I am writing this to follow up our various telephone conversations and emails. You’ll recall that I am seeking a registered nurse to review records, prepare a report and possibly testify in a hospital fault case. The plaintiff, Martin Alvarado, is a brittle diabetic of current age 79. He sustained a fall while under the care of a registered nurse at Newman Regional Hospital. The fall resulted in a foot laceration which then became infected.
In 1991, the United States government initiated the Nursing Home Reform Act, also known as the Omnibus Budget Reconciliation Act (OBRA) of 1987 that outlined “a set of national minimum set of standards of care and rights for people living in certified nursing facilities” (ncmust.com). OBRA requires all nursing home residents have a complete health evaluation upon admission to a long-term care facility, and to be re-evaluated quarterly or after any major changes in health or functional status. This evaluation process is called the Resident Assessment Instrument (RAI) which is composed of three components; Minimum Data Set (MDS), Care Area Assessment Process and RAI Utilization Guidelines. Together, the components of RAI provide information
Which under the current design addresses long- term care for a limited amount of time, such as for rehabilitation purposes. These services cannot be received outside of a Medicare-approved facility, which means the person cannot reside in their home and receive the long-term care assistance under the current system. Therefore, we propose to amend this portion of the program to extend the funding for long-term care to include home care. Which consist of the relatives receiving monetary compensation for their care. Under the current policy, 41% of the Medicare budget of $50,000,000,000 is being advocated this particular area.
Mission Addition takes very basic math concepts and turns them into fun short, picture stories which help children to understand the concept. The book discusses basic addition topics such as adding one and two digit numbers, adding multiple numbers, counting money, and word problems. This would be a fun book to have in a preschool or kindergarten
A physician can maximize reimbursement through improving charting and documentation. They can do this by avoiding EHR shortcuts. Although this feature may be viewed as a time saver, progress notes are crucial to clearly supporting continued hospitalization reasons. Some codes are time based and require precise documentation of time. Make sure each
A therapist may do this once again in order to continue to receive reimbursement from Medicare for their services in order to generate more revenue for the clinic. Prior to the Jimmo versus Sebelius case in 2013, Medicare would deny coverage to patients receiving maintenance care for their condition due to their inability to demonstrate improvement from the skilled therapy services that they received (“Jimmo v Sebelius Settlement Agreement Factsheet,” 2013). However after the Jimmo versus Sebelius case, the Centers for Medicare & Medicaid Services revised portions of the manual which now states that coverage “does not turn on the presence or absence of a beneficiary’s potential for improvement, but rather on the beneficiary’s need for skilled care” (“CMS Manual System,” 2014). The correct action for the therapist to take in order to be in compliance with the rules is to provide adequate documentation as to why the patient would need and benefit from maintenance care services in order to prevent or slow the deterioration of their condition. An alternative would be to discharge the patient if they no longer require skilled and medically necessary services (“Jimmo v Sebelius Settlement Agreement Factsheet,” 2013) (“CMS Manual System,”
The facilities enforcing protocols and policies to secure that employees are meeting government regulations. Doctors, nursing staff and support staff I must use their best ethical and moral judge in most case to ensure patients are being retreated. Thus, sometimes causing conflict with health care administration because health care workers sometimes unknowingly break policies or protocol by putting patients first. As well as hospitals and clinics have so many departments that there can be conflict of interest with patient care that can cause inconsistency with patient care (Santilli, J. el al., 2015, Para
c. Current patients and new patient’s documentation would be different. Current patient’s documentation would be as to when they saw the doctor and the veteran’s feedback of the experience. While, new veteran’s wait times would be documented of when they requested the appointment and their experience of the visit using the Consumer Assessment of Healthcare Providers and Systems (CAHPS). (Shulken,
We would also inform them of any appointments she has that may affect their visits. To use one of these service users as another example, our support workers reported that the lady had deteriorated and it was becoming unsafe to support her. We then contacted her other care agency to inform them and we also reported to all other professionals involved in her care. This included the district nurses, her G.P., physiotherapist, and the Clinical Commissioning Group (CCG). We arranged a full reassessment of her needs and reviewed her support
Hope is not lost for our nations veterans, there are initiatives that may be implemented in order to improve the quality of care. We have identified four key areas that we feel will improve the quality of care for our nations veterans. These areas are; Patient Aligned Care Teams (PACTS), the program of vocational rehab, positive media relations, and universal electronic medical records. PACTS are formed when a veteran works together with multiple care disciplines in order to achieve whole person care and sustain life long wellness (VHA, 2015). These teams focus on patient medical partnerships, access to care, coordinated care among disciplines, and team based care with the veteran as the focus (VHA, 2015).
20% of patients says usually and 21% says sometimes or never. With Providence, 60% of patients says always, 21% says usually, and 19% says sometimes or never. And finally, 49% of Alaska regional patients or caregivers strongly agreed that they understood what type of care is required meaning the kind of medication to be taken and why it is needed after being discharged (medicare.gov). 45% of its patients said they agree, and 6% disagree or strongly disagree. And Providence reports shows 52% strongly agree, 43% agree, and 5% disagree or strongly
My priority is to ensure safety of staff and clients. All the work is done safely. Some residents when admitted to the home are poorly, the care they receive helps them get better. Sometimes when admitted they can’t mobilise at all, we refer them to physio to help with mobility, and they learn to walk with a Zimmer frame.
As an observer and rehab aide I was held to the same standards as the therapists and was expected to complete my job in a professional
As I progress in my career, I feel that it is important to develop a personal style and technique that clients can relate to. I am also interested in learning more about assessments and evaluations as they drive the rehabilitation plan. While I have assessed hundreds of clients, I realize that there is more to learn. For instance, the trend over the next five years will be an increase in applicants who receive state-plan home and community based services. The Final Rule issued by The Center for Medicare and Medicaid will require that individuals receive services in the most integrated settings.
Introduction Enterprise Architecture Enterprise architecture is defined as a “well-defined practice for steering enterprise analysis, design, planning, and implementation, by using a complete approach at all times, for the successful development and execution of a strategy. Enterprise architecture conducts architecture practices and principles to direct organizations during the business, information, process, and technology changes needed to complete their strategies. All these practices use the different characteristics of an enterprise to identify, inspire, and accomplish these changes” (Wikipedia). Ross, Weill & Robertson: “Enterprise Architecture as Strategy” Currently, business funds technology to support it.
