalty. The line of credit is needed for sales seasonal downfalls so that Mr. Mackay could properly manage those tough months. Jackie Patrick, a first time loans officer, has been appointed to Mr. Mackay’s request. Although anxious to finish her first loan, Ms. Patrick knows that this particular case is a difficult one.
The financial implication of this modality of nursing care is relatively on the high side hence it is impracticable for many .Although, those from the higher class