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1/26/22, 9:35 PM Module Four Assignment Guidelines and
Rubric - ACC-201-R3909 Financial Accounting 22EW3
https://learn.snhu.edu/d2l/le/content/957682/viewContent/16293
699/View 1/3
Overview
Internal controls are methods and strategies used to keep
informa�on and inventory safe from the� and to easily tell if
something is compromised or missing. In this assignment, you
will recommend internal controls for safeguarding inventory
from an accoun�ng perspec�ve and explain which financial
statements are affected by missing inventory.
Scenario
One of your friends has opened a new wholesale electronics
business and wants your help figuring out some inventory issues
they are facing.
One night last week, there seemed to be fewer HD televisions in
the warehouse than they expected. The last �me they were in
the warehouse was a week earlier, and they hadn’t
no�ced anything amiss.
As they looked around, they saw that the evening warehouse
worker was filling the last orders of the day. The delivery driver
and day warehouse worker were gone for the day, and the
delivery van keys were on the desk that the warehouse workers
shared. The doors to the loading dock were open, as was the
door to the office area where the accountant, two
customer service specialists, and the owner worked.
Knowing that you are familiar with accoun�ng principles, they
asked for your help in figuring out how to prevent this in the
future.
Prompt
Based on what you have learned about internal controls, provide
recommenda�ons on what controls the business owner should
put in place to prevent loss of inventory and ensure
that any losses are reported immediately. Also, specify which
parts of the financial statements are affected by these losses.
Specifically, you must address the following rubric criteria:
Role of Internal Controls
Explain the role of internal controls in business se�ngs. Also
explain how not having internal controls in place may impact
the accurate analysis of any wrongdoing.
Recommenda�ons
Recommend at least two internal controls that should be put in
place to prevent inventory from going “missing,” no�ng any
assump�ons you are making about the root
cause of the missing products and how your recommenda�ons
will help address them.
Recommend at least one control that should be put in place to
alert the owner if something is actually missing.
Financial Statements
If you found that two $400 HD televisions were missing,
explain which financial statements you would correct and how.
Be specific as to accounts and amounts.
Guidelines for Submission
Submit a 1- to 2-page Word document with 12-point Times New
Roman font, double spacing, and one-inch margins. Sources
should be cited according to APA style.
Module Four Assignment Rubric
Criteria Exemplary (100%) Proficient (85%) Needs
Improvement (55%) Not Evident (0%) Value
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1/26/22, 9:35 PM Module Four Assignment Guidelines and
Rubric - ACC-201-R3909 Financial Accounting 22EW3
https://learn.snhu.edu/d2l/le/content/957682/viewContent/16293
699/View 2/3
Criteria Exemplary (100%) Proficient (85%) Needs
Improvement (55%) Not Evident (0%) Value
Role of Internal Controls Exceeds proficiency in an
excep�onally clear, insigh�ul,
sophis�cated, or crea�ve
manner
Explains the role of internal
controls in business se�ngs
and how not having internal
controls in place may impact
the accurate analysis of
wrongdoing
Shows progress toward
proficiency, but with errors or
omissions; areas for
improvement may include not
fully explaining how a lack of
internal controls may impact
the accurate analysis of
wrongdoing
Does not a�empt criterion 20
Recommenda�ons Exceeds proficiency in an
excep�onally clear, insigh�ul,
sophis�cated, or crea�ve
manner
Recommends at least two
internal controls that should
be put in place to prevent
inventory from going
“missing,” no�ng any
assump�ons about the root
cause of the missing products
and how the
recommenda�ons will help
address them; recommends at
least one control that should
be put in place to alert the
owner if something is actually
missing
Shows progress toward
proficiency, but with errors or
omissions; areas for
improvement may include
recommending only one
internal control to prevent
inventory from going missing,
not including assump�ons
about the root cause of the
missing products and
recommenda�ons to address
them, not recommending an
internal control to alert the
owner if something goes
missing
Does not a�empt criterion 40
Financial Statements Exceeds proficiency in an
excep�onally clear, insigh�ul,
sophis�cated, or crea�ve
manner
Explains which financial
statements would need
correc�on and how; specifies
accounts and amounts
Shows progress toward
proficiency, but with errors or
omissions; areas for
improvement may include
providing only par�al
explana�on of some financial
statements that would need
correc�on, not specifying the
correct accounts and amounts
Does not a�empt criterion 20
1/26/22, 9:35 PM Module Four Assignment Guidelines and
Rubric - ACC-201-R3909 Financial Accounting 22EW3
https://learn.snhu.edu/d2l/le/content/957682/viewContent/16293
699/View 3/3
Criteria Exemplary (100%) Proficient (85%) Needs
Improvement (55%) Not Evident (0%) Value
Ar�cula�on of Response Exceeds proficiency in an
excep�onally clear, insigh�ul,
sophis�cated, or crea�ve
manner
Clearly conveys meaning with
correct grammar, sentence
structure, and spelling,
demonstra�ng an
understanding of audience
and purpose
Shows progress toward
proficiency, but with errors in
grammar, sentence structure,
and spelling, nega�vely
impac�ng readability
Submission has cri�cal errors
in grammar, sentence
structure, and spelling,
preven�ng understanding of
ideas
15
Cita�ons and A�ribu�ons Uses cita�ons for ideas
requiring a�ribu�on, with few
or no minor errors
Uses cita�ons for ideas
requiring a�ribu�on, with
consistent minor errors
Uses cita�ons for ideas
requiring a�ribu�on, with
major errors
Does not use cita�ons for
ideas requiring a�ribu�on
5
Total: 100%
Chapter 4
Nursing Care Facilities
Learning Objectives
1. Define and describe nursing facilities
2. Identify sources of financing for nursing
facilities
3. Identify and describe regulations affecting
nursing facilities
Learning Objectives (continued)
4. Identify and discuss ethical issues
affecting nursing facilities
5. Identify trends affecting nursing
facilities in the near future and
describe the possible impact of those
trends
What is a Nursing Facility?
Includes:
room, board, nursing care and some
therapies
nursing facilities (SNF) and what used to
be called intermediate care facilities (ICF)
How Nursing Facilities Developed
-based forms of care
ublic image
Philosophy of Care
• “care not cure”
Ownership of Nursing Facilities
profit (68%)
Services Provided
-ray services
Special Care Units
• Alzheimer’s disease
• Mental health and intellectual disabilities
• Brain injury
• AIDS
• Pediatric
• Young adult
Those Served
– over 90%
– two-thirds, male – one-third
• Two-fifths have dementia
• Many have depression
Activities of Daily Living (ADLs)
* Average resident needs help with 4 ADLs
Market Forces
-driven admissions
- and physician-initiated admissions
© 2010 Jones an Brtlett Publishers, LLC
Regulations
Purpose of regulations:
Types of Regulations
and safety
Financing Nursing Facilities
Reimbursement sources:
– 66%
– 13%
–
the remainder
Medicare Coverage
Restrictions:
-day hospital stay
mited to 100 days per “benefit period”
-payment for days 21–100
Staffing and Human Resource Issues
• Often on contract basis
Legal and Ethical Issues
Responsibility to:
Types of Legal and Ethical Issues
-to-day quality-of-life issues:
• Autonomy (choice)
• Privacy
-of-life issues:
• Advance directives
• living will or power of attorney
• Patient Self-Determination Act of 1990
• Cognitive ability?
Management Qualifications
• Education requirements
• Hands-on experience
• Continuing education
• NAB
Management Challenges
and Opportunities
organizations
Significant Trends
-term care insurance
Summary
Nursing facilities have a long history but
are evolving, as is the overall system.
They have gone from being the dominant
form of long-term care to one of many
provider types.
Slide 1Learning ObjectivesLearning Objectives
(continued)What is a Nursing Facility?How Nursing Facilities
DevelopedPhilosophy of CareOwnership of Nursing
FacilitiesServices ProvidedSpecial Care UnitsThose
ServedActivities of Daily Living (ADLs)Mar ket
ForcesRegulationsTypes of RegulationsFinancing Nursing
FacilitiesMedicare CoverageStaffing and Human Resource
IssuesLegal and Ethical IssuesTypes of Legal and Ethical
IssuesManagement QualificationsManagement Challenges and
OpportunitiesSignificant TrendsSummary
Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
CHAPTER FOUR: NURSING FACILITIES
CHAPTER HIGHLIGHTS
Introduction
are as Skilled Nursing
Facilities (SNF) and what
used to be called Intermediate Care Facilities (ICF), the primary
difference being the
amount of nursing care provided.
How nursing facilities developed
-based forms of care
for people without family to
care for them or other sources of help.
became involved with assisting
the needy with passage of the Social Security Act in 1935 and
the Medicare and
Medicaid amendments in 1965.
Philosophy of care
- Nursing facilities find themselves
sitting solidly astride the
line between acute care and long-term care.
sciplinary Approach - They utilize a combination of
medical, social, residential,
and other allied professionals to provide needed services,
blending those disciplinary
specialties to develop and implement care plans for individual
consumers.
Chapter 4 1
Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
- Another distinguishing characteristic of
long-term care in general,
and nursing facilities in particular, is the degree to which
family members are involved in
the care of the primary consumer.
Ownership of Nursing Facilities
-profit than nonprofit
-facility chains
Occupancy
high of 89.0 percent in 2007
to 86.0 percent to 2013.
-based
services.
Services Provided
-ray services as needed.
Special Care Units - many facilities created special care units to
meet the needs of a wider
variety of residents. They may be:
Chapter 4 2
Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
Consumers Served
number of medical or
physical conditions
-quarters women
Market Forces Impacting Nursing Facilities
-Driven Vs. Choice-Driven Admissions – most residents
do not choose to be
admitted, but must be due to their conditions.
– admission is usually
not at the request of the
resident but by family or a family physician.
Chapter 4 3
Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
- under the Affordable Care Act's
Hospital Readmissions
Reduction Program, hospitals that readmit "excessive" numbers
of Medicare patients
within 30 days of discharge now face significant penalties.
– facilities are
often chosen so the resident
can be close to family members.
– some are admitted to
nursing facilities because
of a lack of other alternatives (e.g., community-based care).
Regulations
There are three primary categories of regulations:
– Regulations concerning care and
quality of care
– regulations protecting employees
from unfair treatment
– regulations
assuring proper construction
and maintenance of facilities.
Financing Nursing Facilities
-thirds)
-of-pocket
Staffing/Human Resource Issues
Chapter 4 4
Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
- nursing facilities utilize a staffing
mix that combines both
highly trained and relatively untrained staff.
-clinical care
OBRA and Medicare,
specify the numbers of
staff on duty on each work shift and the mix of personnel
categories making up that
staff.
of the workforce - the population group available to
provide care is getting
smaller due to aging
– the amount allowed by Medicaid (the
primary payment source)
is not adequate
– staff can make more
working elsewhere, even in
fast-food restaurants
Legal/Ethical Issues
-To-Day Quality of Life Issues
Chapter 4 5
Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
Management of Nursing Facilities
me variation in state regulations
– never enough resources
– many are part of
a multi-level facility
providing several types of care, possibly including assisted
living, home health care
and/or subacute care in addition to skilled and nursing care.
– it is no
longer possible/feasible to
stand alone.
Significant Trends and Their Impact on Nursing Facilities
– as acute care hospitals try to save
money, higher acuity patients
are sent to nursing facilities.
– has become a primary form of
reimbursement and comes with strings
attached.
Reimbursement Trends:
Chapter 4 6
Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
– not a large enough source of
reimbursement
- the ACA created a system of payment
bundling where a single
entity would receive a sum of money to cover the costs of an
episode of care spanning
two or more providers
– threaten the survival of
providers
- the single, most important trend today is
the demand by consumers
for more choice in their care
Chapter 4 7
CHAPTER FOUR: NURSING FACILITIESCHAPTER
HIGHLIGHTS.cIntroductionNursing facilities used to be called
“nursing homes”How nursing facilities developed.c2.Philosophy
of care.c3.Medical vs. Social Model - Nursing facilities find
themselves sitting solidly astride the line between acute care
and long-term care..c2.A Multidisciplinary Approach - They
utilize a combination of medical, social, residential, and other
allied professionals to provide needed services, blending those
disciplinary specialties to develop and implement care plans for
individual consumers..c3.Family Involvement - Another
distinguishing characteristic of long-term care in general, and
nursing facilities in particular, is the degree to which family
members are involved in the care of the primary
consumer.Ownership of Nursing FacilitiesThe occupancy rate
for nursing facilities has declined from a high of 89.0 percent in
2007 to 86.0 percent to 2013.This may be due to competition
from community-based services.Services Provided.c2.Special
Care Units - many facilities created special care units to meet
the needs of a wider variety of residents. They may
be:.c2.Consumers ServedBy age:Mostly elderly.c3.By care
Needs:AAAdmitted because of functional disabilities, resulting
from a number of medical or physical conditions.c3.;By gender
Mix:.c2.Market Forces Impacting Nursing Facilities.c3.Need-
Driven Vs. Choice-Driven Admissions – most residents do not
choose to be admitted, but must be due to their
conditions..c3.Family/Physician Initiated Admissions –
admission is usually not at the request of the resident but by
family or a family physician..c3. Hospital Readmissions - under
the Affordable Care Act's Hospital Readmissions Reduction
Program, hospitals that readmit "excessive" numbers of
Medicare patients within 30 days of discharge now face
significant penalties.Location Relative to the Resident’s Family
– facilities are often chosen so the resident can be close to
family members..c3.Alternative Types of Care (or Lack of) –
some are admitted to nursing facilities because of a lack of
other alternatives (e.g., community-based
care)..c2.Regulations.c3.There are three primary categories of
regulations:Affecting Residents – Regulations concerning care
and quality of care.c3. Affecting Employees – regulations
protecting employees from unfair treatment.c3. Affecting
Building Construction and Safety – regulations assuring proper
construction and maintenance of facilities..c2.Financing
Nursing Facilities.c2.Staffing/Human Resource Issues.c3.Nature
of the Work Force - nursing facilities utilize a staffing mix that
combines both highly trained and relatively untrained
staff..c4.Nursing.c4.Certified Nurse Aides.c4.Medical
Coverage.c4.Other Specialists.c3.Recruitment/Turnover
IssuesLegal/.c2.Ethical Issues.c3.Day-To-Day Quality of Life
Issues.c3.End of Life Issues.c2.Management of Nursing
Facilities.c3.Management Qualifications:.c3.Management
Challenges & Opportunities:.c4.Bala ncing Cost and Quality –
never enough resources.c4.Integration of Differing Levels of
Service – many are part of a multi-level facility providing
several types of care, possibly including assisted living, home
health care and/or subacute care in addition to skilled and
nursing care..c4.Coordination with Other Facilities,
Organizations – it is no longer possible/feasible to stand
alone..c2.Significant Trends and Their Impact on Nursing
Facilities.c3.Rising Acuity Levels – as acute care hospitals try
to save money, higher acuity patients are sent to nursing
facilities..c3.Managed Care – has become a primary form of
reimbursement and comes with strings attached..c3.Other
Reimbursement Trends:.c4.Prospective Payment.c4.Private LTC
Insurance – not a large enough source of reimbursementPayment
Bundling - the ACA created a system of payment bundling
where a single entity would receive a sum of money to cover the
costs of an episode of care spanning two or more
providersRising Liability Insurance Costs – threaten the
survival of providers.c3.Consumer Choice - the single, most
important trend today is the demand by consumers for more
choice in their care

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12622, 935 PM Module Four Assignment Guidelines and Rubric

  • 1. 1/26/22, 9:35 PM Module Four Assignment Guidelines and Rubric - ACC-201-R3909 Financial Accounting 22EW3 https://learn.snhu.edu/d2l/le/content/957682/viewContent/16293 699/View 1/3 Overview Internal controls are methods and strategies used to keep informa�on and inventory safe from the� and to easily tell if something is compromised or missing. In this assignment, you will recommend internal controls for safeguarding inventory from an accoun�ng perspec�ve and explain which financial statements are affected by missing inventory. Scenario One of your friends has opened a new wholesale electronics business and wants your help figuring out some inventory issues they are facing. One night last week, there seemed to be fewer HD televisions in the warehouse than they expected. The last �me they were in the warehouse was a week earlier, and they hadn’t no�ced anything amiss. As they looked around, they saw that the evening warehouse worker was filling the last orders of the day. The delivery driver and day warehouse worker were gone for the day, and the
  • 2. delivery van keys were on the desk that the warehouse workers shared. The doors to the loading dock were open, as was the door to the office area where the accountant, two customer service specialists, and the owner worked. Knowing that you are familiar with accoun�ng principles, they asked for your help in figuring out how to prevent this in the future. Prompt Based on what you have learned about internal controls, provide recommenda�ons on what controls the business owner should put in place to prevent loss of inventory and ensure that any losses are reported immediately. Also, specify which parts of the financial statements are affected by these losses. Specifically, you must address the following rubric criteria: Role of Internal Controls Explain the role of internal controls in business se�ngs. Also explain how not having internal controls in place may impact the accurate analysis of any wrongdoing. Recommenda�ons Recommend at least two internal controls that should be put in place to prevent inventory from going “missing,” no�ng any assump�ons you are making about the root cause of the missing products and how your recommenda�ons will help address them.
  • 3. Recommend at least one control that should be put in place to alert the owner if something is actually missing. Financial Statements If you found that two $400 HD televisions were missing, explain which financial statements you would correct and how. Be specific as to accounts and amounts. Guidelines for Submission Submit a 1- to 2-page Word document with 12-point Times New Roman font, double spacing, and one-inch margins. Sources should be cited according to APA style. Module Four Assignment Rubric Criteria Exemplary (100%) Proficient (85%) Needs Improvement (55%) Not Evident (0%) Value https://app.readspeaker.com/cgi- bin/rsent?customerid=9568&url=https%3A%2F%2Flearn.snhu.e du%2Fcontent%2Fenforced%2F957682-ACC-201-R3909-OL- TRAD- UG.22EW3%2FFormative%25203%2520Column.html&lang=en _us&voice=9568&readid=d2l_read_element_1 1/26/22, 9:35 PM Module Four Assignment Guidelines and Rubric - ACC-201-R3909 Financial Accounting 22EW3 https://learn.snhu.edu/d2l/le/content/957682/viewContent/16293 699/View 2/3
  • 4. Criteria Exemplary (100%) Proficient (85%) Needs Improvement (55%) Not Evident (0%) Value Role of Internal Controls Exceeds proficiency in an excep�onally clear, insigh�ul, sophis�cated, or crea�ve manner Explains the role of internal controls in business se�ngs and how not having internal controls in place may impact the accurate analysis of wrongdoing Shows progress toward proficiency, but with errors or omissions; areas for improvement may include not fully explaining how a lack of internal controls may impact the accurate analysis of
  • 5. wrongdoing Does not a�empt criterion 20 Recommenda�ons Exceeds proficiency in an excep�onally clear, insigh�ul, sophis�cated, or crea�ve manner Recommends at least two internal controls that should be put in place to prevent inventory from going “missing,” no�ng any assump�ons about the root cause of the missing products and how the recommenda�ons will help address them; recommends at least one control that should be put in place to alert the
  • 6. owner if something is actually missing Shows progress toward proficiency, but with errors or omissions; areas for improvement may include recommending only one internal control to prevent inventory from going missing, not including assump�ons about the root cause of the missing products and recommenda�ons to address them, not recommending an internal control to alert the owner if something goes missing Does not a�empt criterion 40
  • 7. Financial Statements Exceeds proficiency in an excep�onally clear, insigh�ul, sophis�cated, or crea�ve manner Explains which financial statements would need correc�on and how; specifies accounts and amounts Shows progress toward proficiency, but with errors or omissions; areas for improvement may include providing only par�al explana�on of some financial statements that would need correc�on, not specifying the correct accounts and amounts Does not a�empt criterion 20
  • 8. 1/26/22, 9:35 PM Module Four Assignment Guidelines and Rubric - ACC-201-R3909 Financial Accounting 22EW3 https://learn.snhu.edu/d2l/le/content/957682/viewContent/16293 699/View 3/3 Criteria Exemplary (100%) Proficient (85%) Needs Improvement (55%) Not Evident (0%) Value Ar�cula�on of Response Exceeds proficiency in an excep�onally clear, insigh�ul, sophis�cated, or crea�ve manner Clearly conveys meaning with correct grammar, sentence structure, and spelling, demonstra�ng an understanding of audience and purpose Shows progress toward proficiency, but with errors in
  • 9. grammar, sentence structure, and spelling, nega�vely impac�ng readability Submission has cri�cal errors in grammar, sentence structure, and spelling, preven�ng understanding of ideas 15 Cita�ons and A�ribu�ons Uses cita�ons for ideas requiring a�ribu�on, with few or no minor errors Uses cita�ons for ideas requiring a�ribu�on, with consistent minor errors Uses cita�ons for ideas requiring a�ribu�on, with major errors
  • 10. Does not use cita�ons for ideas requiring a�ribu�on 5 Total: 100% Chapter 4 Nursing Care Facilities Learning Objectives 1. Define and describe nursing facilities 2. Identify sources of financing for nursing facilities 3. Identify and describe regulations affecting nursing facilities Learning Objectives (continued) 4. Identify and discuss ethical issues affecting nursing facilities 5. Identify trends affecting nursing facilities in the near future and describe the possible impact of those
  • 11. trends What is a Nursing Facility? Includes: room, board, nursing care and some therapies nursing facilities (SNF) and what used to be called intermediate care facilities (ICF) How Nursing Facilities Developed -based forms of care ublic image Philosophy of Care • “care not cure”
  • 12. Ownership of Nursing Facilities profit (68%) Services Provided -ray services Special Care Units • Alzheimer’s disease • Mental health and intellectual disabilities • Brain injury • AIDS • Pediatric • Young adult
  • 13. Those Served – over 90% – two-thirds, male – one-third • Two-fifths have dementia • Many have depression Activities of Daily Living (ADLs) * Average resident needs help with 4 ADLs Market Forces -driven admissions - and physician-initiated admissions © 2010 Jones an Brtlett Publishers, LLC
  • 14. Regulations Purpose of regulations: Types of Regulations and safety Financing Nursing Facilities Reimbursement sources: – 66% – 13% – the remainder Medicare Coverage Restrictions: -day hospital stay mited to 100 days per “benefit period”
  • 15. -payment for days 21–100 Staffing and Human Resource Issues • Often on contract basis Legal and Ethical Issues Responsibility to: Types of Legal and Ethical Issues -to-day quality-of-life issues: • Autonomy (choice) • Privacy -of-life issues: • Advance directives • living will or power of attorney • Patient Self-Determination Act of 1990 • Cognitive ability?
  • 16. Management Qualifications • Education requirements • Hands-on experience • Continuing education • NAB Management Challenges and Opportunities organizations Significant Trends -term care insurance
  • 17. Summary Nursing facilities have a long history but are evolving, as is the overall system. They have gone from being the dominant form of long-term care to one of many provider types. Slide 1Learning ObjectivesLearning Objectives (continued)What is a Nursing Facility?How Nursing Facilities DevelopedPhilosophy of CareOwnership of Nursing FacilitiesServices ProvidedSpecial Care UnitsThose ServedActivities of Daily Living (ADLs)Mar ket ForcesRegulationsTypes of RegulationsFinancing Nursing FacilitiesMedicare CoverageStaffing and Human Resource IssuesLegal and Ethical IssuesTypes of Legal and Ethical IssuesManagement QualificationsManagement Challenges and OpportunitiesSignificant TrendsSummary Long-Term Care: Managing Across the Continuum, Fourth Edition John R. Pratt CHAPTER FOUR: NURSING FACILITIES CHAPTER HIGHLIGHTS Introduction are as Skilled Nursing
  • 18. Facilities (SNF) and what used to be called Intermediate Care Facilities (ICF), the primary difference being the amount of nursing care provided. How nursing facilities developed -based forms of care for people without family to care for them or other sources of help. became involved with assisting the needy with passage of the Social Security Act in 1935 and the Medicare and Medicaid amendments in 1965. Philosophy of care - Nursing facilities find themselves sitting solidly astride the line between acute care and long-term care. sciplinary Approach - They utilize a combination of medical, social, residential, and other allied professionals to provide needed services, blending those disciplinary
  • 19. specialties to develop and implement care plans for individual consumers. Chapter 4 1 Long-Term Care: Managing Across the Continuum, Fourth Edition John R. Pratt - Another distinguishing characteristic of long-term care in general, and nursing facilities in particular, is the degree to which family members are involved in the care of the primary consumer. Ownership of Nursing Facilities -profit than nonprofit -facility chains Occupancy high of 89.0 percent in 2007 to 86.0 percent to 2013. -based services.
  • 20. Services Provided -ray services as needed. Special Care Units - many facilities created special care units to meet the needs of a wider variety of residents. They may be: Chapter 4 2 Long-Term Care: Managing Across the Continuum, Fourth Edition John R. Pratt
  • 21. Consumers Served number of medical or physical conditions -quarters women Market Forces Impacting Nursing Facilities -Driven Vs. Choice-Driven Admissions – most residents do not choose to be admitted, but must be due to their conditions. – admission is usually
  • 22. not at the request of the resident but by family or a family physician. Chapter 4 3 Long-Term Care: Managing Across the Continuum, Fourth Edition John R. Pratt - under the Affordable Care Act's Hospital Readmissions Reduction Program, hospitals that readmit "excessive" numbers of Medicare patients within 30 days of discharge now face significant penalties. – facilities are often chosen so the resident can be close to family members. – some are admitted to nursing facilities because of a lack of other alternatives (e.g., community-based care). Regulations There are three primary categories of regulations: – Regulations concerning care and quality of care
  • 23. – regulations protecting employees from unfair treatment – regulations assuring proper construction and maintenance of facilities. Financing Nursing Facilities -thirds) -of-pocket Staffing/Human Resource Issues Chapter 4 4 Long-Term Care: Managing Across the Continuum, Fourth Edition John R. Pratt - nursing facilities utilize a staffing mix that combines both highly trained and relatively untrained staff.
  • 24. -clinical care OBRA and Medicare, specify the numbers of staff on duty on each work shift and the mix of personnel categories making up that staff. of the workforce - the population group available to provide care is getting smaller due to aging – the amount allowed by Medicaid (the primary payment source) is not adequate – staff can make more working elsewhere, even in fast-food restaurants Legal/Ethical Issues
  • 25. -To-Day Quality of Life Issues Chapter 4 5 Long-Term Care: Managing Across the Continuum, Fourth Edition John R. Pratt Management of Nursing Facilities me variation in state regulations – never enough resources – many are part of a multi-level facility
  • 26. providing several types of care, possibly including assisted living, home health care and/or subacute care in addition to skilled and nursing care. – it is no longer possible/feasible to stand alone. Significant Trends and Their Impact on Nursing Facilities – as acute care hospitals try to save money, higher acuity patients are sent to nursing facilities. – has become a primary form of reimbursement and comes with strings attached. Reimbursement Trends: Chapter 4 6 Long-Term Care: Managing Across the Continuum, Fourth Edition John R. Pratt – not a large enough source of reimbursement
  • 27. - the ACA created a system of payment bundling where a single entity would receive a sum of money to cover the costs of an episode of care spanning two or more providers – threaten the survival of providers - the single, most important trend today is the demand by consumers for more choice in their care Chapter 4 7 CHAPTER FOUR: NURSING FACILITIESCHAPTER HIGHLIGHTS.cIntroductionNursing facilities used to be called “nursing homes”How nursing facilities developed.c2.Philosophy of care.c3.Medical vs. Social Model - Nursing facilities find themselves sitting solidly astride the line between acute care and long-term care..c2.A Multidisciplinary Approach - They utilize a combination of medical, social, residential, and other allied professionals to provide needed services, blending those disciplinary specialties to develop and implement care plans for individual consumers..c3.Family Involvement - Another distinguishing characteristic of long-term care in general, and nursing facilities in particular, is the degree to which family members are involved in the care of the primary consumer.Ownership of Nursing FacilitiesThe occupancy rate for nursing facilities has declined from a high of 89.0 percent in 2007 to 86.0 percent to 2013.This may be due to competition from community-based services.Services Provided.c2.Special Care Units - many facilities created special care units to meet
  • 28. the needs of a wider variety of residents. They may be:.c2.Consumers ServedBy age:Mostly elderly.c3.By care Needs:AAAdmitted because of functional disabilities, resulting from a number of medical or physical conditions.c3.;By gender Mix:.c2.Market Forces Impacting Nursing Facilities.c3.Need- Driven Vs. Choice-Driven Admissions – most residents do not choose to be admitted, but must be due to their conditions..c3.Family/Physician Initiated Admissions – admission is usually not at the request of the resident but by family or a family physician..c3. Hospital Readmissions - under the Affordable Care Act's Hospital Readmissions Reduction Program, hospitals that readmit "excessive" numbers of Medicare patients within 30 days of discharge now face significant penalties.Location Relative to the Resident’s Family – facilities are often chosen so the resident can be close to family members..c3.Alternative Types of Care (or Lack of) – some are admitted to nursing facilities because of a lack of other alternatives (e.g., community-based care)..c2.Regulations.c3.There are three primary categories of regulations:Affecting Residents – Regulations concerning care and quality of care.c3. Affecting Employees – regulations protecting employees from unfair treatment.c3. Affecting Building Construction and Safety – regulations assuring proper construction and maintenance of facilities..c2.Financing Nursing Facilities.c2.Staffing/Human Resource Issues.c3.Nature of the Work Force - nursing facilities utilize a staffing mix that combines both highly trained and relatively untrained staff..c4.Nursing.c4.Certified Nurse Aides.c4.Medical Coverage.c4.Other Specialists.c3.Recruitment/Turnover IssuesLegal/.c2.Ethical Issues.c3.Day-To-Day Quality of Life Issues.c3.End of Life Issues.c2.Management of Nursing Facilities.c3.Management Qualifications:.c3.Management Challenges & Opportunities:.c4.Bala ncing Cost and Quality – never enough resources.c4.Integration of Differing Levels of Service – many are part of a multi-level facility providing several types of care, possibly including assisted living, home
  • 29. health care and/or subacute care in addition to skilled and nursing care..c4.Coordination with Other Facilities, Organizations – it is no longer possible/feasible to stand alone..c2.Significant Trends and Their Impact on Nursing Facilities.c3.Rising Acuity Levels – as acute care hospitals try to save money, higher acuity patients are sent to nursing facilities..c3.Managed Care – has become a primary form of reimbursement and comes with strings attached..c3.Other Reimbursement Trends:.c4.Prospective Payment.c4.Private LTC Insurance – not a large enough source of reimbursementPayment Bundling - the ACA created a system of payment bundling where a single entity would receive a sum of money to cover the costs of an episode of care spanning two or more providersRising Liability Insurance Costs – threaten the survival of providers.c3.Consumer Choice - the single, most important trend today is the demand by consumers for more choice in their care