BLW512 – Legal Aspects of Health Care Administration

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

 

 

BLW512 – Legal Aspects of Health Care Administration

 

Copyright, 1996, 2002, 2005, 2006, 2009, 2011, 2018 The Taft University System, Inc.

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without

permission in writing from the copyright holder.

 

 

 

1

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Introduction Important: You should take the time to carefully read this syllabus and the Student Handbook before you begin the assignments for this course. This course provides the student with the necessary background on a wide variety of health care topics, enabling professionals to deal with the common legal and practical problems facing the health care industry. This syllabus contains the lesson assignments for the above referenced course. This course presents an overview of the legal issues facing the health care industry. It is important for health care professionals to become familiar with the legal and medical issues associated with the delivery of quality patient care. Because the law is continually evolving, health care professionals must possess a basic understanding of the law as it relates to their particular areas of responsibility. The focus of this course is to impart to the health care professional an extensive overview of the major issues in health law. This course provides clear legal explanations, definitions, and case examples, which will result in your gaining the knowledge necessary to perform your job within legally defined parameters. It provides a basic working knowledge of health law that is comprehensive and inclusive of a wide variety of health care legal issues. The study of law through review of actual cases is a proven method of learning the law. Your study of cases will help you to apply the law that you learned, and better understand how case law brings about change. Legal doctrines and principles must not only be remembered, but also used to solve specific concrete problems. When reviewing cases, however, the reader must keep in mind that state statutes and court decisions in one state are not binding upon another state. Although the text does not offer an exhaustive study of the laws of any particular state, it deals effectively with those of concern in all states. Moreover, although a specific statute might vary in each jurisdiction, the concepts and definitions are generally the same or substantially similar. Expected Student Learning Outcomes Upon the successful completion of this course you should be able to:

• Explain the structure of the legal system, and the sources of statutory, criminal, and tort laws, rules, regulations and guidelines and how they affect various healthcare environments, and healthcare workers, management, and allied professionals.

• Appraise the myriad of legal issues that confront professionals working in

health care organizations. • Evaluate various contracts, legal reporting requirements, and risk-reduction strategies.

 

 

 

2

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

• Demonstrate an awareness of the rights, responsibilities, and duties of various health care professionals.

• Demonstrate a strong foundation of health law knowledge, which you can

use, while working in the health care industry. • Employ a working knowledge of various human resource issues as they apply

in fields of health care. Required Materials

Pozgar, G. (2019). Legal aspects of health care administration, 13/E. Burlington, MA: Jones & Bartlett Learning ISBN: 9781284127171

Suggestions for getting the most out of this course:

• Read professional journals and periodicals.

• Participate in the course discussion forums and learn from the experience and knowledge

of your faculty mentor and fellow students.

• If possible, form a relationship with someone who works in an area related to your course. Explain that you would like to obtain their insights and perspectives from time to time.

 

Academic Engagement Each academic course at William Howard Taft University is assigned a semester unit value equivalent to the commonly accepted and traditionally defined units of academic measurement in accredited institutions. Credit bearing courses are measured by the learning outcomes normally achieved through 45 hours of student work for one semester unit. For example, a course with a value of 3 semester units would require a typical student to commit 135 hours of academic engagement and preparation to complete the course requirements.

Lesson Assignments This course contains a number of lesson assignments. Work through the lessons one at a time. Unless otherwise instructed, you should complete all assignments for a particular lesson in one WORD document. When you complete all of the assignments in a lesson, submit it to the faculty for grading and feedback.

 

 

 

3

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Submit only one lesson at a time, completing them in sequence. Continue on to the next lesson but be sure to incorporate any feedback received on previous lessons into your subsequent assignments – if necessary.

Format Unless otherwise instructed, Lesson Assignments should be prepared in Microsoft Word® using the Times New Roman font, 12-point, single space, double space between paragraphs. Each page must be numbered, and your last name and student number included on the upper left-hand corner of each page.

Your lesson assignment responses should be evidenced from the course textbook and/or from peer-reviewed sources not more than 5 years old. In general, Wikipedia is not a professionally- reviewed resource and should not be used as an assignment reference. You must cite your references so that readers can verify your conclusions, and easily determine what is your work, and what is paraphrased or taken directly from other sources. Failure to give credit for the work of others in your assignments and writing projects constitutes plagiarism.

Citation Machine: http://citationmachine.net/index2.php?start=&reqstyleid=2&newstyle=2&stylebox=2 Citation Machine is an online tool to assist in proper citation of researched information. We recommend APA format, although you may use other approved formats as long as you remain consistent.

Final Examination Final examination requirements and procedures are set forth in the Student Handbook. Notwithstanding any other provision in this syllabus, if you are required to take a Final Examination for this course you must pass the exam to pass the course. Academic Integrity It is the policy of the University that any student found guilty of cheating and/or plagiarism will be subject to immediate dismissal from the University. All students are required to sign a Coursework Certification Form for each course. This form is provided as a link in the last lesson of each course. Evaluation (How You Will Be Graded for This Course) Your grade will be influenced by the accuracy of your research and the quality of your writing. The extent of research necessary will vary from assignment to assignment. In most cases, your work product should not simply consist of quoting from the assigned text.

 

 

 

 

4

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

When grading your assignments, the faculty will consider three general components:

1. A demonstrated understanding of the material and the learning objectives.

2. Your ability to articulate, synthesize and analyze the concepts and issues presented in the material.

3. Clear and logical composition supported by examples and appropriate references.

If at any time you desire additional feedback, you should contact your faculty advisor directly via email. Feel free to ask questions about course progress, grades, etc., at any time, and remember that the faculty and administration are interested in helping you learn and succeed.

The final grade for the course is determined by the sum of each of the grades in the Lesson Assignments. Each of the lesson assignments is weighted equally in determining your grade for the course. Total Possible Points = 800 (100 Points per lesson).

Grade GPA Percentage Comments

A 4 90-100 (Outstanding)

A- 3.67 88-89 B+ 3.33 84-87 B 3 80-83 (Satisfactory)

B- 2.67 78-79 C+ 2.33 74-77 C 2 70-73 (Passing but below the standard accepted in graduate study)

C- 1.67 68-69 D+ 1.33 64-67 D 1 60-63 (Does not meet standard for graduate study, coursework must be repeated for credit) D- 0.67 59 F <0.67 58 or below (Failure)

 

 

 

5

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Faculty Mentors will refer to the following grading rubric when evaluating your assignments:

Excellent Above Average Satisfactory Needs Improvement Unsatisfactory

Understanding of Material and Lesson Objectives

Demonstrates a thorough understanding of the material.

Demonstrates an adequate understanding of material

Responses are generally accurate, but at times lacking coherence.

Demonstrates a marginal understanding of the material and lesson objectives.

Provides marginally complete and/or inaccurate responses showing little understanding of the material

Articulation, Synthesis and Analysis of Concepts

Work is articulated consistent with the degree level integrating or synthesizing concepts in an original and innovative way.

Work demonstrates a solid knowledge of concepts and theories with some individual analysis of issues.

Work demonstrates an elementary knowledge of concepts but lacks original thought and analysis.

Work is primarily paraphrased or quoted directly from the text or other sources. Responses demonstrate little or no individual analysis.

No individual analysis of concepts. Work is poorly articulated and/or derived entirely from the textbook.

Composition, Presentation, and References

Work presented in a logical and coherent way supported by sound resources. Citations are composed in proper format with few or no errors.

Work presented is grammatically sound. Resources are appropriate and cited in proper format with few errors.

Work is grammatically sound with a few minor errors. Resources may be of questionable authority but are cited in proper format with few errors.

Work contains frequent grammatical errors. Resources are few, non- existent, or may be of questionable authority.

Frequent errors in composition, grammar and presentation. Quoted material is incorporated without the use of quotation marks or citation (plagiarism).

 

Course Completion Requirements

The course will be deemed completed only when all the following has been accomplished:

• You have completed the lesson assignments and they have been received by the University.

• You have passed the course Final Examination.

• You have completed the Course Certification Form and it has been received by the University.

• You have completed the Course Evaluation Survey.

 

 

 

6

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Lesson 1 – The Legal System, Tort Law , and Criminal Aspects

Introduction This lesson begins with a brief overview of the advance of civilization as disclosed in the history of hospitals. A study of the past often reveals errors that then can be avoided, customs that persist only because of tradition, and practices that have been superseded by others that are more effectual. The past may also bring to light some long-abandoned practices, which may be revived to some advantage. The story of the birth and evolution of the hospital portrays the triumph of civilization over barbarism and the progress of civilization toward an ideal characterized by an interest in the welfare of the community. The course explores laws, enacted to regulate human behavior for the benefit of society, and designed to prevent harm to others while protecting the rights of individuals. We introduce the development of US law, the functioning of the legal system, and the roles of the different branches of government in creating, administering, and enforcing the law. It is important to understand the foundation of the US legal system before one can appreciate or comprehend the specific laws and principles relating to health care. Next, we explore tort law, with an emphasis on negligence in healthcare settings. A tort is a civil wrong, other than a breach of contract, committed against a person or property (real or personal) for which a court provides a remedy in the form of an action for damages. Tort actions touch an individual both on a personal and a professional level, which is why those involved in the healthcare field should be armed with the knowledge necessary to make them aware of their rights and responsibilities. Criminal law is society’s expression of the limits of acceptable human and institutional behavior. A crime is any social harm defined and made punishable by law. The objectives of criminal law are to maintain public order and safety, to protect the individual, to use punishment as a deterrent to crime, and to rehabilitate the criminal for return to society. Crimes are generally classified as misdemeanors or felonies. The difference between a misdemeanor and a felony revolves around the severity of the crime. A misdemeanor is an offense punishable by less than 1 year in jail and/ or a fine (e. g., petty larceny). A felony is a much more -serious crime (e. g., rape, murder) and is generally punishable by imprisonment in a state or federal penitentiary for more than 1 year. Criminal law distinguishes crimes from civil wrongs such as tort or breach of contract. Criminal law has been seen as a system of regulating the behavior of individuals and groups in relation to societal norms at large, whereas civil law is aimed primarily at the relationship between private individuals and their rights and obligations under the law.

 

 

 

7

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

The objectives of criminal law are to maintain public order and safety, to protect the individual, to use punishment as a deterrent to crime, and to rehabilitate the criminal for return to society. Particular to healthcare organizations is the fact that patients are often helpless and at the mercy of others. Health-care facilities are far too often places where the morally weak and mentally deficient prey on the physically and sometimes mentally helpless. The very institutions designed to make the public well and feel safe can sometimes provide the setting for criminal conduct. The US Department of Justice and state and local prosecutors are vigorously pursuing and prosecuting healthcare organizations and individuals for criminal conduct. Health- care fraud, patient abuse, and other such crimes have caused law enforcement agencies to assume a zero- tolerance level for such acts. This reality requires healthcare professionals to be observant in their environments and to report suspicious conduct, as appropriate. Lesson Learning Objectives By the conclusion of this lesson you should be able to:

• Explain how societal conflicts due to politics, religion, and warfare have both impeded the growth of hospitals and contributed to their progress.

• Describe how advances in medicine led to the rise of the modern-day hospital and improved the quality of patient care.

• Describe how the knowledge gained from best practices (e.g., infection control) can lead to progress while at the same time result in patient harm if not consistently followed over time.

• Explain the development and sources of law.

• Discuss how case law differs from statutory and administrative law.

• Describe what is meant by the following terms: o conflict of laws

o separation of powers

o political malpractice

o negligence

o malpractice

• Describe the three branches of government.

 

 

 

8

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

• Describe the organizational structure of the Department of Health and Human Services.

• Describe the functions of various government ethics committees.

• Describe what a tort is, the objectives of tort law, and the differences between intentional torts and negligence.

• Explain the distinction between negligence and malpractice.

• Explain how the commission and omission of an act differ.

• Explain the elements necessary to prove a negligence case.

• Describe the importance of foreseeability in a negligence case.

• Identify various intentional torts and their application in a healthcare setting.

• Explain the theories a plaintiff can use in pursing a products liability case against a manufacturer.

• Describe the various theories a manufacturer may use when defending itself against a products liability case.

Reading Study Chapters 1 through 4 of the text. Review the Power Points for Chapters 1 through 4. Assignments The following Assignment Questions should be completed and submitted to the course faculty via the learning platform for evaluation and grading. Submit your responses to these questions in one WORD document. List the question first, and then your response. Your response must adequately cover the question without being wordy or relying on “yes” or “no” responses. Short Answer Questions 1. What were two of the greatest influences in the development of present-day hospitals, and

what historical events impeded their progress over the centuries?

2. Describe how social media can have a negative or positive impact on caregivers and healthcare facilities. What Internet sites are patients likely to consult to determine a physician’s or hospital’s reputation for patient care?

 

 

 

9

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

3. The USA population is sharply divided along political, cultural, and demographic lines. Give three examples of how social divisions in the USA have spilled over and impacted health care law.

4. Give three examples of how the “check and balances” envisioned by the Founding Fathers are ineffective when a single political party controls all three branches of the federal government.

5. Explain the difference between negligence and malpractice, and give two examples of how a board-certified medical doctor can be negligent without committing malpractice

6. Explain how a patient can be negligent in taking care of his or her own health. Can a patient be prosecuted for negligence?

7. Provide short answers to the following: a. Describe the various categories of intentional torts. b. Describe the difference between assault and battery.

c. What is defamation of character? What two forms can it take?

d. Under what circumstances can a patient be held in a hospital against his or her will?

e. What is fraud? What three elements must be present to establish fraud?

f. Describe how a patient’s privacy can be invaded.

g. What is the infliction of mental distress? Given an example.

Professional Development In 2018, the Trump Administration came under sharp criticism for attempting to weaken a World Health Organization resolution promoting breast feeding in an effort to get (impoverished) women around the world to feed their infants baby formula rather than mother’s breast milk.

a. What three companies are the largest suppliers of baby formula and what percent of the market do they control?

According to The Los Angeles Times, “Formula consists of little more than dehydrated cow’s milk and vitamins (and lots of sugar), yet it somehow costs $150 a month to feed it to an American baby” (Dayen, 2018, p.1).

b. How would you describe baby formula using your knowledge of

negligence, intentional torts, and fraud?

 

http://nbclatino.com/2012/02/22/18091566837/

 

 

10

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

In most developing countries, the vast majority of the population is impoverished, parents could not afford baby formula, the parents often watered-down baby formula to make a given amount last longer, and babies were undernourished and eventually died. For example, “A 1974 paper called “The Baby Killer” detailed Nestlé’s schemes to confuse young mothers into believing that formula was modern and vital to child development, while bribing Third World hospitals to hook their patients on the stuff. Its success has been credibly linked to millions of unnecessary malnutrition deaths, as poor families struggle to afford high prices and ultimately over-dilute baby formula with water” (Dayen, 2018, p. 1)

c. Provide citations to three other articles that describe the phenomenon of unnecessary malnutrition deaths related to impoverished families over- diluting baby formula.

d. Using health care law terminology, describe the role of the US government in this controversy related to breast feeding.

 

 

http://www.nytimes.com/1981/12/06/magazine/the-controversy-over-infant-formula.html?pagewanted=all

 

 

11

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Lesson 2 – Contracts, Trial Practice, and Corporate Structure Introduction One of the many branches of law that affects healthcare providers is the law of contracts. This lesson begins with an introduction to contracts, focused on providing a general understanding of their concepts, elements, and importance as they pertain to healthcare organizations and professionals. A contract is a special kind of agreement, either written or oral, that involves legally binding obligations between two or more parties. The major purpose of a contract is to specify, limit, and define the agreements that are legally enforceable. A contract forces the participants to be specific in their understandings and expectations of each other. Contracts, particularly those in writing, serve to minimize misunderstandings and offer a means for the parties of a contract to resolve any disputes that may arise. Next, we strive to provide an understanding the law and its application in the courtroom. Trials, especially jury trials, are vital to fostering the respect of the public in the civil justice system. Trials do not represent a failure of the system. They are the cornerstone of the civil justice system. Unfortunately, because of expense and delay, both civil bench trials and civil jury trials are disappearing. For many students and healthcare practitioners, this course will be their only formal introduction to the legal aspects of health care. Although many of the procedures leading up to and followed during a trial are discussed in this lesson, civil procedure and trial practice are governed by each state’s statutory requirements. Cases on a federal level are governed by federal statutory requirements. Finally, we introduce the healthcare professional to the responsibilities, as well as legal risks, of healthcare organizations and their governing bodies. Healthcare organizations are incorporated under state law as freestanding for-profit or not-for-profit corporations. Each corporation has a governing body (e. g., board of directors) that has ultimate responsibility for the operation of the organization. The existence of this authority creates certain duties and liabilities for governing boards and their individual members. The governing body is legally responsible for establishing and implementing policies regarding the management and operation of the organization. Responsibility for the day-to-day operations of an organization is generally accomplished by appointing a chief executive officer. Not-for-profit healthcare organizations are usually exempt from federal taxation under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. Such federal exemption usually entitles the organization to an automatic exemption from state taxes as well. Such tax exemption not only relieves the organization from the payment of in- come taxes and sales taxes, but also permits the organization to receive contributions from donors, who then may obtain charitable deductions on their personal income tax returns.

 

 

 

12

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Although healthcare organizations may operate as sole proprietorships or partnerships, most function as corporations. Thus, an important source of law applicable to governing boards and to the duties and responsibilities of their members is found in state incorporation laws. These duties include holding meetings, establishing policies, being financially scrupulous, providing adequate insurance, and paying taxes. Lesson Learning Objectives By the conclusion of this lesson you should be able to:

• Discuss the ways in which a provider can practice defensive medicine.

• Describe the various tort reform programs designed to lower the cost of malpractice insurance.

• Describe the various programs that can help reduce the number of malpractice claims.

• Explain what criminal law is, its main objectives, and the classification of crimes.

• Describe the criminal procedure process from arrest through trial.

• Describe several of the more common crimes that occur in the healthcare setting.

• Explain what a contract is.

• Describe the elements of a contract.

• Describe how a hospital can be liable for the acts of a physician under contract.

• Explain the possible defenses and remedies for nonperformance of a contract.

• Describe under what circumstances an employee handbook could be considered a contract and how to avoid that assumption.

 

Reading

Study Chapters 5 through 7 of the text.

Review the Power Points for Chapters 5 through 7.

 

 

 

13

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Assignments

The following Assignment Questions should be completed and submitted to the course faculty via the learning platform for evaluation and grading. Submit your responses to these questions in one WORD document. List the question first, and then your response. Your response must adequately cover the question without being wordy or relying on “yes” or “no” responses. Short Answer Questions 1. It has been said that the Affordable Care Act (also known as Obamacare) was designed to

fail, because it contained no mechanism to control health costs. Given that the statute was over 1,500 pages long, why were no provisions added to limit the cost of contractual reimbursements?

2. Explain how despite risk management, performance improvement, and peer review processes implemented by health care facilities, medical errors are still the third leading cause of death in the USA (Allen, 2016, p. 1

3. Identify who is right and wrong, who are criminal actors, which parties should be prosecuted, and who are victims in the following situation: “High prices, which formula manufacturers colluded to produce in the 1990s, have triggered a black market and a ring of grocery thefts” (Dayen, 2018, p. 1).

4. Which parties are subject to criminal prosecution, and which parties are immune from criminal prosecution, in describing to a member of the general public an off-label use of a drug or medical device?

5. Hospitals can be victims of cybercrimes, but unlike bank account information which can used to steal funds, health care records offer little obvious financial reward. What is motivating cybercrime in a health care setting?

6. Describe the advantages and disadvantages of establishing a contractual relationship with a health care employer as a wage-earning employee vs. a business income-earning consultant or independent contractor. Would a cardiovascular surgeon generally prefer to be a consultant or employee? Would a nursing assistant generally prefer to be an employee or independent contractor?

7. Describe the various defenses and remedies available for nonperformance of a contract. Professional Development How can contract law be used to assist insurers obtain more affordable drug prices from their Pharmacy Benefit Managers (PBMs)? What key contract terms would you suggest between an insurer and its PBM?

 

https://www.nytimes.com/1991/07/28/business/all-about-baby-formula-price-fixing-and-other-charges-roil-a-once-placid-market.html

 

 

14

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Lesson 3 – Medical Staff, Nursing and the Law Introduction This lesson begins with an overview of medical ethics, medical staff organization, the credentialing process, and a review of cases focused on the legal risks of physicians. The cases presented highlight those areas in which physicians tend to be most vulnerable to lawsuits. The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. As a member of this profession, a physician must recognize responsibility to patients first and foremost, as well as to society, to other health professionals, and to self. The medical staff is an integral part of a healthcare organization with defined responsibilities under its bylaws. The medical staff is formally organized with officers, committees, and by-laws. At regular intervals, the various committees of the medical staff review and analyze their responsibilities, clinical experiences, and opportunities for improvement. The responsibilities of a variety of medical staff committees are described in this lesson. Finally, we explore the role of nursing and associated legal obligations and implications. Each state has its own nurse practice act that defines the practice of nursing. Although most states have similar definitions of nursing, differences generally revolve around the scope of practice permitted. The scope of practice of a licensed practical nurse (LPN) is generally limited to routine patient care under the direction of a registered nurse (RN) or a physician. An RN is one who has passed a state registration examination and has been licensed to practice nursing. The scope of practice of a registered professional nurse includes, for example, patient assessment, patient teaching, health counseling, executing medical regimens, and operating medical equipment as prescribed by a physician, dentist, or other licensed healthcare provider. A nurse practitioner (NP) is an RN who has completed additional training beyond basic nursing education. The NP provides primary healthcare services in accordance with state nurse practice laws or statutes. Although the actual authority of nurses to act varies considerably from state to state, the scope of nursing functions and licensure is expanding.

Lesson Learning Objectives By the conclusion of this Lesson you should be able to:

• Discuss the pretrial discovery process.

• Describe the trial process.

• Describe the forms of evidence presented by the plaintiff.

 

 

 

15

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

• Describe defenses offered by the defendant.

• Explain the purpose of the judge’s charge to the jury.

• Describe the types of damages and how they are awarded.

• Explain from where a corporation derives its authority.

• Explain the difference between express, implied, and corporate authority.

• Discuss corporate organization and committee structure.

• Describe corporate ethics, the Sarbanes Oxley Act of 2002, and corporate compliance.

• Explain the terms corporate compliance, negligence, respondent superior, and independent contractor.

• Describe the duties of healthcare organizations, the chief executive officer (CEO), and medical staff.

• Explain the purpose of corporate reorganization and the process of restructuring.

• Describe what is meant by parent holding company model.

• Describe what the Safe Harbor Act is designed to regulate. Reading Study Chapters 8 and 9 of the text. Review the Power Points for Chapters 8 and 9. Assignments

The following Assignment Questions should be completed and submitted to the course faculty via the learning platform for evaluation and grading. Submit your responses to these questions in one WORD document. List the question first, and then your response. Your response must adequately cover the question without being wordy or relying on “yes” or “no” responses.

 

 

 

 

 

16

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Short Answer Questions 1. A health care facility captioned Urgent Care can bill Medicare and insurers for a higher

amount per visit than one captioned Walk-In Clinic or Minute Clinic, yet the wait times for patients are comparable at either facility.

Write a paragraph on how excessively long wait times would violate explicit contract terms between the clinic and the payers. Write a separate paragraph on how these wait times violate implicit contract terms and identify who suffers from the violations.

How would a patient determine the contract provision for a reasonable wait time at a walk-in clinic compared to a grocery store Minute Clinic compared to an Urgent Care clinic?

2. If a healthcare clinic is staffed by Nurse Practitioners rather than medical doctors, how does

that change the type and nature of the medical practice?

3. In what settings and for what kind of surgical operations are Nurse Anesthetists typically used instead of Anesthesiologists?

4. Identify, by name and Internet web site, two hospitals with separate corporate structures located within a 30-mile radius of your home. How does the ownership structure for the hospital affect its staffing and quality?

5. How does the Sarbanes-Oxley Act of 2002 apply to health care, and how does the Act impose different obligations on for-profit and non-profit medical facilities?

6. Explain the common legal risks faced by a nurse anesthetist, a clinical nurse specialist, a nurse practitioner, and a nurse midwife. What are the contrasting limitations in their scope of practice?

Professional Development Should a nurse ever attempt to fix a piece of medical equipment that he or she knows is defective? If no, why not? If yes, under what circumstances?

 

 

 

17

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Lesson 4 – All ied Professionals, Information Management and Patient Consent

Introduction This lesson begins with an overview of selected departments and healthcare professions. Although it describes a variety of legal issues, there is no intensive review of any specific department or profession. The cases presented illustrate that no healthcare profession is exempt from the legal system. Healthcare professionals are held to the prevailing standard of care required in their profession, which includes proper assessments, reassessments, diagnosis, treatment, and follow- up care. Next, we explore information management systems in the healthcare environment. To significantly reduce the tens of thousands of deaths and injuries caused by medical errors every year, health care organizations must adopt information technology systems that are capable of collecting and sharing essential health information on patients and their care. The effective and efficient delivery of patient care requires that an organization determine its information needs. Organizations that do not centralize their information needs will often suffer scattered databases, which may result in such problems as duplication of data gathering, inconsistent reports, and inefficiencies in the use of economic resources. As the principal means of communication between healthcare professionals in matters relating to patient care, the medical record primarily provides documentation of a patient’s illness, symptoms, diagnosis, and treatment and is used as a planning tool for patient care. Practitioners also use medical records to document communication; assist in protecting the legal interests of the patient, the organization, and the practitioner; provide a database for use in statistical reporting, continuing education, and research; and provide information necessary for third-party billing and regulatory agencies. Healthcare organizations are required to maintain a medical record for each patient in accordance with accepted professional standards and practices. Finally, this lesson reviews the many issues surrounding consent in the healthcare setting. Consent, in the healthcare setting, is the voluntary agreement by a person who possesses sufficient mental capacity to make an intelligent choice to allow a medical procedure and/ or treatment proposed by another to be performed on himself or herself. Consent changes a touching that otherwise would be nonconsensual to one that is consensual.

 

 

 

18

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Lesson Learning Objectives By the conclusion of this lesson you should be able to:

• Describe medical staff organization and committee structure.

• Describe the credentialing and privileging process and discuss the purpose of physician supervision and monitoring.

• Discuss common medical errors involving patient assessment, diagnosis, treatment, discharge, and follow-up care.

• Explain how the physician-patient relationship can be improved.

• Describe how the scope of nursing practice continues to evolve.

• Describe common categories of nursing staff.

• Explain the process of obtaining nurse licensure.

• Describe a variety of the legal risks nurses encounter.

• Discuss the ways in which a nurse is a patient advocate.

• Describe a variety of legal issues that occur in patient care settings.

• Discuss the purpose of the Emergency Medical Treatment and Active Labor Act.

• Describe the purpose of certification and licensure, and the reasons for revocation of licenses.

• Explain the importance of a multidisciplinary approach to patient care. Reading Study Chapters 10 through 12 of the text. Review the Power Points for Chapters 10 through 12.

 

 

 

19

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Assignments The following Assignment Questions should be completed and submitted to the course faculty via the learning platform for evaluation and grading. Submit your responses to these questions in one WORD document. List the question first, and then your response. Your response must adequately cover the question without being wordy or relying on “yes” or “no” responses. Short Answer Questions 1. What was the reasoning for enacting the Emergency Medical Treatment and Active Labor

Act?

2. Considering your answer for question 1, search for videos on youtube.com and perform a general search on the Internet using the keywords “patient dumping.” First, indicate how many videos are displayed on youtube and how many articles were found on the general search using those keywords. Second, explain why the practice of patient dumping is still occurring despite your answer for question 1.

3. Argue for and against ethical requirements for physicians to treat all patients. What exceptions would you carve out, if any, that would allow doctors to reject patients with, e.g., severe depression, risk-taking behavior, or belief in nonsense?

4. Give three examples in which a nurse can interfere in a doctor-patient relationship, and what

ethical challenges are posed by that interference?

5. Sadly, in many emergency department settings, the staff are not operating “to go the extra mile” to save lives, but routinely apply mediocre effort to treat patients and get them either admitted to the hospital, if obvious medical conditions are present, or discharged, if non- obvious medical conditions are present. How can unmotivated (read “ethically-challenged”) health care staff, accustomed to patient death and misery, be motivated “to go the extra mile” towards providing diligent health care?

6. Explain the arguments for and against having “telemedicine” conversations with physicians to obtain medical advice. Argue for and against allowing telemedicine physicians to write prescriptions for their telemedicine patients.

7. What does federal health care law require of doctors today in terms of electronic records and information management? What legal constraints are imposed on a doctor who refuses to utilize a computer and uses only paper charting of patients?

Professional Development Some state and local governments have tried to discourage abortions by, among other things, dictating to physicians an elaborate litany of specific information that must be communicated to a patient as a necessary precondition of her informed consent for an abortion. Discuss:

 

 

 

20

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

a. the legal status of such requirements

b. the implications of these requirements for the professional autonomy of physicians

c. the role of the medical profession in challenging these restrictions, on its own behalf and in concert with its patients

 

 

 

21

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Lesson 5 – Reporting Requirements, Patient Rights, and AIDS Considerations Introduction This lesson begins with an overview of a variety of legal reporting requirements mandated by both federal and state regulatory agencies. Through such reporting, appropriate measures are taken to safeguard the health of the nation’s population. Most states have legislative reporting requirements for child abuse, elder abuse, and diseases that pose a threat to public health and safety (e. g., anthrax, smallpox). Although most statutory reporting requirements do not contain an express immunity from liability for disclosure without the permission of the person affected, as a general rule, a person making a report in good faith and under statutory command is protected. Next, we examine patient rights in the healthcare system. Every person possesses certain rights guaranteed by the Constitution of the United States and its amendments, including freedom of speech, religion, and association and the right not to be discriminated against on the grounds of race, creed, color, or national origin. The Supreme Court has interpreted the Constitution as also guaranteeing certain other rights not expressly mentioned, such as the right to privacy and self- determination and the right to accept or reject medical treatment. Keeping those Constitutional guarantees and interpretations in mind, this lesson provides a brief overview of both the rights and responsibilities of patients. Finally, we discuss the AIDS epidemic, considered to be the deadliest epidemic in human history. The first case was recorded in the literature in 1981. It has been estimated that more than 21 million people have died from AIDS. AIDS, generally, is accepted as a syndrome—a collection of specific, life- threatening, opportunistic infections and manifestations that are the result of an underlying immune deficiency. AIDS is caused by HIV, a highly contagious blood-borne virus, and is the most severe form of the HIV infection. It is a fatal disease that destroys the body’s capacity to ward off bacteria and viruses that ordinarily would be fought off by a properly functioning immune system. Although there is no effective long-term treatment of the disease, indications are that proper management of the disease can improve the quality of life and delay progression of the disease. Internationally, AIDS is posing serious social, ethical, economic, and health problems. Lesson Learning Objectives By the conclusion of this lesson you should be able to:

• Describe the contents of medical records.

• Explain the importance of maintaining complete and accurate records.

 

 

 

22

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

• Explain the ownership of and who can access a patient’s medical record.

• Describe the advantages and disadvantages of electronic medical records.

• Describe why the medical record is important in legal proceedings.

• Describe a variety of ways in which medical records have been falsified.

• Explain what is meant by the medical records battleground.

• Describe the purpose of the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act of 1996 and how they affect hospital and physician practices.

• Discuss the difference between verbal, written, and implied consent.

• Describe the role of the patient, physician, nurse, and hospital in informed consent.

• Describe the theories under which the validity of consent might be proven.

• Explain how consent differs among competent patients, minors, guardians, and incompetent patients.

• Discuss the importance of understanding patient rights.

• Discuss the importance of understanding patient responsibilities.

• Describe the concepts of ethics and morality.

• Describe how an understanding of ethical theories, principles, and virtues is helpful in resolving ethical dilemmas.

• Explain the relationship between spirituality and religion.

• Discuss situational ethics and how one’s moral character can change as circumstances change.

• Explain how one’s reasoning skills influence the decision-making process.

 

Reading Study Chapters 13 through 15 of the text. Review the Power Points for Chapters 13 through 15.

 

 

 

 

23

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Assignments The following Assignment Questions should be completed and submitted to the course faculty via the learning platform for evaluation and grading. Submit your responses to these questions in one WORD document. List the question first, and then your response. Your response must adequately cover the question without being wordy or relying on “yes” or “no” responses Short Answer Questions 1. Argue for and against this proposition: “Patient consent is more than a patient’s agreement

to follow a doctor’s recommendation. Patient consent operates as an order from the patient to the physician to perform the lab test, administer the exam, or perform the operation to which the patient consents.”

2. In all areas of the law, attorneys are called upon to predict changes in the law and their consequences. What are the top three or four consequences that would follow from repeal of the Affordable Care Act?

3. Discuss separately how the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act of 1996 safeguard a patient’s privacy.

4. Attack or defend the accuracy of the following statement: “If the Affordable Care Act is repealed, private health insurers will be free to come up with a package of health care services offered to their customers that could exclude treatment for particular diseases or medical conditions.”

5. If the Affordable Care Act is repealed, what other federal laws, if any, would

prevent a private health insurer from no longer providing coverage for treatment of AIDS?

6. What freedom do states have in deciding what services are offered under the state’s administration of the Medicaid program? Can states select treatments for medical conditions (AIDS, opioid addiction, abortion) that Medicaid in their states will not cover?

7. What health care laws, if any, prevent states with large religious populations from allowing doctors and medical facilities to refuse to offer transgender patients appropriate therapies or surgeries?

Professional Development In Mexico, citizens do not need a doctor’s prescription to obtain a drug, e.g., for hyperlipidemia or hypertension. Eliminating the necessity of going to see a doctor and pay for the doctor visit dramatically lowers the complete cost of drugs in Mexico vs. the USA.

 

 

 

24

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Provide arguments for and against the proposition that the citizens of the USA would benefit from being able to purchase non-controlled drugs from pharmacies without first obtaining a doctor’s prescription. In your answer, comment on whether Mexico has a higher or lower drug overdose or drug misuse problem than the USA.

 

 

 

25

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Lesson 6 – Healthcare Ethics, End-of-Life Issues, & Reporting Introduction This lesson begins with an overview of healthcare ethics and moral principles. An ethical dilemma arises in situations where a choice must be made between unpleasant alternatives. It can occur whenever a choice involves giving up something good and suffering something bad, no matter what course of action is taken. Ethical dilemmas often require caregivers to make decisions that may break some ethical norm or contradict some ethical value. For example, should I choose life knowing that an unborn child will be born with severe disabilities, or should I choose abortion and thus prevent pain for both parent and child? Should I adhere to my spouse’s wishes not to be placed on a respirator, or should I choose life over death, disregarding her wishes and right to self- determination? There is a wide range of ethical and legal issues impacting the healthcare system. This lesson will focus on some of the more common ethical and legal dilemmas facing health-care professionals. We will next examine numerous ethical questions involving issues of procreation. Primary emphasis is placed on abortion. Discussed to a lesser extent are issues relating to sterilization, artificial insemination, and wrongful birth, wrongful life, and wrongful conception. We will explore end-of-life issues including a patient’s autonomy and one’s right to choose when to proceed with treatment or discontinue it. Discussed to a lesser extent are issues relating to autopsy, organ donations, research and experimentation, surrogacy, and human genetics. The human struggle to survive and dreams of immortality have been instrumental in pushing humankind to develop the means to prevent and cure illness. Advances in medical technology have resulted in the power to prolong a productive life, as well as delay inevitable death. Finally, we will examine legal reporting requirements related to child abuse, elder abuse, communicable diseases, adverse drug reactions, and infectious diseases. The important of reporting births and deaths will be discussed. This lesson also considers the importance of reporting physician incompetence, incidents, and sentinel events and the purpose of root cause analysis. Lesson Learning Objectives By the conclusion of this lesson you should be able to:

• Discuss the 1973 Supreme Court ruling in Roe v. Wade and the continuing controversy over abortion.

 

 

 

26

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

• Describe the flow of abortion cases beginning with Roe v. Wade, concentrating on counseling, spousal consent, parental consent, and funding.

• Define and explain the legal issues of sterilization, artificial insemination, and surrogacy.

• Describe the legal and moral issues of wrongful birth, wrongful life, and wrongful conception.

• Discuss the human struggle to survive and the right to autonomous decision

making.

• Describe how patient autonomy has been impacted by case law and legislative enactments.

• Discuss the following concepts:

o Preservation of life with limits

o Euthanasia

o Advance Directives

o Futility of treatment

o Withholding and withdrawal of treatment

o Do-not-resuscitate orders

• Explain end-of-life issues as they relate to autopsy, organ donations, research, experimentation, and clinical trials.

• Describe how human genetics and stem cell research can have an impact on end-of-life issues.

• Describe various forms of child abuse, how to recognize it, and reporting

requirements.

• Describe various forms of elder abuse, how to recognize it, and reporting requirements.

• Explain why it is important to report communicable diseases, adverse drug

reactions, and infectious diseases.

• Discuss the importance of reporting births and deaths.

• Explain how and why physician incompetence is reported.

• Understand the importance of incident reporting, sentinel events, and the purpose of root cause analysis.

 

 

 

27

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Reading Study Chapters 16 through 18 of the text. Review the Power Points for Chapters 16 through 18. Assignments The following Assignment Questions should be completed and submitted to the course faculty via the learning platform for evaluation and grading. Submit your responses to these questions in one WORD document. List the question first, and then your response. Your response must adequately cover the question without being wordy or relying on “yes” or “no” responses Short Answer Questions 1. Write a two-paragraph explanation of the U.S. Supreme Court’s “undue burden”

standard for abortion legislation.

2. Give three examples of abortion restrictions that would violate the undue burden standard and three examples of restrictions that would be allowed under that standard.

3. Aside from abortion, describe how patient autonomy in making healthcare decisions has been impacted by case law and legislative enactments.

4. Explain who benefits from the “Right to Try” statute of 2018 and why did it take so many decades for this legislation to be enacted? Why should the “Right to Try” be limited to one class of patients but not all patients?

5. Explain why the Genetic Information Nondiscrimination Act was enacted.

6. Explain how state and federal attempts to limit access to marijuana, in general, and medical marijuana, in particular, represents an attempt to legislate morality. Provide citations to three credible (scientifically-sound, non-political) articles and summarize their content on whether the scientific evidence shows that cigarettes, alcohol, or marijuana has the most harmful impact on health.

7. Locate and view two video interviews with Atul Gawande, M.D., on end of life issues. Describe what reforms, if any, are needed in health care laws to address end of life issues after listening to the ideas expressed by Dr. Gawande.

 

 

 

 

28

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Professional Development A majority of the US population now accepts the proposition that patients with terminal conditions should be provided death with dignity. Often the treatment will lead to pain medication doses that eventually cause the patient to cease breathing as an unintended consequence. Present arguments for and against the proposition that the Right to Self-Determination should not be limited to people with terminal diseases but is an inalienable right for all competent and fully rational citizens.

 

 

 

29

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Lesson 7 – Liability Insurance, Labor Relations, and Employee Issues

Introduction This lesson begins with an introduction to some of the basic concepts related to liability insurance. The purpose of liability insurance is to spread the risk of economic loss among members of a group who share common risks. For example, an obstetrician would share risk with other obstetricians. As risks increase, premiums increase to cover associated risks. The premiums are placed in a shared risk fund from which funds are drawn to cover the costs of lawsuits. As high awards are paid out of the fund, there is a danger that patients will have a more difficult time to find physicians willing to accept them as patients. Some physicians, because of skyrocketing malpractice premiums, find it too costly to maintain a private practice. As a result, they often limit their practice to less costly procedures or close their practices. Medical malpractice insurance, as in all insurance, is subject to the cyclical nature of the insurance market. Problems intrinsic in malpractice insurance include the uncertainty of the US legal system, the effects of inflation on ultimate claim values, emerging technology, and new treatments. Next, we provide an overview of employment laws affecting the healthcare industry. Federal or state regulation generally pervades all areas of employer–employee relationships. Healthcare organizations are not exempt from the impact of these laws and therefore are required to consider such matters as employment practices (wages, hours, and working conditions), union activity, workers’ compensation laws, occupational safety and health laws, and employment discrimination law. The most significant piece of federal legislation dealing with labor relations is the National Labor Relations Act. Although federal laws generally take precedence over state laws when there is a conflict between the state and the federal laws, state laws are applicable and must be considered, especially when state regulations are more rigid than federal legislation. For the healthcare worker, an unexpected termination may mean a significant setback in career progression, financial hardship, and loss of self-esteem. For the organization and its community, a termination means a lack of stability in the management structure and possible disruption and re-alignment of services provided. A growing consensus is that high turnover rates are unhealthy and provide a disservice to an industry already plagued with cost constraints and other pressures. Wrongful discharge claims are difficult and time consuming and often mean expensive lawsuits to defend. Employers who experience favorable court decisions in wrongful discharge claims often have unfavorable repercussions because of bad press and the negative effects a discharge has on employee morale. Fairly balancing the rights and responsibilities of the employee and the needs of the organization is at times a difficult task. The rights and responsibilities of employees in the healthcare setting are often expressed in both federal and state laws. Healthcare organizations are not exempt from the impact of these laws.

 

 

 

30

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Lesson Learning Objectives By the conclusion of this lesson you should be able to:

• Describe the various federal labor acts.

• Discuss the rights and responsibilities of unions and management.

• Describe the purpose of an affirmative action plan.

• Describe a patient’s rights during labor disputes.

• Discuss the types of discrimination that occur in the workplace.

• Describe what sexual harassment is and what forms it can take.

• Discuss the employment-at-will doctrine.

• Explain public policies that protect employees from unlawful discharge.

• Describe what is meant by retaliatory and constructive discharge and how to defend a claim for unfair discharge.

• Describe under what circumstances employers often discharge an employee.

• Describe effective hiring practices and the importance of clear communications.

• Describe and understand the rights of employees.

• Describe and understand the responsibilities of employees.

• Describe the purpose of a malpractice insurance policy, including risk categories, and the importance to professionals of carrying professional liability insurance.

• Explain the elements and conditions of an insurance policy.

• Describe the investigation and settlement of claims.

• Describe the common models of managed care organizations.

• Describe the purpose and process of utilization review.

• Discuss the purpose and various titles of the Patient Protection and Affordable Care Act (ACA) of 2010.

• Describe the various court rulings involving the ACA.

 

 

 

31

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Reading Study Chapters 19 through 21 of the text. Review the Power Points for Chapters 19 through 21.

Assignments The following Assignment Questions should be completed and submitted to the course faculty via the learning platform for evaluation and grading. Submit your responses to these questions in one WORD document. List the question first, and then your response. Your response must adequately cover the question without being wordy or relying on “yes” or “no” responses Short Answer Questions 1. Nearly all the states in the USA are “Right to Work” states, which means any

employer can discharge an employee with or without cause. Given this complete freedom to hire and fire at will, what prevents employers from firing employees who have above average medical insurance claims and thereby drive up the costs of insurance for all employees?

2. Identify which industrialized countries do not treat health care as a right, and which of the industrialized countries have health care costs that could bankrupt a citizen. What is Single Payer healthcare, and how is Single Payer healthcare in the UK different from Japan and France?

3. Prior to the Affordable Care Act, employers across the USA offered employees health insurance with limited health care coverage and sometimes no insurance at all. If the Affordable Care Act is repealed, what are the most likely ways employers will scale back health insurance benefits to their employees?

4. Identify four or five problems for the insured population when states impose work requirements for people to receive Medicaid health insurance.

5. What is the cost to citizens from purchasing Part D Medicare insurance, and present an example in which a citizen benefits from Part D insurance and another example in which a citizen would lose by paying for Part D insurance?

6. How did “pre-existing conditions” affect employees’ health insurance prior to the passage of the Affordable Care Act, and what would you expect to happen to employees with pre-existing conditions after the repeal of the Affordable Care Act?

 

 

 

32

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

7. Please identify your home state and indicate whether an employee in your state has the legal right to order his or her own blood test to check for overall health or even a particular medical condition? If so, how does the employee go about ordering the blood test without consulting a doctor? If not, explain why not.

Professional Development Using the hospital as a setting, give two examples of what would violate the National Labor Relations Act (NLRA).

 

 

 

33

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Lesson 8 – Managed Care, Risk Reduction, and Internet Resources Introduction Health care has changed dramatically over the years. The healthcare setting is a bombardment of mergers, buyouts, upsizing and downsizing, health maintenance organizations (HMOs), cost controls, regulations, and monitoring regulators. Managed care organizations (MCOs) represent a major shift away from the domination of the fee- for-service system toward networks of providers supplying a full range of services. Managed care is the process of structuring or restructuring the healthcare system in terms of financing, purchasing, delivering, measuring, and documenting a broad range of healthcare services and products. Managed care is nothing new to the US healthcare delivery system; it has been around in some form for decades. The two major and objected to constraints of MCOs are their (1) limitations on the choice of providers by the consumer and (2) requirements for prior authorization in order to obtain services. This lesson reviews managed care and its various packages. Next, we review selected schemes for tort reform and suggested programs for coping with the malpractice crisis. Given the difficulties in the present tort system, we often become victims of the failures of medicine as opposed to beneficiaries of its many successes. The tort system has proven to be inadequate in the prevention of medical malpractice. Damage awards as a deterrent to malpractice have failed to adequately reduce the number of claims. Exorbitant jury awards and malpractice insurance premiums are costing the healthcare industry billions of dollars annually, thus bringing healthcare organizations ever closer to a day of reckoning with financial disaster. Physicians who wish to practice medicine and survive have accepted the concept of practicing defensive medicine. Defensive medicine (self-protective) is believed to be one of the most harmful effects produced by the threat of malpractice litigation. Such medicine is practiced to forestall potential litigation and provide an advantageous legal defense should a lawsuit be instituted. Defensive medicine often results in undertreatment, perhaps by avoiding high-risk tests and procedures, or overtreatment, such as the excessive use of diagnostic tests. “The message the tort system is sending to doctors is not so much deterrence, in terms of practicing good medicine, but more just ‘drive defensively,’ because any patient you may see may be a litigant.” Then, we explore the development of a corporate culture of safety with emphasis on patient safety concerns. The Institute of Medicine (IOM) is an independent, non-profit organization that works outside of government to provide unbiased and authoritative advice to decision makers and the public. The IOM was chartered in 1970 and is the healthcare arm of the National Academy of Sciences. The November 1999 IOM report, “To Err Is Human: Building a Safer Health System,” indicated that at least 44,000 and perhaps as many as 98,000 people die in hospitals each year as a result of preventable medical errors. Such figures rank medical errors as the eighth leading cause of death in the United States, ahead of deaths from motor vehicle accidents, breast cancer, or acquired immunodeficiency syndrome (AIDS). Both healthcare organizations and

 

 

 

34

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

accrediting bodies are adopting a zero-tolerance policy toward poor judgment and careless mistakes by focusing on processes and not individuals. Strides are being made to ensure that 25 BLW512 – Legal Aspects of Health Care Administration Course Syllabus desired outcomes are more closely aligned with predictability. More focus on how to do things right the first time will lessen the likelihood of having to ask why things went wrong after a medical error occurs. The message as described in this course serves as a reminder to us all: health care must thoroughly address the needs of each patient. As we in health care serve others, we all will one day face some of the same or similar sadness, loneliness, and pain that accompany disease. This journey encourages all health-care professionals to continuously work together and seek new ways to improve the quality of patient care. Progress lies with those who have the vision to see and act on the limit-less possibilities for improving patient care. The journey to excellence involves searching for best practices worldwide. Lesson Learning Objectives By the conclusion of this lesson you should be able to:

• Explain the scope and purpose of Managed Care Organizations.

• • Demonstrate the continuous quality improvement and risk-management processes.

• • Appraise reforms to the tort system and their effect on the malpractice crisis.

• • Demonstrate steps that hospitals can take to achieve a culture of safety.

• • Utilize the Internet to locate and research appropriate healthcare resources.

• • Explain the purpose and benefits of a healthcare war room. Reading Study Chapter 22 of the text. Review the Power Point for Chapter 22.

 

 

 

35

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

Assignments The following Assignment Questions should be completed and submitted to the course faculty via the learning platform for evaluation and grading. Submit your responses to these questions in one WORD document. List the question first, and then your response. Your response must adequately cover the question without being wordy or relying on “yes” or “no” responses. Short Answer Questions 1. What are the advantages and disadvantages of HMOs? 2. What is the purpose of utilization review? 3. Why did Congress pass the Health Care Quality Improvement Act of 1986? 4. Describe some of the more common models of MCOs. 5. How does a structured award work? 6. How is the risk management process helpful in reducing the number of malpractice suits? 7. Describe the continuous quality improvement process as it applies to healthcare organizations. 8. What is the purpose and importance of Health on the Net Foundation (HON)? 9. What is the purpose of a healthcare war room? Professional Development What steps can a hospital take to achieve a culture of safety?

 

 

 

36

BLW512 – Legal Aspects of Health Care Administration

Course Syllabus

References Allen, M. &. (2016, May 3). Medical errors are no. 3 cause of U.S. deaths, researchers say.

Retrieved from npr.org: https://www.npr.org/sections/health- shots/2016/05/03/476636183/death-certificates-undercount-toll-of-medical-errors]

Dayen, D. (2018, July 9). The U.S. bullied the world to stop a pro-breastfeeding resolution?

That’s the American way. Retrieved from Los Angeles Times: http://www.latimes.com/opinion/op-ed/la-oe-dayen-infant-formula-trade-20180709- story.html

 

 

  • Final Examination
  • Academic Integrity
  • Lesson 1 – The Legal System, Tort Law, and Criminal Aspects
    • Professional Development
    • Reading
    • Lesson Learning Objectives
      • Short Answer Questions
      • Professional Development
    • Lesson Learning Objectives
    • Assignments
      • The following Assignment Questions should be completed and submitted to the course faculty via the learning platform for evaluation and grading. Submit your responses to these questions in one WORD document. List the question first, and then your res…
      • Short Answer Questions
        • Professional Development
    • Reading
    • Reading
      • Professional Development
    • Introduction
    • Lesson Learning Objectives
    • Reading
      • Professional Development
Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)