Medical Transforming Ideas into Laws and Policies Presentation

Medical Transforming Ideas into Laws and Policies Presentation

Instructions/Descriptions

Medical Transforming Ideas into Laws and Policies Presentation

Instructions

Create a visual depiction using any tool you wish (graphs, charts, figures, pictures or PowerPoint) to explain the process of how ideas become regulations and rules and how rules and regulations become policy and laws on the local, state, and national levels for the nursing home industry. Research the path of how local, state, and national rules, regulations and laws are created and include the knowledge you find from this research into the visual depiction you create. The depiction should be concise and easy to understand. For example, no more than five PowerPoint® slides if PowerPoint® is used or no more than 2 pages of graphs, charts, figures, or pictures if WORD® is used. APA is not required except for the references section. You must include three (3) scholarly resources.

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Requirements

Writer visually depicts a clear and easy to understand path of how ideas become healthcare policy on a local, state and national level.

Writer visually depicts how individuals or groups can impact this process and their role in the process.

Writer visually depicts how the process impacts the nursing home industry.

HCAD 650 Health Law Litigation and Managerial Legal Compliance Discussion

read and contribute to the peer discussion below:

Peer 1:

Part 1: Critical Analysis of the Law

The one health law chosen is the Affordable Care Act (ACA). The Affordable Care Act is a federal civil law signed by congress under President Barack Obama on March 23, 2010. This law intended to expand healthcare coverage, control the healthcare cost and improve the quality and services of the healthcare system for everyone. Not just those that can afford healthcare. The citation and code for the ACA are P.L. 111-148 ( KFF, 2013). It is also a public law because it was passed by congress to benefit all United States citizens. It is also essential to know when a statute has been modified by the courts, new and revised law, or even changed by the administrative regulation so that laws are obeyed by everyone and avoid individual and public health disasters. Changes to statutes law can be found on the U.S Laws, codes, and statues website (Justia U.S law, 2022).

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The penalties associated with non-compliance with the ACA law mainly consist of fines such as a U.S citizen without healthcare coverage will pay a tax penalty of greater than $695 per year and up to the maximum of three times that amount for a family. Employers with 50 or more employees that do not offer coverage pay a premium tax credit of $2.000 per full-time employee. There are also civil penalties, according to federal law, that can cost up to $11,000, depending on the severity of the sentence. It will be necessary for an organization to avoid these penalties because ACA directly affects the Medicare and Medicaid services which are vital to the business success of any healthcare organization. The healthcare organization can comply with the laws of ACA by keeping up with any new revisions and changes to the law and providing employees with proper and affordable healthcare insurance (KFF, 2013).

2. The health care administrator’s role is vital in preventing litigation and supporting legal compliance because they can provide a safe working environment and facilitate a proper patient care environment for patients and care providers while limiting legal issues to the organization. Administrative work involves finding a resolution to personal matters, recruitment, performance review, dispute resolution, discipline, and termination. Knowing employment law helps management apply the correct decisions and responsibilities (Showalter, 2020).

The legal compliance tool of Enterprise Document Management (EDM), An Enterprise Document Management System, enables organizations to place documents in a digital format to be easily accessed. It controls the risks of losing documentation with proper management, use, and document achievement. To reduce the legal risks of medical records, all patient documentation will strictly be done electronically and do away with paper documentation. That will eliminate loss or misplaced documents and be left somewhere for anyone to see. Electronic documentation will also encourage care providers to securely, quickly, and effortlessly share patient information.

Part 2: Strategic Compliance with the Law.

1. It is essential to preserve documents for litigation because the records are easily retrieved, authenticated, and show good faith in the hospital’s behavior. It offers transparency of the hospital’s services provided.

The three actions needed to be taken to preserve the documentation needed for this litigation will be

1)Electronically store the documentation information. 2). Stop all documentation retention or destruction of the documents needed for the litigation. 3). Label the documents as litigation hold to ensure they somehow do

not get destroyed.

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The key documents that will need to be reserved because they are directly related to the litigation will be the checklists of all the supplies and instruments brought into the surgery before, used during, and collected after the procedure. The notes taken by Dr. Quick and the nurse sleep back, during, and after the surgery.

2. medical records can limit or increase legal liability because of how well the notes were taken or what was neglected in the notes at the time of notation. A well-written letter can be specific with times, while an ignored message can have missing time and specifics. This can cause the courts to dismiss the case or find the healthcare organization liable. A point may be trialed later, so depending on good documentation is crucial. According to the Medical Mutual Insurance Company of Maine (n. d), a complete medical record is the best defense. It serves as a communication tool and supports decision-making.

A solid medical record will include patient identification, medical history, family history, and medication history.

To improve medical records, surgical care documentation, and sponge count, there will be

1). A surgical tech in the operating room to keep counts of sponges used and removed during the procedure and effectively communicate that to the team. Excellent and effective communication is essential to safe and successful surgery and to prevent complications (WHO, 2009).

2). A computer system that will only allow a sponge to be taken at a time. Unless a sponge is returned, another one cannot be taken out.

3). Every sponge and instrument will be computer scanned. After a certain period, the computer will let the surgery team know if any is not observed as been removed, that the surgeon, nurses, and the surgical tech has to fill out about the count of sponge and instruments used.

References

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Kaiser Family Foundation (2013, April 25). Summary of the Affordable Care Act. https://www.kff.org/health-reform/fact-sheet/summary-of-the-affordable-care-act/

Medical Manual Insurance Company of Maine. (n. d). Complete medical records: your best defense. https://learn.umgc.edu/content/enforced/718307-004637-01-2228-GO1-9040/Medical%20Mutual%20Insurance%20Company%20of%20Maine%20-%20Complete%20Medical%20Records%20Your%20Best%20Defense%20PDF.pdf?_&d2lSessionVal=GhkTKz4shFi5F3wZ6AOlmyho3

University of Maryland Global Campus (2022). Week 1: Sources of law, litigation, and managerial legal compliance. https://learn.umgc.edu/d2l/le/content/718307/viewContent/26758010/View

University of Maryland Global Campus (2022). Week 1: The law, compliance tools, and managerial actions. https://learn.umgc.edu/d2l/le/content/718307/viewContent/26757986/View

World Health Organization (2009). Patient safety. Implementation manual. WHO surgical safety checklist 2009. https://apps.who.int/iris/bitstream/handle/10665/44186/9789241598590_eng.pdf?sequence=1&isAllowed=y

Peer 2:

Part 1

Emergency Medical Treatment and Active Labor Act (EMTALA)

The Emergency Medical Treatment and Active Labor Act (EMTALA), is legislation enacted by Congress that ensures patients have the right to receive emergency services despite their ability to pay. Code 1395dd, is the U.S. code for EMTALA. The code protects the examination and treatment of women in labor and experiencing an emergency medical condition. EMTALA is a federal law. The law prohibits the financial discrimination of patients who are unable to pay for emergency health services including the obstetrics population. Women’s rights particularly those affecting pregnant women needing emergency services fall under the protection of EMTALA. Following the recent overturning of Roe v Wade led to the U.S. Department of Health and Human Services (HHS) bringing forth new guidance that will guarantee pregnant women or those who have lost a pregnancy recently, have full legal rights as well as safeguards for emergency medical services (hhs, 2022). President Biden soon after signed an executive order protecting access to reproductive health care services. One place to find changes in laws and regulations is the electronic code of federal regulations e-CFR website.

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Despite regulations, hospitals continue to be cited for EMTALA violations particularly related to labor and obstetrical care. Violators of EMTALA can face civil monetary penalties up to $103,139, a sufficient increase from the previous $50,000 penalty (Terp, et al., 2020). Hospitals with fewer than 100 beds would expect to pay no more than $25,000 per violation. Paying penalties and fines not only affects the financial stability of the organization but also can play a negative effect on the reputation of the healthcare system as well. Hospitals rely on funding from government programs and insurance reimbursements to provide the necessary services to patients. Having these funds decreased or even eliminated can prove detrimental to the safety net of hospitals and other healthcare systems (Lagasse, 2020). Being educated on the importance and ramifications of EMTALA is important. Ensuring each patient is properly evaluated, stabilized, and if necessary, the appropriate arrangements for transferring have occurred.

The role of the healthcare administrator is important in preventing litigation because healthcare organizations stand to lose more than just money when filed cases led to paying out losses. These judgments also affect the reputation of the organization and provider practices. Administrators work to prevent misunderstanding, improve and track communications, and recognize and correct errors if they are to remain aligned with legal compliance.  There are several managerial compliance tools that can assist administrators as they navigate the legal aspect of healthcare. From various checklists, templates, and forms for corporate management, guidelines and protocols, training materials, policies, and procedures, as well as risk management and assessment tools, this is a great place to browse for guidance on an array of issues.

The EMTALA compliance checklist falls under the compliance and risk management tools. If followed correctly the checklist will eliminate the possible violation of EMTALA by ensuring the patient has been properly evaluated and treated regardless of the inability to pay. It will also ensure that if the patient requires transferring to another facility that the patient is stabilized, and it is medically necessary and not due to the chance of financial discrimination.

Part 2

When an organization is issued a letter of litigation hold it becomes important that documents are preserved. Documents may contain information that is relevant to a dispute. The primary purpose of a litigation hold is to preserve evidence that can be used in helping to make a fully informed and just decision (litigation holds-the, 2018). Three important steps to take in ensuring the preservation of documents is to first create a document retention policy. This policy will outline what documents need to be kept and for how long. Generally, federal and state laws require certain records are kept, including financial and employee records. Secondly, develop a policy for how documents are stored versus destroyed. Finally, develop a plan for implementation of the policy and assigning role responsibility to ensure these policies are being followed.

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In this pending case involving potential negligence, certain documents will be of the utmost importance to review and preserve. Nursing documentation, surgery and procedure notes, and time-out records detailing who was present during the case and what instruments were counted in and out. The time-out documentation will list everyone who was present at the beginning time of the procedure. It will not speak to who was left at the end so this is where the surgeon’s note and procedure note will become important. The surgeon will be required to document the case and it should detail if he was there at the end of the case. Nursing documentation will capture the instrument count at both the beginning and end of the case which is performed by a circulating nurse and scrub nurse, however, it is everyone’s responsibility in the surgical room to ensure the count is accurate (Perry, 2018). Medical records and documentation contain important information pertaining to a patient’s medical history and hospital stay. As nurses, we are taught to document events by being subjective and non-bias. Documentation should state true and accurate accounts of an event. Documentation is a vital tool that can increase liability, such as in a situation where the documentation substantiates the negligence. Recently I encountered a situation where a nurse had two patients with the same first name and she subsequently mixed the patients up leading to inaccurate lab results and causing one to receive the medication they did not need and causing a delay to the one that needed the medication. In this case, documentation will show that the nurse caused potential harm.

Time-outs have been proved to increase patient safety when it comes to performing surgical procedures. Therefore, I would initiate a policy mandate of instrument counting where the responsibility is not just on the two designated nurses but everyone in the room. The time out will require everyone to pause, eliminate distractions, and perform the count. I would also implement a mandatory visual wound sweep performed by the surgeon and the assisting surgeon in the room that will require them to sign off on stating that no visual foreign objects are left in the patient prior to the closing of the surgical site. Lastly, a required count of every instrument/sponge handed off, how many, and to who. During a cardiac arrest, there is so much recall of actions that are documented and the same should go for surgeries.

References

HHS (2022, July 11). Following President Biden’s Executive Order to Protect Access to Reproductive Health Care, HHS Announces Guidance to Clarify that Emergency Medical Care Includes Abortion Services, https://www.hhs.gov/about/news/2022/07/11/followin…

Lagasse, J. (2020, July 10). Value-Based Payment Penalties Disproportionately Impact Safety Net Hospitals. Healthcare Finance, https://healthcarefinancenews.com/news/value-based…

Litigation Holds- The Triggers and Consequences for Failing to Preserve Evidence (2018, July 11). https://www.tandllaw.com/blog/litigation-holds-the…

Perry, M. (2018, May 4). Surgical Counts – Accuracy Keeps Everyone Safe. The Circulating Life: OR Nursing with a Dose of Reality, https://thecirculatinglife.com/2018/05/04/surgical…

Terp, S., Wang, B., Burner, E., Arora, S., and Mecnhine, M. (2020). Penalties for Emergency Medical Treatment and Labor Act Violations Involving Obstetrical Emergencies. The Western Journal of Emergency Medicine, 21(2), 235-243. https://doi.org/10.5811/westjem.2019.10.40892

Medical Transforming Ideas into Laws and Policies Presentation

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