home healthcare fraud

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ASSIGNMENT 08
HE310 Survey of Healthcare Management
Directions: Be sure to make an electronic copy of your answer before submitting it to
Ashworth College for grading. Unless otherwise stated, answer in complete sentences,
and be sure to use correct English spelling and grammar. Sources must be cited in APA
format. Your response should be three (3) to six (6) pages in length; refer to the
“Assignment Format” page for specific format requirements.
This written assignment has two parts and involves combining the case studies from
lessons 5-8. For each of the case studies, you are responsible for selecting the appropriate
case at the end of the applicable chapter and response to the question. In each of the cases
you will respond as if you are the hospital administrator. For part I of this written
assignment, please see case studies relating to lessons 5-8 below. Please combine your
response to these case study questions into part I of your written assignment.
Part I
Lesson 5
Case Study 2. Home Healthcare Fraud
An investigation by the Medicare Fraud Strike Force resulted in the discovery and
ultimate sentencing of a registered nurse who defrauded her home health agency and the
federal government. Read Box 8-5.
a. If you were the administrator of this home health agency what could you have
done to prevent this individual, or any staff member, from committing fraud of
this nature?
b. What policies or procedures could you implement?
c. What actions could you enforce, within your organization that could have
uncovered this illegal behavior sooner?
Lesson 6
Case Study 1. Benefits of Electronic Health Records in a Rural Critical Access Hospital
Imagine that you are the administrator of Sierra Vista Hospital.
a. How will you help the hospitalâ??s physicians and staff overcome their skepticism
and get on board with the adoption of EHR?
b. What specific benefits can you share with them?
c. What specific objections might they express?
d. How will you overcome their objections and convince them to agree?
Lesson 7
Case Study 3. Fast Food in Hospitals
Identify the benefits and concerns about permitting a fast food franchise to set up an
outlet in your facility. How would you address the controversies connected with the â??bad
health� image of this sector of the foodservice industry? Nutritional information should
be included in this discussion. Virtually all fast food companies include nutritional data
on their websites.
Lesson 8
Case Study 3.
You have discovered that one of your physicians is violating the Stark law by sending
patients to an imaging center in which she has an ownership percentage. She offers you a
monthly consulting fee if you donâ??t say anything and let her continue to refer patients.
She tells you that the facility is good and the patients are not being harmed.
a. Explain what the Stark law is.
b. Discuss what you would do in this situation.
c. What consequences should be taken against the physician, if any?
Part II
For part II of the written assignment, explain why the following course objectives are
important for hospital administrators:
1. Describe how the essential activities of healthcare administration such as
workplace safety, compliance plans, strategic planning, risk management, and
crisis management influence the success of a healthcare organization.
2. Explain how the use of administrative and clinical technology can enhance
healthcare operations.
3. Describe how food operations are handled in the health care industry.
4. Describe how internal and external activities of healthcare operations such as
performance improvement, audits and inspections, legal and ethical issues, and
healthcare marketing, advertising, and public relations improve healthcare
operations overall.
Please include at least 3 scholarly articles within your response. Overall response will be
formatted according to APA style and the total assignment should be between 3-6 pages
not including title page and reference page.
Grading Rubric
Please refer to the rubric below for the grading criteria for this assignment.
CATEGORY
Part I: Combining Case
Study Activities from
Lessons 5-8 (25 Points)
Exemplary
25 points
Student provides all case
study activities and presents
information in a manner that
demonstrates the skills of
hospital administrator. A
deeper level of critical
thinking skills are displayed
in case study activity
responses.
Part II: Explains Why 50 points
the Last Four Course Student applies critical
Learning Objectives
thinking skills to
are Important for
appropriately discuss why
Hospital
last four learning objectives
Administrators Using are critical to hospital
at Least 3 Scholarly
administrators. Student uses
Articles to
more than 3 scholarly articles
Substantiate
to substantiate response.
Response (50 Points) Each objective discussion
exceeds expectations and
demonstrates deep level of
analysis.
Mechanics (10 Points) 10 points
Student does not make any
errors in grammar or spelling,
especially those that distract
the reader from the content.
Format – APA Format, 15 points
Citations,
The paper is written in
Organization,
proper APA and
Transitions (15 Points) organizational format. All
sources used for quotes and
facts are credible and cited
correctly. Excellent
organization, including a
variety of thoughtful
transitions.
Satisfactory
20 points
Student provides all case
study activities and presents
information in a manner that
demonstrates some skills of
hospital administrator.
Critical thinking skills are
displayed in case study
activity responses.
Unsatisfactory
15 points
Student does not provide all
case study activities or does
not demonstrate skills of a
hospital administrator
appropriately. No critical
thinking skills displayed in
response.
Unacceptable
10 points
Student does not provide all
case study activities and does
not demonstrate skills of a
hospital administrator
appropriately. No critical
thinkings skills displayed in
response.
40 points
Student applies some critical
thinking skills to
appropriately discuss why
last four learning objectives
are critical to hospital
administrators. Student uses
3 scholarly articles to
substantiate response. Each
objective discussion is
adequately discussed, but
further, deeper level of
analysis is needed.
8 points
Student makes 1-2 errors in
grammar or spelling that
distract the reader from the
content.
12 points
The paper is written in
proper format with only 1-2
errors. All sources used for
quotes and facts are credible,
and most are cited correctly.
Adequate organization
includes a variety of
appropriate transitions.
30 points
Student does not apply
critical thinking skills to
explain why last four
learning objectives are
critical to hospital
administrators or the student
uses less than 3 scholarly
articles to substantiate
response. Each objective
discussion is not adequately
discussed and some
objective could be omitted.
5 points
Student makes 3-4 errors in
grammar or spelling that
distract the reader from the
content.
8 points
The paper is written in
proper format with only 3-5
errors. Most sources used for
quotes and facts are credible
and cited correctly. Essay is
poorly organized, but may
include a few effective
transitions.
20 points
Student does not apply
critical thinking skills to
explain why last four
learning objectives are
critical to hospital
administrators and the
student uses less than 3
scholarly articles to
substantiate response. Each
objective discussion is not
adequately discussed and
some objectives are omitted.
2 points
Student makes more than 4
errors in grammar or spelling
that distract the reader from
the content.
5 points
The paper is not written in
proper format. Many sources
used for quotes and facts are
less than credible (suspect)
and/or are not cited
correctly. Essay is
disorganized and does not
include effective transitions.

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