1.) Identification of Problem:
Key Issues/Problems:
Carson Manor is a nursing home that houses the elderly and provides them with nursing care. This case of Carson Manor the nursing home is fraught with cost inefficiencies. There are more issues with the system of classifying patients and the levels of nursing care given to each of those patients.
Potential Problems include: * Budget is massively inefficient in keeping and taking care of the elderly within the nursing home. * Nurses will not be able to provide good quality care for their patients. * Patients of a certain status will receive unequal care. * Whether or not to outsource or to improve present system. * Deciding on the criteria to evaluate nursing care
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* Has a higher price than the proposal from Patientcare. * Would require a steering committee to be formed in order to oversee the operation of Clarke-Hamilton.
Alternative 3: Keep Standardcare Service
Advantages: * Anticipated savings are to be in the order of 8 to 10 percent of total expenses, approximately 1.1millon * Has widespread experience in similar situations. * Having already established foot hold in this market heavily increases their odds of achieving Carson Manor’s goals of cost and efficiency. * Owns/manages 2,400 nursing home bed and units in Carson Manor’s state and Florida. * Already has 15 facilities either completed or in progress.
Disadvantages: * Too large to be cater to Carson Manor as efficiently as they would like. * Standard Care would have to juggle meeting the needs of Carson Manor with the many other nursing establishments. * Such a large operator of nursing homes it would be easy to overlook problems within Carson Manor. * May base their proposal too heavily on their past experience, robbing Carson Manor of original identity and ideas that will pertain to them effectively. * Their anticipated savings are more projections than concrete expectancies, therefore may not be dependable.
Recommendation:
Alternative 2: Outsource Carson Manor care to Clarke-Hamilton
This recommendation comes after weighing what we thought the most important aspects were to the selection of a nursing
One of their issues with staffing physicians is the local competition. They are either employed with other managed care facilities, contractually obligated to another facility, or have other priorities. Due to the number of patients, they are outgrowing their current facility and looking to expand. They have found an ideal location, but would have to invest $500,000 to remodel as well as $479,000 to purchase the building. Although the new location would appeal to Medicaid patients and the insured population, Mrs. Marrs is unsure if the time is perfect to expand.
Team B chose to cover Emeritus at Harbour of Pointe Shores, a senior community located in Ocean Shores, Washington. The team was interested in learning more about an assisted living and rehabilitation facility. It is also an opportunity to uncover the differences from an assisted living community and a skilled nursing facility. Emeritus at Harbour of Pointe Shores provides retirement and assisted living, respite services, and on-site rehabilitation. Similar to other long-term care facilities, the facility and staff are required to follow specific guidelines and regulations to maintain licensing and accreditation. However, these
Throughout Unit 6 we reviewed the continuum of care in long-term care facilities and its many aspects. The continuum of care, also referred to as the delivery system of health care, is best defined as a full range of long-term care services increasing in level of acuity and complexity from one end to the other (PowerPoint). This delivery system is comprised of three substantial components. These components are the informal system, community based care, and the institutional system.
5) There is no burden on the residents even though they demand different needs and service
Another lady who resides at an assisted living facility that I operate gave me her views of living there. Her history is that of having dementia and she was becoming so forgetful, she was scared of burning her home down. Therefore, she and her family decided to move her to a place where she would have assistance in getting things done. She states
Within the practice of nursing, situations often arise where nurses are forced to make decisions regardless of their level of experience in the profession. Providing care and following the physician’s orders historically were the nurse’s sole responsibilities. However, social change, changes in health care finances, increasing international perspectives, and demographic population changes, have resulted in a significant evolution of the roles and responsibilities emplaced on today’s nurses (The National Association of Clinical Nurse Specialists (NACNS), 2007). Kelly and Crawford (2013) believe budget cuts, higher client acuity and clients with complex needs, mergers of hospital corporations as well as a general shortage of qualified nurses has made it necessary for nurses to play a role in decision making. Decision making is defined as “cognitive process leading to the selection of a course of action among alternatives” (Kelly & Crawford, 2013, p. 352).
Huber (2006, p154) states that clinical decision making in nursing relates to the quality of care the patient receives and how competent the nurse is.
Opportunities Abilities to expand in hospital departments and health care services in facility. Location of hospital serves a large population area. Easy of public transportation to the hospital.
Both of the gentlemen stated they had been in other homes and that this was the nicest home they had been in. Kenneth complained of his first home ¡°smelling more like a zoo than a nursing home.¡± John told me that his last home was on the South Side and that the neighborhood was filled with gang bangers and hoodlums. When his family visits here though, they wheel him through the Lincoln Park neighborhoods and it¡¯s nice. For all of the questions that I asked these two men, they had just as many questions for me. Heading in to this assignment, I hadn¡¯t really considered that someone would be asking ME questions. In the midst of all that happens in nursing homes, it¡¯s important to remember that these residents aren¡¯t just dependent, older people, but that they are still people just like you and I.
It states the difficulties in the senior homes with little staff and the many complaints received. The complaints are said to be hard to distinguish between serious complaints or just small problems. An example was given like Nancy Hardman who stated that she is removing her mother from the nursing home because it is dangerous and unhealthy to live in.
The ever-increasing cost of Medicare and Medicaid is one of the reasons for the rushing United States budget deficit.
Standing (2011), defines clinical decision-making as a complex process that involves observation, gathering information, critical thinking, evaluating evidence, applying necessary knowledge, reflection and problem-solving skills. Every day nurses make important clinical decisions and these decisions have important implications for patient outcomes and deserve serious consideration. Therefore, it is important for nurses to have a better insight of the decision-making process, be able to deliver holistic care and meet essential and complex physical and mental health needs of the patient.
“There is some evidence that the quality of care for nursing home residents has improved, such as the decreased use of physical restraints and psychotropic medications, serious problems continue for many residents, especially those at the end of their lives.” Some of the issues have been corrected, not abusing or neglecting the elderly patients but the services are not handling the most important part of the patients’ lives. They are still having some issues with handling the patients that are at the end of their lives, they need to focus on the end of their lives in dealing with this they need to know how deal with this part with them and the families.
* Not emphasizing the importance of realistic project cost estimates from the outset. IT project cost estimates are low to start with or based on unclear project requirements.
The predominance of residents in nursing homes are long- term, meaning they will never recover enough to be on their own again. For every 100 residents there are 35 that will die in the nursing home and 37 will transfer to a hospital before dying (Day). This does not mean that it was the facilities fault, it just shows that many patients are already reaching their final days when they are placed in a nursing home. People should not expect the nursing homes to revitalize every single resident, considering most are in there for extreme health problems.