Instructions:

A. Develop a written proposal by doing the following: 1. Identify a problem or issue related to practice, policy, population, or education that aligns with the

organizational priorities you seek to solve.

The problem: Uncontrolled blood glucose levels in the perioperative (Before and after surgery) setting.

Maintaining strict monitoring and control of patient blood glucose levels before and after surgery for all patients, diabetic or not, and the risks/benefits of strict management of same.

a. Explain the problem or issue, including why it is applicable to the area of practice you chose and

the healthcare environment. 2. Discuss your investigation of the problem or issue.

a. Provide evidence to substantiate the problem or issue (e.g., organizational assessment, national source documents, evidence from a stakeholder).

3. Analyze the state of the situation using current data. a. Analyze areas that might be contributing to the problem or issue.

4. Propose a solution or innovation for the problem or issue. Strict monitoring and control of patient blood glucose levels.

a. Justify your proposed solution or innovation based on the results of your investigation and

analysis. 5. Recommend resources to implement your proposed solution or innovation. Include a cost-benefit

analysis of your proposed solution or innovation. 6. Provide a timeline for implementation based on your proposal.

7. Discuss why each key stakeholder or partner is important for the implementation of the solution or innovation.

a. Summarize your engagement with the key stakeholders or partners, including the input and feedback you received.

b. Discuss how you intend to work with those key stakeholders or partners in order to achieve success.

8. Discuss how your proposed solution or innovation could be implemented, including how the

implementation could be evaluated for success.

B. Explain how you fulfilled the following roles during your process of investigation and proposal development:

1. scientist 2. detective

3. manager of the healing environment

C.

D. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted,

paraphrased, or summarized.

E. Demonstrate professional communication in the content and presentation of your submission.

JLP Task 1 (0318) Not Evident Approaching Competence Competent

A1. Problem or Issue An identification of the problem or issue is not provided.

The identified problem or issue is not related to practice, policy, population, or education, or it does not align with organizational priorities that are in need of solving.

The identified problem or issue is related to practice, policy, population, or education, and it aligns with organizational priorities that are in need of solving.

A1a. Explanation of Problem or Issue

An explanation of the problem or issue is not provided.

The explanation addresses the problem or issue, but it does not include an appropriate, logical rationale for why the problem or issue applies to the chosen area of practice and the healthcare environment.

The explanation of the problem or issue includes an appropriate, logical rationale for why the problem or issue applies to the chosen area of practice and the healthcare environment.

A2. Investigation A discussion of the investigation of the problem or

The discussion of the investigation of the problem or

The discussion of the investigation of the problem or

issue is not provided. issue is illogical or vague. Or the discussion is trivial or missing key details. Or the discussion of the investigation is irrelevant to the problem or issue.

issue is logical and sufficiently detailed. The discussion of the investigation is thorough and relates to the problem or issue.

A2a. Evidence of Problem or Issue

Evidence to substantiate the problem or issue is not provided.

The provided evidence fails to substantiate the problem or issue because it is not an appropriate form of evidence, or the evidence does not logically support the problem or issue.

The provided evidence substantiates the problem or issue because it is an appropriate form of evidence (e.g., organizational assessment, national source documents, or evidence from a stakeholder), and it logically supports the problem or issue.

A3. Analysis An analysis is not provided. The analysis addresses the state of the situation, but current data is not used to support the analysis. Or the analysis is implausible or is not supported by specific examples.

The analysis addresses the state of the situation using current data, and it is plausible and well supported with specific examples.

A3a. Contributors to Problem or Issue

An analysis is not provided. The analysis is limited to addressing minor areas that contribute to the problem or issue. Or the analysis is implausible or is not supported with specific examples.

The analysis addresses all the areas that potentially contribute to the problem or issue. The analysis is plausible and well supported with specific examples.

A4. Proposed Solution or Innovation

A proposal for a solution or innovation for the problem or issue is not provided.

The proposal of a solution or innovation to the problem or issue is illogical, inappropriate, or missing significant components.

An appropriate solution or innovation is proposed for the problem or issue. The solution or innovation is logical, well reasoned, and includes all significant components.

A4a. Justification of Proposed Solution or Innovation

A justification of the proposed solution or innovation is not

The justification of the proposed solution or

The justification of the proposed solution or

provided. innovation does not make logical connections between the problem and the solution, or it is not based on the results of the investigation or analysis.

innovation makes logical connections between the problem and the solution, and it is based on the results of the investigation and analysis.

A5. Resources and Cost- Benefit Analysis

A recommendation or a cost- benefit analysis is not provided.

The resources recommended for implementation of the proposed solution or innovation are inappropriate for the needs of the solution or innovation. Or the recommendation is missing key resources. Or a cost- benefit analysis is not included, or the analysis is illogical or not an accurate representation of the needs of the proposed solution or innovation.

The resources recommended for implementation of the proposed solution or innovation are appropriate for the needs of the solution or innovation. The recommendation includes all essential resources. A cost- benefit analysis is included, and it is a logical and accurate representation of the needs of the proposed solution or innovation.

A6. Timeline A timeline for implementation is not provided.

The timeline is not accurate or not achievable given the needs of the proposed solution or innovation.

The timeline is accurate and achievable for the needs of the proposed solution or innovation.

A7. Importance of Key Stakeholders or Partners

A discussion is not provided. At least 1 of the stakeholders or partners that are identified in the discussion are inappropriate for the implementation of the solution or innovation. Or essential stakeholders or partners are missing in the discussion. Or the discussion does not address why each identified stakeholder or partner is important for the implementation of the solution

All of the key stakeholders or partners that are identified are appropriate for the implementation of the solution or innovation, and there are no missing essential stakeholders or partners. The discussion also addresses why each identified stakeholder or partner is important for the implementation of the solution or innovation.

or innovation.

A7a. Engagement with Key Stakeholders or Partners

A summary is not provided. The summary of the engagement with the key stakeholders or partners is vague or trivial. Or the summary does not include the input and feedback received from them.

The summary of the engagement with the key stakeholders or partners is sufficiently detailed and meaningful, and it includes the input and feedback received from them.

A7b. Success A discussion is not provided. The discussion ineffectively addresses how to work with the key stakeholders or partners discussed in part A7 in order to achieve success. The discussion is illogical or is missing supportive details.

The discussion effectively addresses how to work with the key stakeholders or partners discussed in part A7 in order to achieve success. The discussion is logical and includes supportive details.

A8. Implementation A discussion is not provided. The discussion ineffectively addresses how the proposed solution or innovation could be implemented. Or the plan for implementation is illogical or missing key details. Or the discussion does not include an appropriate, well-supported, or well-reasoned plan for how the implementation could be evaluated for success.

The discussion effectively addresses how the proposed solution or innovation could be implemented. The plan for implementation is logical and thorough. The discussion includes an appropriate, well- supported, and well-reasoned plan for how the implementation could be evaluated for success.

B1. Role of Scientist An explanation is not provided. The explanation ineffectively addresses how the role of the scientist was fulfilled during the investigation process and proposal development. Or the explanation is vague or lacks specific, relevant examples.

The explanation effectively addresses how the role of the scientist was fulfilled during the investigation process and proposal development. The explanation is detailed and includes specific, relevant examples.

B2. Role of Detective An explanation is not provided. The explanation ineffectively addresses how the role of the

The explanation effectively addresses how the role of the

detective was fulfilled during the investigation process and proposal development. The explanation is vague or lacks specific, relevant examples.

detective was fulfilled during the investigation process and proposal development. The explanation is detailed and includes specific, relevant examples.

B3. Role of Manager of the Healing Environment

An explanation is not provided. The explanation ineffectively addresses how the role of the manager of the healing environment was fulfilled during the investigation process and proposal development. The explanation is vague or lacks specific, relevant examples.

The explanation effectively addresses how the role of the manager of the healing environment was fulfilled during the investigation process and proposal development. The explanation is detailed and includes specific, relevant examples.

C. Verification Form A submission is not provided. The “Professional Verification Form” from the organizational leader advising leadership experience is submitted, but the submission is incomplete.

The submission of the “Professional Verification Form” from the organizational leader advising leadership experience is complete.

D. /orders/lrps.wgu.edu/provision/ 71484321

The submission does not include in-text citations and references according to APA style for content that is quoted, paraphrased, or summarized.

The submission includes in- text citations and references for content that is quoted, paraphrased, or summarized but does not demonstrate a consistent application of APA style.

The submission includes in- text citations and references for content that is quoted, paraphrased, or summarized and demonstrates a consistent application of APA style.

E. /orders/lrps.wgu.edu/provision/ 27641407

Content is unstructured, is disjointed, or contains pervasive errors in mechanics, usage, or grammar. Vocabulary or tone is unprofessional or distracts from the topic.

Content is poorly organized, is difficult to follow, or contains errors in mechanics, usage, or grammar that cause confusion. Terminology is misused or ineffective.

Content reflects attention to detail, is organized, and focuses on the main ideas as prescribed in the task or chosen by the candidate. Terminology is pertinent, is used correctly, and effectively conveys the intended meaning. Mechanics, usage,

and grammar promote accurate interpretation and understanding.

Perioperative management of patients blood glucose level is critically important, yet frequently ignored or overlooked by even the most skilled

surgeon and operative staff. Research Documents the delayed healing and increase of infection risk in patients who have poor blood glucose

control in and around the peri operative area.

If a patient is diabetic This Risk is exponentially increased Because of the impaired circulation And poor tissue profusion and tissue

nourishment , wound healing, as a result of their underlying illness.

Patients that are not diabetic, sometimes Have Increase glucose Response due to stress and the trauma of surgery, Creating an opportunistic

environment for any Pathogens that have inadvertently found their way into patient as a result of surgery. All these complications result in

Additional length of stay, increased cost of treatment risk for Sepsis, Risk for organ failure and organ dysfunction And ultimately risk for death.

The cost is negligible to monitor blood glucose levels Before and after surgery and to Maintain strict control of the patient’s blood glucose level

during the same time. We’re talking about the cost of test strips And Having the qualified personnel to Take the blood glucose reading and

communicate that to The appropriate staff for the appropriate treatment. In the event of Patient developing Uncontrolled glucose levels, early

signs of sepsis Could be Recognized and treated efficiently and effectively Again thereby reducing complications and costs.

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Legal Aspects of Health Care Administration

THIRTEENTH EDITION

George D. Pozgar, MBA, CHE, D.Litt. Author, Speaker, Consultant

Gp Health Care

Annapolis, Maryland

Legal Review Nina M. Santucci, MSCJ, JD

JONES & BARTLETT LEARNING

2

World Headquarters Jones & Bartlett Learning 5 Wall Street Burlington, MA 01803 978-443-5000 info@jblearning.com www.jblearning.com

Jones & Bartlett Learning books and products are available through most bookstores and online booksellers. To contact Jones & Bartlett Learning directly, call 800-832-0034, fax 978-443-8000, or visit our website, www.jblearning.com.

Substantial discounts on bulk quantities of Jones & Bartlett Learning publications are available to corporations, professional associations, and other qualified organizations. For details and specific discount information, contact the special sales department at Jones & Bartlett Learning via the above contact information or send an email to specialsales@jblearning.com.

Copyright © 2019 by Jones & Bartlett Learning, LLC, an Ascend Learning Company

All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the copyright owner.

The content, statements, views, and opinions herein are the sole expression of the respective authors and not that of Jones & Bartlett Learning, LLC. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise does not constitute or imply its endorsement or recommendation by Jones & Bartlett Learning, LLC and such reference shall not be used for advertising or product endorsement purposes. All trademarks displayed are the trademarks of the parties noted herein. Legal Aspects of Health Care Administration, Thirteenth Edition is an independent publication and has not been authorized, sponsored, or otherwise

3

approved by the owners of the trademarks or service marks referenced in this product.

There may be images in this book that feature models; these models do not necessarily endorse, represent, or participate in the activities represented in the images. Any screenshots in this product are for educational and instructive purposes only. Any individuals and scenarios featured in the case studies throughout this product may be real or fictitious, but are used for instructional purposes only.

This publication is designed to provide accurate and authoritative information in regard to the Subject Matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional service. If legal advice or other expert assistance is required, the service of a competent professional person should be sought.

23986-7

Production Credits VP, Product Management: David D. Cella Director of Product Management: Michael Brown Product Specialist: Danielle Bessette Production Manager: Carolyn Rogers Pershouse Production Assistant: Brooke Haley Senior Marketing Manager: Sophie Fleck Teague Manufacturing and Inventory Control Supervisor: Amy Bacus Composition: codeMantra U.S. LLC Cover Design: Kristin E. Parker Director of Rights & Media: Joanna Gallant Rights & Media Specialist: Merideth Tumasz Media Development Editor: Shannon Sheehan Cover Image: © Marilyn Nieves/Getty Images Printing and Binding: Edwards Brothers Malloy Cover Printing: Edwards Brothers Malloy

Library of Congress Cataloging-in-Publication Data Names: Pozgar, George D., author. Title: Legal aspects of health care administration / George D. Pozgar, MBA, CHE, D.Litt. Description: Thirteenth edition. | Burlington, MA: Jones & Bartlett Learning, [2019] | Includes bibliographical references and index. Identifiers: LCCN 2018002863 | ISBN 9781284127171 (casebound) Subjects: LCSH: Health services administration—Law and legislation—United States. | Medical laws and legislation—United States. | Medical personnel— Malpractice—United States. | BISAC: BUSINESS & ECONOMICS / Information Management.

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Classification: LCC KF3821 .P69 2018 | DDC 344.7304/1—dc23 LC record available at /orders/lccn.loc.gov/2018002863

6048

Printed in the United States of America 22 21 20 19 18 10 9 8 7 6 5 4 3 2 1

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I dedicate this book to Denise Mirafuentes.

Your life was an inspiration.

Your love for family, friends, caregivers, and the many lives you have touched never failed.

Your unwavering faith in God and the challenges you faced have forever changed the lives of so many.

Your life is a testimony to goodness, kindness, and compassion.

Though the thoughts I wish to impart continue to swirl in my mind, words alone will never suffice.

So I leave you with this my dear friend,

Your signature phrase to “Live, Laugh, and Love” describes you well.

“The best and most beautiful things in the world cannot be seen or even touched, they best be felt with the heart.”

Helen Keller ALOHA & MAHALO

Until We All Meet Again

6

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Contents Epigraph Preface About the Book Acknowledgments

Chapter 1 Hospitals Through the Ages Learning Objectives Early Hindu and Egyptian Hospitals Greek and Roman Hospitals Hospitals of the Early Christian Era Islamic Hospitals Early Military Hospitals Medieval Hospitals The “Dark Age” of Hospitals Hospitals of the Renaissance Hospitals of the 18th Century Early Hospitals in the United States Late 19th Century Renaissance 20th-Century Progress Health Care and Hospitals in the 21st Century History Challenges Us to Do Better Chapter Review Review Questions Notes

Chapter 2 Government, Law, and Ethics Learning Objectives Development of Law Sources of Law Government Organization Department of Health and Human Services Government Ethics Political Malpractice Chapter Review Review Questions Notes

Chapter 3 Tort Law—Negligence Learning Objectives Objectives of Tort Law Negligence Forms of Negligence

8

Degrees of Negligence Elements of Negligence Summary Case Chapter Review Review Questions Notes

Chapter 4 Intentional Torts Learning Objectives Assault and Battery False Imprisonment Defamation of Character Fraud Invasion of Privacy Infliction of Mental Distress Products Liability Chapter Review Review Questions Notes

Chapter 5 Tort Reform and Risk Reduction Learning Objectives Mediation and Arbitration Statute of Limitations Structured Awards Medical Malpractice Screening Panels Collateral Source Rule Contingency Fee Limitations Countersuits: Frivolous Claims Joint and Several Liability Malpractice Caps No-Fault System Regulation of Insurance Practices Reducing the Risks of Malpractice Collaboration in Tort Reform Chapter Review Review Questions Notes

Chapter 6 Criminal Aspects of Health Care Learning Objectives Criminal Procedure Healthcare Fraud Kickbacks Tampering with Drugs

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Internet Pharmacy and Sale of Drugs Falsification of Records Patient Abuse Criminal Negligence Homicide Manslaughter Rape and Sexual Assault Theft Chapter Review Review Questions Notes

Chapter 7 Contracts and Antitrust Learning Objectives What Is a Contract? Types of Contracts Elements of a Contract Breach of Contract Corporate Contracts Partnership Agent Independent Contractor Conditions Performance Nonperformance Defenses Remedies Employment Contracts Medical Staff Bylaws: A Contract Exclusive Contracts Restraint of Trade Hospital Staff Privileges Transfer Agreements Insurance Contract Chapter Review Review Questions Notes

Chapter 8 Civil Procedure and Trial Practice Learning Objectives Pleadings Discovery Motions Pretrial Conference Notice of Trial Memorandum of Law The Courtroom and the Judge

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The Jury Subpoenas Burden of Proof Res Ipsa Loquitur Opening Statements Examination of Witnesses Judicial Notice Rule Evidence Defenses Against Plaintiff’s Allegations Closing Statements Judge’s Charge to the Jury Jury Deliberation and Determination Awarding Damages Joint and Several Liability Appeals Execution of Judgments Chapter Review Review Questions Notes

Chapter 9 Corporate Structure and Legal Issues Learning Objectives Authority of Corporations Corporate Committee Structure Corporate Ethics Corporate Negligence Doctrine of Respondeat Superior Governing Body Responsibilities Corporate Reorganization and Mergers Chapter Review Review Questions Notes

Chapter 10 Medical Staff Organization and Malpractice

Learning Objectives Medical Staff Organization Medical Director Medical Staff Privileges Common Medical Errors Patient Assessments Diagnosis Treatment Discharge and Follow-Up Care Infections Psychiatry

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Principles of Medical Ethics Physician–Patient Relationship Chapter Review Review Questions Notes

Chapter 11 Nursing and the Law Learning Objectives Scope of Practice Nurse Licensure Nursing Careers Advanced Practice Nurses Legal Risks of Nurses Duty to Question Discharge Duty to Report Physician Negligence Chapter Review Review Questions Notes

Chapter 12 Hospital Departments and Allied Professionals

Learning Objectives Paramedics and First Responders Emergency Department Laboratory Medical Assistant Nutritional Services Pharmacy Physical Therapy Physician Assistant Radiology and Related Lawsuits Respiratory Therapist Chiropractor Dentistry Podiatrist Security Licensure and Certification of Healthcare Professionals Helpful Advice for Caregivers Chapter Review Review Questions Notes

Chapter 13 Information Management and Patient Records

Learning Objectives

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Information Management Medical Record Contents Documentation of Care Privacy Act of 1974 Health Insurance Portability and Accountability Act Patient Objects to Record Entries Ownership and Release of Medical Records Use of Patient Data Collected Retention of Records Electronic Medical Records Legal Proceedings and the Medical Record Falsification of Records Illegible Handwriting Timely Completion of Medical Records Confidential and Privileged Communications Charting: Some Helpful Advice Chapter Review Review Questions Notes

Chapter 14 Patient Consent, Rights, and Responsibilities

Learning Objectives Patient Consent Patient Rights Patient Responsibilities Chapter Review Review Questions Notes

Chapter 15 Healthcare Ethics Learning Objectives Ethics Morality Ethical Theories Principles of Healthcare Ethics Values Pillars of Moral Strength Religious Ethics and Spirituality Secular Ethics Professional Ethics Ethics Committee Reasoning and Decision Making Moral Compass Gone Astray Chapter Review Review Questions

13

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