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Assignment - LONG- TERM CARE - INTERVIEWS
Part A - The first interview is an interview with a long-term care leader.
1. Tell me about your organization (who served, services provided). How long you have worked here and how you were drawn to the long-term care industry?
2. Explain your charges and how your organization is reimbursed for care and services provided.
3. Identify the challenges in long-term care reimbursement today.
4. How is the long-term care industry regulated?
5. How is your organization governed? Do you have a board of directors? Bylaws?
6. What do you find most satisfying about your role? Most challenging?
Answer - Interview with a long term care Leader:
The current health care organization is Best care, it is home health care organization located in South Florida. They do provide nursing services in home, hospital as well as in independent living facilities (Coulter et al., 2015). The following part of the discussion is the brief up from the interview of the leader of the health care organization.
As per the information obtained from Marc Spector, CEO of the best care the following information is collected. He is graduate from University of Florida and from Nova South Eastern University as well.
The current Best care organization is in service since more than two decades, The health care leader Marc Spector is associated with this organization since 2002. After leaving a legal position after 5 years of service, he joined in the organization in a leadership position and as of now, he is the CEO of the organization and taking care of all strategic and daily operational planning and management of the overall organization.
He said that the charges for the health care in the home, will be paid through multiple channels. Typical payment collection will include collection from the pension of the patients, from insurance and also from personal funding. Based on the case to case basis, either advance will be collected or billing will be done at the end of every month. However in most of the cases, there will be patient accounting fund and bills will be deducted from this fund after approval of the same by the patient or representative of the patient. However for care givers charges will be collected in advance.
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The key challenges are the hiking prices of the employees. The care givers and other nursing charges have increased several times than what they are used to be before. Administration charges have also increased in general due to the incorporation of the better infrastructure, IT facitlies and logistics for the nursing staff. So revenue cycle management has become tougher and the profit margins were reduced. This is the main challenge today to make the ends meet financially. At the same time, expectations of quality of care and patient satisfactions are more demanding now than before.
There are two regulations guiding the services and regulating in the long term care services. The first is Department of Health (State regulation) and the second is the federal authorities (US Department of Health and Human services Centers for Medicare and Medicaid services (CMS).
Yes the best care organization has full-fledged board of directors and there are bylaws regulating the services and operations of the organization. The governance is through well established organizational structure and management system inforce. It is a typical democratic governance system in place governed by mission and service oriented philosophy.
The most satisfying part of my work is the satisfaction obtained from serving the old people and the most challenging part of the work is letting the ends meet, financially and sustaining the organization as per the expectations of the board.
Other three questions:
What is your advice for new career aspirants into long term care services?
Only those who do have passion for the profession, need to join this service, rather than salaries, it is more a service oriented profession. People with that attitude can excel here.
What are your future plans?
Best care is going to get expanded into few more locations in the state in the coming years.
What is your immediate task ahead?
There is need to upgrade the accounting systems and need to align the services as per the insurance coding requirements. For this IT department is working and I need to provide directives and assistance any if required by the end of this week.
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Part B - The second interview is for a person in Information Technology.
1. Tell me about your position, how long you have held this position and your background.
2. How would you compare the use of Information Systems in Long-Term Care compared to other aspects of the health care industry?
3. What software technology do you use for managing the health information of your patients/residents/clients?
4. How do you manage protected health information and HIPAA in your organization?
5. Do your patients have any access to their own health information (patient portal, apps, jump drives, etc)?
6. How do you manage the billing and reimbursement processes within your information systems?
7. How large is your department and what positions are in the department?
8. What do you see the biggest challenges to be for Information System management in long-term care?
Answer - Interview with Mrs. Delly from IT department (Acting CIO)
Mrs. Delly is the IT operations manager and is part of the operations management Team in the organization. She is in the organization in the last five years and is taking care of IT operations of the organization since then. Before joining here, she had about 5 years of experience in IT management of a health care organization.
The scope for using IT in Long term care is limited when compared with other aspects of the health care industry in general. As here the scope of the services are limited when compared with full fledged health care unit, the need for complex integration of the services does not exist here. Also there is no need for extensive DBMS systems and cloud integration etc. However as part of their service utility they do employ financial accounting and patient information management as key operations of IT department in the organization.
Best Care is using Net solutions the software developed by Cantata health for its current requirements. It is a fully integrated electronic health record and finance management solution.
The current software has competent access control and authorization systems, that can work for keeping the system secured and this is in line with the HIPPA security provisions.
Yeah patient can access their information from the portal. They will be provided with a login, either patient or any representative can use the same for accessing their vital accounting information.
Billing and reimbursement will be based on case to case of the service. For care giver services the charges will be collected in advance. For other reimbursable services, billing will be done to get reimbursements from the pension schemes, insurance coverages and from direct bank payments from the client. In any case, the system is flexible and will consider different modes of payment procedures.
The department is upto the organization needs. There are about 2 managers and 4 co-ordinators.
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There are no big challenges, only issue will be continuous updating of the systems as per the growing demands of the organization and it is being done conveniently. However security updating is a concern and organization is taking care of privacy and security from time to time.
Other three questions -
How do you find the job and career prospects?
Completely satisfied and had good prospectus in future as well.
What is your advice for new IT trainers?
Need to focus more on security standards and financial management systems of the organization.
What is your advice for Best care?
No advice, but recommended to increase the budget for the coming year to include inhouse data base and cloud integration of the services. It is accepted and operations will commence from the next financial year.
Summary of Interviews
As per the interview of Marc Spector, the CEO of Best Care long term care organization, it is understood that he is educated from premier institutions and is working from more than 5 years in the organization. Charges for diverse care and treatments in the organization will be collected from multiple channels from time to time and is flexible in the channel of collection; however care giver charges will be collected in advance. Hike in expenses is the key challenge making it difficult to meet end to end at present. The organization has full-fledged board of directors. Marc is quite satisfied with the nature of work. He advised for new aspirants to choose the profession, only if they have necessary commitment. He is looking forward to expand the organization in near future.
Acting CIO, Delly informed that she is in the division from the last five years. She said that the scope of IT in long term organization is limited. As of now major domains that she is working on is DBMS, Accounting and finance of Best care. Delly said that current IT system is user friendly and patients can access key information from the system. IT enabled billing and reimbursement are done case to case basis. Delly informed about IT division structure. The key challenges are about privacy and security of data at present. She is totally satisfied with her profession and advised new IT trainers to focus more on security and financial aspects of IT. She is expecting cloud integration in near future.
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