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 hospital’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 “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 don’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.

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