Healthcare Programs Compliance
Course Objective for Assignment:
- Assess the roles of various healthcare stakeholders to ensure that health care programs meet the needs of the recipients and comply with regulatory and payor requirements.
Instructions: Complete a Managerial Report based upon the case and your selected role. The healthcare setting in the report will be based upon the course’s selected case study and the role will be based upon your selected role for the course. An example Managerial Report Template has been provided for your reference, ensure each section is completed with sufficient details. Students are welcome to customize their report, but all aspects of the report must be completed with the appropriate amount of details for each section. Please provide a separate APA cover page and APA reference page with the managerial report that includes at least two credible sources. (Refer to the Announcement Page for the case or the Week 1 Content.) Managerial Report Template PDF Managerial Report Template Word Document (Student may elect to use the Word document, if desired. Please appropriately adjust the spacing and formatting, when entering your information into the report.)
Healthcare Programs Compliance
The managerial report should include the following items:
- Managerial Issue Defined: Identification of one managerial issue with the information on the severity, impact, and scope. Ensure the report includes the appropriate amount of details for each element of the managerial issue, impact, severity, and scope.
Impact: An effect one event makes on the other. For example, the impact would be the restriction to the health services accessibility for all area residents served by the hospital due to the impacted transportation and infrastructure systems. Another impact point could have been the lowered capacity of the hospital to offer health care services to all served area residents (in-patient and out in the community) due to the power failure.
Severity: The fact or condition of being severe. Talking about the severity you needed to concentrate on the wider community. For example, a snowstorm affected a half of the served area living in widespread geographic allocation. The power failure and infrastructure issues would generate public health issues in the community. That should serve as an argument that this is a severe situation for the only health service organized institution in the area which duty is to prevent and mitigate public health issues along with offering routine services.
Healthcare Programs Compliance
Scope: The opportunity or possibility to do or deal with something. Power failure and the infrastructure system failure in the community restrict the scope of hospital influence (opportunity and possibility) on the natural disaster and associated health issues developing in the community.
- Identify 2 Healthcare Case Study Issues: Discuss at least two healthcare-related characteristics of the case.
- Role Perspective: Offer insight to the situation through the lens of your role.
- Identify a Minimum of 2 Policies, Laws, and/or Regulations with Responsible Parties Information: Describe the two policies, laws, or regulations and include a discussion on the responsible parties such as the government agency or regulatory body.
- Explain Your Role for Managing the Situation: Offer at least two specific tasks or steps that you can conduct to appropriately address the issues.
- Identify at Least 2 Stakeholders: Provide a response that includes two stakeholders that your role will work with to address the issues, explain the relationship of the stakeholder to your role, and why this relationship is important.
- Provide at least 2 credible sources with corresponding in-text citations.
Healthcare Programs Compliance
Full sentences with proper grammar, articulation, and punctuation are required throughout the report. Provide the in-text citations throughout the report for the supervising manager’s reference.
Example of Responses for a HIPAA & Compliance Director for a Case Study Involving an Urgent Care Setting: (Please note that these examples may not be used in your submission and the responses are not reflective of a managerial report format.)
- High severity issue: Potential for patient safety violations, Protected Health Information (PHI) violations, and Health Insurance Portability and Accountability Act (HIPAA) violations. (Note: Offer supporting details on the severity level.)
- Impact-HIPAA violations, PHI exposed, patients’ information at risk, and patient safety at risk. (Note: Offer supporting details on the impact.) Scope-Operational, Clinical, & Legal. (Note: Offer supporting details on the scope.)
- Urgent Care Case Study: 2 Issues- Patient tracking issues and staff unaware of patients’ locations including the collection of blood and urine. (Note: Offer supporting details regarding the two issues for the assigned course’s case study, clearly stating the issues as each one relates to the role and healthcare setting.)
- Role Perspective- Compliance & HIPAA Director: Address the identified issues to minimize the risks, ensuring all aspects of compliance are clearly defined, while following all regulatory elements, rules, and laws. (Note: Describe your role as this leader related to the response provided.)
Healthcare Programs Compliance
- 2 Policies/Laws with Regulatory Parties- Apply HIPAA regulations to the issues and revise the organization’s PHI policy. Students do not need to identify specific regulatory definitions but need to demonstrate an understanding of HIPAA regulations and PHI policies for this example. The regulatory parties that may be involved with these laws include the Centers for Medicare and Medicaid (CMS) including CMS surveyors, the Joint Commission, or the Department of Health and Human Services’ Office for Civil Rights (OCR) related to HIPAA enforcement. (Note: Students must include the regulatory body for the selected policies, laws, or regulations that will be presented in the managerial report.)
- 2 Collaborative Stakeholders: Under this scenario, two collaborative stakeholders could be the facility manager and the risk manager. (Note: Discuss how, and why, these two stakeholders were selected, offer a discussion on their roles associated to your role, and provide information to the importance of their role.