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Briefing Note Assignment Rubric Student Name:
Weight: 15% Student Number:
Criteria from Associated Course and Unit Outcomes
Unique and Distinguished
(90-100%)
Unique and Distinguished
(80-89%)
Good
(70-79%)
Needs Developing
(65-69%)
Fails to meet requirements /Inadequate
(<64%)
Considerable evidence of original thinking – synthesizes
information from high quality sources from and draws own
clear, logical, and compelling conclusions; sophisticated ability
to analyze, integrate, and extend course concepts; outstanding
grasp of subject matter.
Evidence of original thinking – good ability to make appropriate
links between course concepts; draws own logical and fairly
compelling conclusions from quality information sources; solid
grasp of subject matter evident.
Some evidence of original thinking – fair ability to make
appropriate links between course concepts; draws own
conclusions from information sources; arguments may not
always be clear, compelling, or logical; some grasp of subject
matter evident.
Minimal to no evidence of original thinking – weak/no ability to
draw own conclusions; arguments rarely clear, logical or
compelling; little to no capacity to make appropriate links
between information sources and course concepts; very little/no
credible information sources used to support argument; little to
no grasp of subject matter evident.
Impact
Briefing note is engaging, persuasive and moving such that the
reader feels compelled to take action and solve the issue
immediately.
(18-20 points)
Briefing note is engaging, persuasive. The reader feels action is
required to solve the issue now.
(16-17.9 points)
Briefing note is mostly engaging and persuasive. The reader
may feel to some degree that action is required to solve the
issue in the near future.
(14-15.9 points)
Briefing note is not always engaging and persuasive. The reader
feels little motivation to take action and solve the issue in the
distant future
(13-13.9 points)
Briefing note is neither engaging nor persuasive. The reader
feels little to no motivation to ever take action and solve the
issue.
(0-12.9 points)
Quality of Briefing Note
Clear, accurate summary of the topic supported by detailed and
relevant discussion in all content areas. Key message clear, and
supported by accurate, detailed discussion.
(9-10 points)
Topic summarized well with an accurate and complete
discussion evident in all content areas. Key message clear and
mostly supported by accurate, detailed discussion.
(8-8.9 points)
Although topic was fairly well-summarized, discussion was not
always relevant and sometimes lacked detail in the content
areas. Key message could be inferred with support of
accompanying discussion.
(7-7.9 points)
Explanations of key areas have several inaccuracies or are
incomplete. A few minor key content areas of are missed and/or
may have some ambiguity.
(6.5-6.9 points)
Explanations have many inaccuracies and most key content
areas are incomplete and/or mostly ambiguous.
(0-6.4 points)
Level of Information Synthesis
Combines and evaluates existing ideas to form new insights.
Obvious original thinking demonstrated in the development of a
clear, logical argument.
(18-20 points)
Combines existing ideas to form new insights for the most part;
some original thought demonstrated in addition to incorporating
other authors’ ideas from information resources to develop a
logical argument.
(16-17.9 points)
Combines existing ideas of other authors from information
resources to develop a clear and logical argument; lacking in
original thought.
(14-15.9 points)
Occasional evidence of combining existing ideas of other
authors from information resources. Several transgressions
evident in logic and clarity of argument.
(13-13.9 points)
Minimal/no evidence of combining existing ideas of other
authors in any logical or clear manner. No evidence of critical
thinking as evidenced by an argument that is illogical, unclear,
and/or vague.
(0-12.9 points)
Research Effort and Use of Information Resources
Integrated extensive, varied, current, relevant, and credible
information resources effectively throughout assignment to
support claims and arguments.
(9-10 points)
Integrated multiple current, relevant, credible resources
effectively throughout assignment to support claims and
arguments.
(8-8.9 points)
Integrated information resources throughout most of the
assignment to support claims and arguments but some resources
may not be varied, current, entirely relevant or credible
(7-7.9 points)
Integrated information resources throughout some of the
assignment to support claims and arguments but resources may
not be varied, current, relevant, or credible.
(6.5-6.9 points)
Did not integrate information resources throughout any of
assignment to support claims and arguments.
(0 points)
Total
/ 60 points
Essential Employment Skills (EES)
Unique and Distinguished
(90-100%)
Unique and Distinguished
(80-89%)
Good
(70-79%)
Needs Development
(65-69%)
Fails to meet requirements /Inadequate (<64%)
Spelling/Grammar
No spelling and grammatical errors
(5 points)
There are occasional spelling errors (<2) or grammatical errors
(4 points)
There are more than occasional spelling errors (<3) or
grammatical errors
(3.5 points)
There are numerous spelling errors (<5) or grammatical errors
(3.3 points)
Spelling errors are frequent (>5) or grammatical errors
(0-3.2 points)
[email protected] Citations and Referencing
In-text citing and complete reference list meets
[email protected] Standards
(9-10 points)
There are some [email protected]
In-text citation and/or complete reference list errors (<2)
(8-8.9 points)
There are occasional [email protected] referencing errors (<3)
(7-7.9 points)
There are numerous APA referencing errors (>4) and/or citation
– reference list mismatches
(6.5-6.9 points)
No complete reference list and/or no in-text citations, and/or
evidence of plagiarism** and/or breach of copyright laws
(0 points)
Clarity/Flow/
Layout
Clear and logical flow and layout
(9-10 points)
Clear and easy to read & follow
(8-8.9 points)
Requires concentration to read and follow
(7-7.9 points)
Challenging to read and follow
(6.5-6.9 points)
Very difficult to read and follow
(0-6.4 points)
Length
Within 3 page limit but greater than 2 pages (exclusive of
complete reference list or appendices)
(5 points)
Up to 3 lines beyond 3 page limit and/or less than 2 pages
(exclusive of complete reference list or appendices)
(4 points)
4 – 6 lines beyond 3 page limit and/or less than 2 pages
(exclusive of complete reference list or appendices)
(3.5 points)
7-10 lines beyond 3-page limit and/or less than 2 pages
(exclusive of complete reference list or appendices)
(3.3 points)
Grossly outside of 3 page limit and/or less than 2 pages
(exclusive of complete reference list or appendices)
(0-3.2 points)
Format
Single-spaced
12’ font
Arial
Report format
(9-10 points)
Did not adhere to 1/4 criteria:
Single-spaced
12’ font
Arial font
Report format
(8-8.9 points)
Did not adhere to 2/4 criteria:
Single-spaced
12’ font
Arial font
Report format
(7-7.9 points)
Did not adhere to 3/4 criteria:
Single-spaced
12’ font
Arial font
Report format
(6.5-6.9 points)
Complete non-adherence to formatting guidelines
(0 points)
Total
/40
Late Penalty
Refer to
Program Handbook
Conestoga College Policy from Student Handbook states “Late
marks will be deducted at a rate of 10% per day, including
weekends, from the total percent value of the assignment”. It is
your responsibility to ensure your assignment is submitted to
the Dropbox correctly and on time.
Academic Integrity
The
Academic Integrity Policy is in effect for
this assignment. It is your responsibility to ensure you know
and understand what constitutes academic dishonesty and its
consequences. *In the event of plagiarism, a grade of 0 will be
assigned for that section of the rubric, a report of academic
dishonesty will be filed according to the Academic Integrity
Policy; the final grade will be assigned according to the
academic integrity policy’s consequence and prior incident
reports.
Total
/60 points plus / 35 points (minus _____ for late) =
/100
Comments:
Prepared by Valerie Abbott, March, 2019.
Adapted from:
Fostaty Young, S. (2005). Teaching, learning, and assessment in
higher education: Using ICE to improve student learning.
Proceedings of the Improving Student Learning
Symposium, London, UK,
13, 105-115. Imperial College, London, UK, Oxford
Centre for Staff and Learning Development. Retrieved March 8,
2019 from:
http://www.queensu.ca/teachingandlearning/modules/principles/
documents/Teaching,%20Learning%20and%20Assessment%20in
%20Higher%20Education.pdf
Wiggins, G. (2017). How to create a rubric that does what you
want it to. Retrieved from:
https://www.teachthought.com/pedagogy/how-to-create-
a-rubric-that-does-what-you-want-it-to/ (based on Wiggins’
Impact, Process, Content, and Polish framework for creating
effective rubrics)
In consultation with: Lisa Trimble, Teaching and Learning
Consultant, Conestoga College
Chapter 4
The Legal and Regulatory
Environment of Health Care
Learning Objectives
1. Understand how legal and regulatory issues shape
and define good financial management of a health
care organization.
2. Appreciate the consequences of failing to manage the
finances of a health care organization without regard
for the complex and ever-changing array of laws and
regulations that are unique to this industry.
3
Learning Objectives
3. Recognize when and how to involve legal counsel
on a Medicare or Medicaid reimbursement issue or
other financial matter that has regulatory
compliance implications or would otherwise require
you to seek legal advice before making a decision.
4. Identify the most common federal regulatory issues
such as fraud and abuse, Stark, HIPAA privacy and
security, EMTALA, and IRS requirements for tax-
exempt organizations, as well as less common
concerns that arise under the antitrust laws, Red
Flag Rules, and state insurance regulations.
Learning Objectives
5. Identify the major components of a corporate compliance
plan, including the establishment of internal controls
relating to the finances of an organization.
6. Be prepared to respond to a compliance audit or
investigation, particularly when the subject of that inquiry
includes financial records.
7. Be aware of the most important aspects of the Patient
Protection and Affordable Care Act of 2010 (Health
Reform Act) as it relates to financial management in the
post-Reform environment.
5
Law and Healthcare Financial Management
– Corporate Compliance Plans
• Office of Inspector General (OIG)
Requirements
– Internal Control and Corporate Compliance
• AICPA Elements
6
Primary Regulatory Issues
1. Medicare Reimbursement
– Parts A – Parts D
– Certification of Providers
– Payment to Providers
2. Medicaid Reimbursement
– Eligibility Determination
• Federal Poverty Level (FPL)
• Supplemental Security Income (SSI)
– Coverage of Services
– Establishment of Payment Rates
– Medicaid DSH Payments 7
Primary Regulatory Issues
3. Beneficiary Appeal Rights & Process
– Medicare’s 5 Levels
4. Fraud & Abuse
– False Claims Act
– Qui Team Actions
– Kickback’s and Self-Referrals
• Anti-Kickback Statute
• Stark Physician Self-Referral Law
– Safe Harbors 8
Privacy of Healthcare Information
(HIPAA)
– HIPAA Overview
– Privacy Standards
• Protected Health Information (PHI)
– Security Standards
9
Third Party Payor Contracts
– State Regulator
• “Any willing Provider”
– Federal Law
• ERISA
10
Tax Exemption Issues
– 501 (C) (3) Organizations
– Public Charity vs. Private Foundation
– Charity Care
– Unrelated Business Income
– Form 990 11
Antitrust Issues
– Purpose of Laws
• Promote a competitive free marketplace
– Sherman Act
• Agreements that unreasonably restrain trade
• Price fixing
– IPA’s and PHO’s
– Per Se Violations 12
– Reviews of Mergers, Acquisitions, and Joint
Venture Agreements
• “Statements of Antitrust Enforcement Policy in
Health Care,” (August 1996)
– Sharing Competitive Information
• Financial and/or clinical integration
13
Antitrust Issues
• Prohibits mergers and acquisitions that may
substantially lessen competition
• Analytical Methodology Provided
– Will merger increase concentration in market?
– Does increased concentration raise anti competitive
concerns?
– Can another competitor enter market?
– Are there efficiencies to be realized?
– Without merger would either or merging parties
fail?
14
Clayton Act
Emergency Medical Transfer and Active
Labor Act (EMTALA)
– Prohibits hospitals from transferring an emergency
patient because of inability to pay.
15
Summary
• Healthcare financial managers need to have some
understanding
of the major rules and regulations related to health care.
• The legal and regulatory environment in health care is
increasingly complex.
• A prudent manager must plan for an adapt to this
environment.
• Failure to comply can put the organization at significant
financial
risk and can put individuals at both criminal and financial risk.
• Proper planning, implementation, execution, documentation,
and
evaluation of corporate compliance programs is vital for the
financial security of today’s health care organizations.
16
Anti-Trust
You are a manager with five years of
experience and need to write a report for
senior
management on how your firm can avoid the
threat of a Federal Trade Commission
investigation if you were to merge with
other health care organizations. Research on
your own to select a health care
organization in the United States that has
been charged
with an antitrust action within the last five
years and use this information as the basis
for
your paper. In your report
● Summarize the charges and rebuttal or
mitigation of charges used by the
health care organization you researched.
● Discuss lessons learned and propose actions
that can be taken by your
management to avoid similar anti- trust actions
in your proposed merger.
Briefing Note Assignment - Examples
http://www.publicsectorwriting.com/wp-
content/uploads/2009/10/Options-Recommendation-Briefing-
Note.pdf
http://rnao.ca/policy/briefing-notes/preventing-managing-
violence-workplace
The links above provide examples of briefing notes. There are
many ways of writing a briefing note.
The first example is not related to nursing but it is addressed to
a person (audience), the Purpose is the issue/problem is stated
concisely, the Background gives a brief history of the issue, and
the Current Situation speaks to what is happening now. The Key
Considerations are the 3 bulleted points in the Current Situation
section. There are 3 Options related directly to and may help to
solve the considerations outlined in the 3 bulleted points (Key
Considerations). Note that each option provides at least one
advantage and one disadvantage. This briefing note ends with a
Recommendations section but in this example, only states the
preferred option and does not summarize the major important
points the reader should take away. Often busy decision-makers
only read the last section; therefore, the writer of this briefing
note lost the opportunity to quickly draw attention to and
inform the decision-maker.
Alternatively, in the RNAO briefing note example, the issue
relates directly to nursing but the briefing note does not follow
the recommended format (Issue, Background, Current Situation,
Key Considerations, Recommendations) that should be
addressed in the Briefing Note Assignment guidelines.
Therefore, it is suggested you use the above examples to get the
general idea of how a briefing note is written
but be sure to include all of the key areas in the
Briefing Note Assignment guidelines when writing your
briefing note.
Notice there are no citations or reference list in these examples!
For your Briefing Note assignment, you are expected to
acknowledge your sources of information with citations and a
complete reference list according to Conestoga College’s
Academic Integrity Policy.
Finally, you might consider the briefing note to be similar to
SBAR (Situation, Background, Assessment, Recommendations)
and similar to papers you wrote in COMM1085
(introduction/thesis statement, significance, background, 2-3
body paragraphs with support and development of the thesis,
and one concluding paragraph). Consider booking an
appointment with Student Success Services if you require added
support with your writing skills.
Prepared by Valerie Abbott, March 2019, in consultation with
Lisa Trimble, Teaching and Learning, Conestoga College
Briefing Note Assignment Guidelines
Weight: 15%
Learning Outcomes Addressed in this Assignment:
Purpose:
The purpose of the Briefing Note assignment is to practice an
effective and efficient strategy to inform decision-makers about
an important health issue that impacts the health of the
population. This assignment involves the production of an
original briefing note on a nursing, health or health care
problem of interest to you. Examples of broad topic areas from
which you can choose
a specific focus (see example below) include, but are
not limited to:
End of life care Social determinants of health
Patient Safety
Harm reduction Community-based care
Chronic illness
Health human resources Aging and seniors’ care
Access to care
Health system financing Care delivery models
Immigrant health
Pharmaceutical policy Quality of care
Non-medical cannabis use
COVID Management
An
example of what is meant by ‘broad topic area”:
Indigenous health in Canada
· An abundance of evidence demonstrates that Indigenous
peoples (First Nations, Metis, Inuit) in Canada live with a
greater percentage of serious health issues compared to the rest
of the Canadian population.
On the following page, you will find examples of what is meant
by “choose a
specific focus” from the broad topic area for writing
your briefing note. This means you might choose
one of the following
specific focus areas
from the broad topic area, Indigenous health in Canada,
for writing your briefing note:
Malnutrition
Lower levels of education
Higher suicide rates
Inadequate, crowded housing
Higher rates of chronic illness
Higher rates of death in children due to
High rate of tuberculosis
Unsafe drinking water
Alcohol misuse
Content:
Write your Briefing Note using the following sub-headings:
Audience, Issue, Background, Current Status, Key
Considerations, Options, and Recommendations as below.
Notice there are questions associated with each sub-heading. It
may not be necessary to address each question in each sub-
heading because not all may be relevant to your topic. However,
you may decide to use the questions under each sub-heading
questions as threads to help you frame your briefing note.
1)
Audience: Who are you addressing in this briefing note?
Be sure your briefing note is written with consideration of the
target audience (please note, the audience of your briefing note
is not your professor)
2)
Issue: Short, concise statement or two about what is the
specific issue is about. Who is affected by the issue? What is
the significance of the issue? Why should the issue matter to the
reader (audience of your briefing note)?
3)
Background: Give a brief summary of the background
events leading up to the issue.
What is the history leading up to the development of the issue
and/or how has the issue evolved?
4)
Current Status: Describe the current situation of the
issue in terms of its current state. What is the current situation
or status of the issue? What is happening now? Who is
involved?
5)
Key Considerations: Inform your reader about aspects
of the issue that need to be factored in, thought carefully about,
studied, or contemplated prior to making decisions about how to
address the issue. Key considerations must be supported with
credible, current evidence.
6)
2Options about how the issue could be addressed. The
options should relate directly to the key considerations. Include
the advantages and disadvantages for each option.
7)
Recommendation: Concise, brief summary of what you
want your reader to conclude from the reasoning and evidence
you provided. What are the key points you want your audience
to be clear about? Finally, state the most preferred option from
#6 above.
Adapted from Doyle, S. 92013). How to Write a Briefing Note.
Retrieved February 22nd, 2019 from
https://web.uvic.ca/~sdoyle/E302/Notes/WritingBriefingNotes.h
tml)
Process:
The assignment requires the items included in the checklist
below:
· Report format; this is not a scholarly paper. You may decide
to follow the template available for use located in the Briefing
Note Resources located in the Briefing Note Assignment module
to frame your briefing note.
· APA format with citations and references according to
[email protected] Conestoga.
· Arial 12 font
· No more than 3 pages – single spaced (does not include list of
references)
· Newspaper/magazine articles are not to be used in your
assignment; use only credible, relevant, and quality resources.
· Submission must be made to the assignment dropbox in the e-
Conestoga shell for course NURS8945 by the due date and time.
· See
Student Handbook for regulations regarding late
assignments
·
Academic Integrity Policy is in effect; Turnitin feature
enabled in the assignment dropbox. You may use the Turnitin
feature as an educative strategy to correct any potential
plagiarism, and citation and referencing errors in advance of
your final submission. Your final submission to the assignment
dropbox will be the submission that is evaluated.
Use the resource documents contained in the Briefing Note
Assignment module to guide your thinking as you prepare to
write this assignment. Remember, three pages may seem short,
however, you will be graded on the quality of the briefing note
you produce and the level of synthesis and thoughtfulness
contained therein.
Prepared by Valerie Abbott, March, 2019, in consultation with
Lisa Trimble, Teaching and Learning, Conestoga College

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Briefing Note Assignment RubricStudent NameWeight 15Stude.docx

  • 1. Briefing Note Assignment Rubric Student Name: Weight: 15% Student Number: Criteria from Associated Course and Unit Outcomes Unique and Distinguished (90-100%) Unique and Distinguished (80-89%) Good (70-79%) Needs Developing (65-69%) Fails to meet requirements /Inadequate (<64%) Considerable evidence of original thinking – synthesizes information from high quality sources from and draws own clear, logical, and compelling conclusions; sophisticated ability to analyze, integrate, and extend course concepts; outstanding grasp of subject matter. Evidence of original thinking – good ability to make appropriate links between course concepts; draws own logical and fairly compelling conclusions from quality information sources; solid grasp of subject matter evident. Some evidence of original thinking – fair ability to make appropriate links between course concepts; draws own conclusions from information sources; arguments may not
  • 2. always be clear, compelling, or logical; some grasp of subject matter evident. Minimal to no evidence of original thinking – weak/no ability to draw own conclusions; arguments rarely clear, logical or compelling; little to no capacity to make appropriate links between information sources and course concepts; very little/no credible information sources used to support argument; little to no grasp of subject matter evident. Impact Briefing note is engaging, persuasive and moving such that the reader feels compelled to take action and solve the issue immediately. (18-20 points) Briefing note is engaging, persuasive. The reader feels action is required to solve the issue now. (16-17.9 points) Briefing note is mostly engaging and persuasive. The reader may feel to some degree that action is required to solve the issue in the near future. (14-15.9 points) Briefing note is not always engaging and persuasive. The reader feels little motivation to take action and solve the issue in the distant future (13-13.9 points) Briefing note is neither engaging nor persuasive. The reader feels little to no motivation to ever take action and solve the issue. (0-12.9 points) Quality of Briefing Note
  • 3. Clear, accurate summary of the topic supported by detailed and relevant discussion in all content areas. Key message clear, and supported by accurate, detailed discussion. (9-10 points) Topic summarized well with an accurate and complete discussion evident in all content areas. Key message clear and mostly supported by accurate, detailed discussion. (8-8.9 points) Although topic was fairly well-summarized, discussion was not always relevant and sometimes lacked detail in the content areas. Key message could be inferred with support of accompanying discussion. (7-7.9 points) Explanations of key areas have several inaccuracies or are incomplete. A few minor key content areas of are missed and/or may have some ambiguity. (6.5-6.9 points) Explanations have many inaccuracies and most key content areas are incomplete and/or mostly ambiguous. (0-6.4 points) Level of Information Synthesis
  • 4. Combines and evaluates existing ideas to form new insights. Obvious original thinking demonstrated in the development of a clear, logical argument. (18-20 points) Combines existing ideas to form new insights for the most part; some original thought demonstrated in addition to incorporating other authors’ ideas from information resources to develop a logical argument. (16-17.9 points) Combines existing ideas of other authors from information resources to develop a clear and logical argument; lacking in original thought. (14-15.9 points) Occasional evidence of combining existing ideas of other authors from information resources. Several transgressions evident in logic and clarity of argument. (13-13.9 points) Minimal/no evidence of combining existing ideas of other authors in any logical or clear manner. No evidence of critical thinking as evidenced by an argument that is illogical, unclear, and/or vague. (0-12.9 points) Research Effort and Use of Information Resources
  • 5. Integrated extensive, varied, current, relevant, and credible information resources effectively throughout assignment to support claims and arguments. (9-10 points) Integrated multiple current, relevant, credible resources effectively throughout assignment to support claims and arguments. (8-8.9 points) Integrated information resources throughout most of the assignment to support claims and arguments but some resources may not be varied, current, entirely relevant or credible (7-7.9 points) Integrated information resources throughout some of the assignment to support claims and arguments but resources may not be varied, current, relevant, or credible. (6.5-6.9 points) Did not integrate information resources throughout any of assignment to support claims and arguments. (0 points) Total / 60 points Essential Employment Skills (EES)
  • 6. Unique and Distinguished (90-100%) Unique and Distinguished (80-89%) Good (70-79%) Needs Development (65-69%) Fails to meet requirements /Inadequate (<64%) Spelling/Grammar No spelling and grammatical errors (5 points) There are occasional spelling errors (<2) or grammatical errors (4 points) There are more than occasional spelling errors (<3) or grammatical errors (3.5 points) There are numerous spelling errors (<5) or grammatical errors (3.3 points) Spelling errors are frequent (>5) or grammatical errors (0-3.2 points) [email protected] Citations and Referencing In-text citing and complete reference list meets [email protected] Standards
  • 7. (9-10 points) There are some [email protected] In-text citation and/or complete reference list errors (<2) (8-8.9 points) There are occasional [email protected] referencing errors (<3) (7-7.9 points) There are numerous APA referencing errors (>4) and/or citation – reference list mismatches (6.5-6.9 points) No complete reference list and/or no in-text citations, and/or evidence of plagiarism** and/or breach of copyright laws (0 points) Clarity/Flow/ Layout Clear and logical flow and layout (9-10 points) Clear and easy to read & follow (8-8.9 points) Requires concentration to read and follow (7-7.9 points) Challenging to read and follow
  • 8. (6.5-6.9 points) Very difficult to read and follow (0-6.4 points) Length Within 3 page limit but greater than 2 pages (exclusive of complete reference list or appendices) (5 points) Up to 3 lines beyond 3 page limit and/or less than 2 pages (exclusive of complete reference list or appendices) (4 points) 4 – 6 lines beyond 3 page limit and/or less than 2 pages (exclusive of complete reference list or appendices) (3.5 points) 7-10 lines beyond 3-page limit and/or less than 2 pages (exclusive of complete reference list or appendices) (3.3 points) Grossly outside of 3 page limit and/or less than 2 pages (exclusive of complete reference list or appendices) (0-3.2 points) Format Single-spaced 12’ font Arial Report format (9-10 points) Did not adhere to 1/4 criteria: Single-spaced 12’ font Arial font Report format (8-8.9 points)
  • 9. Did not adhere to 2/4 criteria: Single-spaced 12’ font Arial font Report format (7-7.9 points) Did not adhere to 3/4 criteria: Single-spaced 12’ font Arial font Report format (6.5-6.9 points) Complete non-adherence to formatting guidelines (0 points) Total /40 Late Penalty Refer to Program Handbook Conestoga College Policy from Student Handbook states “Late marks will be deducted at a rate of 10% per day, including weekends, from the total percent value of the assignment”. It is your responsibility to ensure your assignment is submitted to the Dropbox correctly and on time.
  • 10. Academic Integrity The Academic Integrity Policy is in effect for this assignment. It is your responsibility to ensure you know and understand what constitutes academic dishonesty and its consequences. *In the event of plagiarism, a grade of 0 will be assigned for that section of the rubric, a report of academic dishonesty will be filed according to the Academic Integrity Policy; the final grade will be assigned according to the academic integrity policy’s consequence and prior incident reports. Total /60 points plus / 35 points (minus _____ for late) = /100 Comments: Prepared by Valerie Abbott, March, 2019. Adapted from: Fostaty Young, S. (2005). Teaching, learning, and assessment in higher education: Using ICE to improve student learning. Proceedings of the Improving Student Learning Symposium, London, UK, 13, 105-115. Imperial College, London, UK, Oxford Centre for Staff and Learning Development. Retrieved March 8, 2019 from: http://www.queensu.ca/teachingandlearning/modules/principles/ documents/Teaching,%20Learning%20and%20Assessment%20in
  • 11. %20Higher%20Education.pdf Wiggins, G. (2017). How to create a rubric that does what you want it to. Retrieved from: https://www.teachthought.com/pedagogy/how-to-create- a-rubric-that-does-what-you-want-it-to/ (based on Wiggins’ Impact, Process, Content, and Polish framework for creating effective rubrics) In consultation with: Lisa Trimble, Teaching and Learning Consultant, Conestoga College Chapter 4 The Legal and Regulatory Environment of Health Care Learning Objectives 1. Understand how legal and regulatory issues shape and define good financial management of a health care organization. 2. Appreciate the consequences of failing to manage the finances of a health care organization without regard for the complex and ever-changing array of laws and regulations that are unique to this industry.
  • 12. 3 Learning Objectives 3. Recognize when and how to involve legal counsel on a Medicare or Medicaid reimbursement issue or other financial matter that has regulatory compliance implications or would otherwise require you to seek legal advice before making a decision. 4. Identify the most common federal regulatory issues such as fraud and abuse, Stark, HIPAA privacy and security, EMTALA, and IRS requirements for tax- exempt organizations, as well as less common concerns that arise under the antitrust laws, Red Flag Rules, and state insurance regulations. Learning Objectives 5. Identify the major components of a corporate compliance plan, including the establishment of internal controls relating to the finances of an organization. 6. Be prepared to respond to a compliance audit or investigation, particularly when the subject of that inquiry includes financial records. 7. Be aware of the most important aspects of the Patient Protection and Affordable Care Act of 2010 (Health Reform Act) as it relates to financial management in the post-Reform environment.
  • 13. 5 Law and Healthcare Financial Management – Corporate Compliance Plans • Office of Inspector General (OIG) Requirements – Internal Control and Corporate Compliance • AICPA Elements 6 Primary Regulatory Issues 1. Medicare Reimbursement – Parts A – Parts D – Certification of Providers – Payment to Providers 2. Medicaid Reimbursement – Eligibility Determination • Federal Poverty Level (FPL) • Supplemental Security Income (SSI) – Coverage of Services – Establishment of Payment Rates
  • 14. – Medicaid DSH Payments 7 Primary Regulatory Issues 3. Beneficiary Appeal Rights & Process – Medicare’s 5 Levels 4. Fraud & Abuse – False Claims Act – Qui Team Actions – Kickback’s and Self-Referrals • Anti-Kickback Statute • Stark Physician Self-Referral Law – Safe Harbors 8 Privacy of Healthcare Information (HIPAA) – HIPAA Overview – Privacy Standards • Protected Health Information (PHI) – Security Standards 9
  • 15. Third Party Payor Contracts – State Regulator • “Any willing Provider” – Federal Law • ERISA 10 Tax Exemption Issues – 501 (C) (3) Organizations – Public Charity vs. Private Foundation – Charity Care – Unrelated Business Income – Form 990 11 Antitrust Issues – Purpose of Laws • Promote a competitive free marketplace – Sherman Act
  • 16. • Agreements that unreasonably restrain trade • Price fixing – IPA’s and PHO’s – Per Se Violations 12 – Reviews of Mergers, Acquisitions, and Joint Venture Agreements • “Statements of Antitrust Enforcement Policy in Health Care,” (August 1996) – Sharing Competitive Information • Financial and/or clinical integration 13 Antitrust Issues • Prohibits mergers and acquisitions that may substantially lessen competition • Analytical Methodology Provided – Will merger increase concentration in market? – Does increased concentration raise anti competitive
  • 17. concerns? – Can another competitor enter market? – Are there efficiencies to be realized? – Without merger would either or merging parties fail? 14 Clayton Act Emergency Medical Transfer and Active Labor Act (EMTALA) – Prohibits hospitals from transferring an emergency patient because of inability to pay. 15 Summary • Healthcare financial managers need to have some understanding of the major rules and regulations related to health care. • The legal and regulatory environment in health care is increasingly complex. • A prudent manager must plan for an adapt to this environment. • Failure to comply can put the organization at significant
  • 18. financial risk and can put individuals at both criminal and financial risk. • Proper planning, implementation, execution, documentation, and evaluation of corporate compliance programs is vital for the financial security of today’s health care organizations. 16 Anti-Trust You are a manager with five years of experience and need to write a report for senior management on how your firm can avoid the threat of a Federal Trade Commission investigation if you were to merge with other health care organizations. Research on your own to select a health care organization in the United States that has been charged with an antitrust action within the last five years and use this information as the basis for your paper. In your report ● Summarize the charges and rebuttal or mitigation of charges used by the health care organization you researched. ● Discuss lessons learned and propose actions that can be taken by your
  • 19. management to avoid similar anti- trust actions in your proposed merger. Briefing Note Assignment - Examples http://www.publicsectorwriting.com/wp- content/uploads/2009/10/Options-Recommendation-Briefing- Note.pdf http://rnao.ca/policy/briefing-notes/preventing-managing- violence-workplace The links above provide examples of briefing notes. There are many ways of writing a briefing note. The first example is not related to nursing but it is addressed to a person (audience), the Purpose is the issue/problem is stated concisely, the Background gives a brief history of the issue, and the Current Situation speaks to what is happening now. The Key Considerations are the 3 bulleted points in the Current Situation section. There are 3 Options related directly to and may help to solve the considerations outlined in the 3 bulleted points (Key Considerations). Note that each option provides at least one advantage and one disadvantage. This briefing note ends with a Recommendations section but in this example, only states the preferred option and does not summarize the major important points the reader should take away. Often busy decision-makers only read the last section; therefore, the writer of this briefing note lost the opportunity to quickly draw attention to and inform the decision-maker. Alternatively, in the RNAO briefing note example, the issue relates directly to nursing but the briefing note does not follow the recommended format (Issue, Background, Current Situation, Key Considerations, Recommendations) that should be addressed in the Briefing Note Assignment guidelines. Therefore, it is suggested you use the above examples to get the general idea of how a briefing note is written but be sure to include all of the key areas in the Briefing Note Assignment guidelines when writing your
  • 20. briefing note. Notice there are no citations or reference list in these examples! For your Briefing Note assignment, you are expected to acknowledge your sources of information with citations and a complete reference list according to Conestoga College’s Academic Integrity Policy. Finally, you might consider the briefing note to be similar to SBAR (Situation, Background, Assessment, Recommendations) and similar to papers you wrote in COMM1085 (introduction/thesis statement, significance, background, 2-3 body paragraphs with support and development of the thesis, and one concluding paragraph). Consider booking an appointment with Student Success Services if you require added support with your writing skills. Prepared by Valerie Abbott, March 2019, in consultation with Lisa Trimble, Teaching and Learning, Conestoga College Briefing Note Assignment Guidelines Weight: 15% Learning Outcomes Addressed in this Assignment: Purpose: The purpose of the Briefing Note assignment is to practice an effective and efficient strategy to inform decision-makers about an important health issue that impacts the health of the population. This assignment involves the production of an original briefing note on a nursing, health or health care
  • 21. problem of interest to you. Examples of broad topic areas from which you can choose a specific focus (see example below) include, but are not limited to: End of life care Social determinants of health Patient Safety Harm reduction Community-based care Chronic illness Health human resources Aging and seniors’ care Access to care Health system financing Care delivery models Immigrant health Pharmaceutical policy Quality of care Non-medical cannabis use COVID Management An example of what is meant by ‘broad topic area”: Indigenous health in Canada · An abundance of evidence demonstrates that Indigenous peoples (First Nations, Metis, Inuit) in Canada live with a greater percentage of serious health issues compared to the rest of the Canadian population. On the following page, you will find examples of what is meant by “choose a specific focus” from the broad topic area for writing your briefing note. This means you might choose one of the following
  • 22. specific focus areas from the broad topic area, Indigenous health in Canada, for writing your briefing note: Malnutrition Lower levels of education Higher suicide rates Inadequate, crowded housing Higher rates of chronic illness Higher rates of death in children due to High rate of tuberculosis Unsafe drinking water Alcohol misuse Content: Write your Briefing Note using the following sub-headings: Audience, Issue, Background, Current Status, Key Considerations, Options, and Recommendations as below. Notice there are questions associated with each sub-heading. It may not be necessary to address each question in each sub- heading because not all may be relevant to your topic. However, you may decide to use the questions under each sub-heading questions as threads to help you frame your briefing note. 1) Audience: Who are you addressing in this briefing note? Be sure your briefing note is written with consideration of the target audience (please note, the audience of your briefing note is not your professor) 2) Issue: Short, concise statement or two about what is the specific issue is about. Who is affected by the issue? What is the significance of the issue? Why should the issue matter to the reader (audience of your briefing note)?
  • 23. 3) Background: Give a brief summary of the background events leading up to the issue. What is the history leading up to the development of the issue and/or how has the issue evolved? 4) Current Status: Describe the current situation of the issue in terms of its current state. What is the current situation or status of the issue? What is happening now? Who is involved? 5) Key Considerations: Inform your reader about aspects of the issue that need to be factored in, thought carefully about, studied, or contemplated prior to making decisions about how to address the issue. Key considerations must be supported with credible, current evidence. 6) 2Options about how the issue could be addressed. The options should relate directly to the key considerations. Include the advantages and disadvantages for each option. 7) Recommendation: Concise, brief summary of what you want your reader to conclude from the reasoning and evidence you provided. What are the key points you want your audience to be clear about? Finally, state the most preferred option from #6 above. Adapted from Doyle, S. 92013). How to Write a Briefing Note. Retrieved February 22nd, 2019 from https://web.uvic.ca/~sdoyle/E302/Notes/WritingBriefingNotes.h tml)
  • 24. Process: The assignment requires the items included in the checklist below: · Report format; this is not a scholarly paper. You may decide to follow the template available for use located in the Briefing Note Resources located in the Briefing Note Assignment module to frame your briefing note. · APA format with citations and references according to [email protected] Conestoga. · Arial 12 font · No more than 3 pages – single spaced (does not include list of references) · Newspaper/magazine articles are not to be used in your assignment; use only credible, relevant, and quality resources. · Submission must be made to the assignment dropbox in the e- Conestoga shell for course NURS8945 by the due date and time. · See Student Handbook for regulations regarding late assignments · Academic Integrity Policy is in effect; Turnitin feature enabled in the assignment dropbox. You may use the Turnitin feature as an educative strategy to correct any potential plagiarism, and citation and referencing errors in advance of your final submission. Your final submission to the assignment dropbox will be the submission that is evaluated. Use the resource documents contained in the Briefing Note Assignment module to guide your thinking as you prepare to write this assignment. Remember, three pages may seem short,
  • 25. however, you will be graded on the quality of the briefing note you produce and the level of synthesis and thoughtfulness contained therein. Prepared by Valerie Abbott, March, 2019, in consultation with Lisa Trimble, Teaching and Learning, Conestoga College