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Now that you have a foundation in the nature of ethics and law, as well as contemporary ethical dilemmas that present to healthcare administrators, it is time to broaden your outlook. In Week 3, you will examine some of the ways that the government, organizations, and healthcare professionals contend with ethics and law. Your Learning Objectives for the Week: Apply legal and ethical principles, procedures, and cases to practical management problems frequently found in healthcare settings. Examine the healthcare plans and discuss the legislation that affects these plans. Evaluate how local, state, and federal laws affect a healthcare organization. MHA 6060 WEEK 3 LECTURE, DISCUSSION AND PROJECT INSTRUCTIONS 1 Ethics and Law: Government A successful healthcare administrator must have a working knowledge of both the government and the organizational policies that impact healthcare practice. The government is primarily responsible for enacting legislation to protect the rights of citizens—the right to privacy and the right to self-determination. Such legislation is subject to examination by various ethics committees in the House of Representatives and in the Senate, which is, in turn, supervised by the Office of Congressional Ethics. This demonstrates how ethics and law are interdependent and intertwined with one another. Federal laws that the healthcare administrators should be aware of include: · Title VI: The Civil Rights Act —prohibits racial discrimination in any agency supported by the Department of Health and Human Services (HHS) · The Sherman Antitrust Act—prevents efforts to monopolize an industry through price fixing or exclusive contracts designed to reduce market competition in the healthcare industry · The Privacy Act—promotes access to medical records concerning an individual, while simultaneously protecting against the misuse of the information contained within these records · The Health Insurance Portability and Accountability Act (HIPAA)—promotes privacy, confidentiality, and security of patient information in all formats · The Emergency Medical Treatment and Active Labor Act (EMTALA)—forbids Medicare-participating hospitals from “dumping” patients, that is, turning away any individual seeking emergency care · The Patient Protection and Affordable Care Act (PPAC)—mandates health reforms designed to expand medical insurance coverage and create a health insurance marketplace While the number of federal laws pertaining to healthcare is large, those that impact day-to-day healthcare organization operations are commonly expressed through organizational rules and regulations. By mandating specific behaviors and care practices, healthcare organizations can help to ensure their compliance with federal regulations, while promoting organizational success. Healthcare Related Laws Review each year to learn more about the healthcare laws. 1965 Social Security was amended with Titles XVIII and XIX, which established Medicare Part A and Part B for individuals sixty-five years and over. 1972 Social Security was amended with Title XVIII expansion to include disabled persons and those with end-stage renal disease. 1973 The Health Maintenance Organization (HMO) Act that moved healthcare away from fee-for-service toward prepaid group practice plans. 1985 The Consolidated Omnibus Reconciliation Act (COBRA), which amended Title X of the IRS code to deny tax deductions for plans that prevented employee coverage. 1996 The HIPAA established national standards for patient privacy and information security. 1997 The Balanced Budget Act that amended Social Security with Title XXI to establish the Children’s Health Insurance Program (CHIP). Additional Materials From your course textbook, Legal and Ethical Issues for Health Professionals, review the following chapter: · Government Ethics and the Law From the South University Online Library, review the following articles: · HIPAA Security Compliance Challenges: The Case for Small Healthcare Providers  · Antitrust and Hospital Mergers: Uniqueness and Consistency in Market Definition Analysis  · Maximizing Out-of-Network Payment for Patients with ACA Exchange Products  Ethics and Law: Organizations In recent years, there has been an increased oversight of healthcare organizations by regulatory agencies in an effort to both curb healthcare costs and improve patient outcomes. Organizations must be extremely careful to follow rules of legal and ethical conduct to prevent negative outcomes. In this lecture, you will learn more about how organizations generate content for their code of ethics, as well as the risks to which healthcare organizations are commonly exposed. The code of ethics statements provide guidance to employees regarding appropriate behaviors that are needed to carry out an organization’s mission. The benefits of having an organizational code of ethics include building trust, increasing awareness, and informing decision-making processes, that is, a code of ethics serves to support employees to act ethically, while guarding the agency against employees who engage in unprofessional conduct. Such unethical organizational conduct may include violations of trust and false advertising or financial incentive schemes. To ensure an effective and efficient healthcare organization, it is important that the healthcare administrator consider and work toward the following: · Credentialing and appointing professional staff · Providing appropriate staff and supplies · Allocating scarce resources in a responsible manner · Complying with rules, regulations, and accreditation standards · Avoiding conflicts of interest · Providing a safe environment for patients and staff While the role of a healthcare administrator may change from organization to organization, the requirements for professional and ethical conduct in line with legal and regulatory requirements persist. Importance of Accreditation 1 Three field consultants were assigned by their employer, the National Accreditation Association (NAA), to review the quality of care being delivered at Newtown Medical Center and its three outpatient centers. Newtown was larger and even more complex than the consultants had anticipated, offering multiple services. On the first day of the consulting assignment, only three of the six assigned consultants reported to the medical center for duty. Patrick, the team leader, called the corporate office to discuss the need for additional help. Mike, the manager responsible for addressing field requests, did not return Patrick’s call. Despite the lack of a follow-up call from Mike, the team covered the assigned task. 2 On the fourth day of the five-day survey Cheri, Newtown’s survey coordinator, asked Patrick if there was anything that needed to be covered prior to the exit conference to be held the following afternoon. Patrick replied, “Yes there is. At the leadership conference this morning, there was no representation from the governing body. I find it difficult to score the various aspects of leadership since no one attended the scheduled interview.” Somewhat concerned about the outcome of the quality review, the following day when the consultants presented their report, Cheri said, “The medical center’s leadership has not taken these surveys very seriously in the past. It has been an uphill battle to get them involved. Let me see what I can do to arrange for a leadership conference in the morning. We have thirty-six members on our board; hopefully, I can find a few to attend.” The following morning, Cheri approached Michael and said, “I was able to convince two board members to meet with you at 11:00 a.m.” 3 Michael met with the two board members along with the Chief Executive Officer (CEO). After the meeting had ended, a board member approached Michael and said, “You sure are persistent. But I must say, it was truly a worthwhile meeting.” Evaluate the questions below: · Do you agree with Michael’s persistence in conducting the leadership interview? Discuss your answer. · Because the survey team was short three consultants, would you consider this a meaningful survey as to the quality of care being rendered at Newtown Medical Center? Discuss your answer. · Do you think the CEO would complain about being billed for six consultants when only three were present to conduct the survey? Discuss your answer knowing that the results of the survey were positive and that three additional consultants could have added to the number of findings, resulting in a more negative report and an unhappy board. Additional Materials From your course textbook, Legal and Ethical Issues for Health Professionals, review the following chapter: · Organizational Ethics and the Law From the South University Online Library, review the following articles: · Literature Review: The Changing Health Care Landscape and Implications of Organizational Ethics on Modern Medical Practice  · Novel Paths to Relevance: How Clinical Ethics Committees Promote Ethical Reflection  · Perspectives: Adapting to the Rapid Evolution of Healthcare from a Shared Perspective  Ethics and Law: Healthcare Professionals As discussed throughout this week, the contents of organizational codes of ethics vary from organization to organization, depending on particular risks to which the organization is exposed. For healthcare workers, the risk of negligence and malpractice is high, particularly when healthcare workers seek to move outside of their scope of practice. The scope of practice is defined as, “. . . the permissible boundaries of practice for healthcare professionals, as is often defined in state statutes, which define the actions, duties, and limits of professionals in their particular roles” (Pozgar, 2016, p. 338). That is, a violation of scope of practice is when a healthcare worker engages in duties that he or she is not credentialed or certified to perform. This becomes a significant threat to the healthcare organizations and promotes the need for clear codes of ethics to guide behavior and curtail any unprofessional actions. Monitoring the certification and licensure of healthcare professionals is an important part of the healthcare administrator’s job. Such certification by a government or professional association guarantees that an individual possesses the requisite knowledge and skills to perform a duty. It is important to note that certification by an association is a self-regulation credentialing process. Licensure is the sanction of duties that would be illegal to perform without such licensure, that is, the legal right to perform healthcare services. In a hospital setting, for example, employees who require licensure include nurses, pharmacists, physician assistants, and physicians. Licensure occurs at the state level, and licensing boards have the authority to establish practice standards and the minimum qualifications to ensure public safety. Ensuring proper credentialing of staff not only promotes compliance with state and federal laws but also promotes ethical practice among healthcare professionals. Principles of Medical Ethics · According to the American Medical Association (2001), below are the nine principles of medical ethics: · Review each principal to learn more. Principle 1 A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights. Principle 2 A physician shall uphold the standards of professionalism. Be honest in all professional interactions and strive to report physicians deficient in character or competence or engaging in fraud or deception to appropriate entities. Principle 3 A physician shall respect the law and also recognize a responsibility to seek changes in those requirements, which are contrary to the best interests of the patient. Principle 4 A physician shall respect the rights of patients, colleagues, and other health professionals and shall safeguard patient confidences and privacy within the constraints of the law. Principle 5 A physician should continue to study, apply, and advance scientific knowledge; maintain a commitment to medical education; make relevant information available to patients, colleagues, and the public; obtain consultation; and use the talents of other health professionals when indicated. Principle 6 A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care. Principle 7 A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health. Principle 8 A physician shall, while caring for a patient, regard responsibility to the patient as paramount. Principle 9 A physician shall support access to medical care for all people. Reference: American Medical Association. (2001, June). AMA code of medical ethics. Retrieved from https://www.ama-assn.org/sites/default/files/media-browser/principles-of-medical-ethics.pdf Additional Materials From your course textbook, Legal and Ethical Issues for Health Professionals, review the following chapter: · Health Care Professionals Legal–Ethical Issues From the South University Online Library, review the following articles: · Certified in Public Health Program: Credentialing Public Health Leaders  · Aligning Healthcare Safety and Quality Competencies: Quality and Safety Education for Nurses (QSEN), The Joint Commission, and American Nurses Credentialing Center (ANCC) Magnet® Standards Crosswalk  · Continuing Professional Development in the Twenty-First Century  Week 3 Discussion Instructions Before beginning work on this discussion forum, please review the link “Doing Discussion Questions Right” and any specific instructions for this topic. Your initial posting should be addressed at 300–500 words. Make your post to this Discussion Area by the due date assigned. Before the end of the week, begin commenting on at least two of your classmates’ responses. You can ask technical questions or respond generally to the overall experience. Be objective, clear, and concise. Always use constructive language, even in criticism, to work toward the goal of positive progress. Submit your responses to the Discussion Area. CODE OF ETHICS Review the following case study and address the questions that follow: General Hospital’s staff aggregated its infection rate data for comparison purposes with four other hospitals in the community. The staff members were aware that the data was flawed. They presented a false perception that General Hospital’s postoperative infection rates were lower than those of peer hospitals. The comparison data was published in the local newspaper. The Jones family, believing the data to be correct and concerned about the number of deaths related to hospital-acquired infections, relied on the data in selecting General Hospital as their preferred hospital. Tasks: 1. Describe how organizational and professional codes of ethics were violated in this case. 2. Describe what role an organization’s ethics committee could play in addressing this or similar issues. To support your work, use your course and textbook readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format. Week 3 Project Instructions  Instructions Before beginning work on this assignment, please review the expanded grading rubric for specific instructions relating to content and formatting. DEONTOLOGICAL ETHICS Each week, you will have the opportunity to explore an ethical theory—consequential ethics, utilitarian ethics, deontological ethics, and nonconsequential ethics—in the context of a case scenario from your textbook. In this week, the focus will be on deontological ethics. Deontological ethics is a duty-based theory that originated from the work of Kant, which suggests that doing the right thing is important whether or not it results in the maximum good. Tasks: 1. Download and save the  assignment template  to your computer and update the file name to include your last name. 2. Review the assigned case in its entirety. 3. Address the questions posed in detail and with appropriate scholarly support. To support your work, use your course and textbook readings and also use the  South University Online Library . As in all assignments, cite your sources in your work and provide references for the citations in APA format. Submission Details · By the due date assigned, submit your document to the Submissions Area. MHA6060: Health Law and Ethics Week 3 Assignment DEONTOLOGICAL ETHICAL THEORY Please review the following case: At thirty-three years of age, I was the youngest administrator in New York State and was about to learn that adhering to company policies sometimes conflicts with the needs of patients. In this case, it was a thirty-eight-year-old employee who had been diagnosed with cancer. I remember the day well, even though it was more than thirty years ago. My secretary alerted me that Carol, a practical nurse and employee, had been admitted to the 3-North medical-surgical week, where she worked. Without delay, I left my office and went to the nursing week and inquired as to what room Carol was in. Beth, the week’s nurse manager, overheard my question. She walked up to me and asked, “Daniel, could I please talk to you for a moment before you visit Carol?” I looked at her and nodded my head yes, and without thought, we both walked into her office. She closed the door and said, “As you know, we are self-insured and the health insurance program that we have does not cover Carol’s chemotherapy treatments. She cannot bear the cost. Is there anything you can do to help her?” I replied that I would make an inquiry with our human resources director to see what could be done. Beth asked, “Would you mind if I went with you to Carol’s room for a few minutes.” Daniel compassionately replied, “Of course, you can.” They walked to Carol’s room. Her husband and children had just left. Beth stayed for a few minutes while Daniel remained behind chatting with Carol for a few moments and said he would be back to talk with her more. Daniel went to speak with Christine, the human resources director for his hospital. There were two other hospitals in the multihospital system. He explained Carol’s financial situation and her lack of funds for her chemotherapy treatment. Christine replied, “Daniel, this is a corporate policy that is applicable to all three hospitals with which we must comply.” Following much discussion, Daniel said, “Christine, Carol is an employee, and I realize there are conflicting duties here. One is to follow corporate policy or choose to do, as I see it, what is right for Carol. If you prefer, I can request an exception to the rule. To me, right trumps duty.” Christine looked at Daniel and said, “Daniel, I will see what I can do. I have a good relationship with the corporate vice president for human resources. If anyone can make an exception, he can make it happen. I know you would do the same for me or any other employee.” Please address the following questions drawing support from your course resources and credible scholarly resources cited in APA format : Discuss at least three potential long-term effects of granting an exception for Carol. Justify the position that doing the right thing is always more important that maximizing good and defend the argument that “right trumps duty.” Be sure to provide examples from personal or professional scenarios. References 8/30/2021 Rubric Assessment - MHA6060-Health Law and Ethics SU01 - South University https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=80786&evalObjectId=402680&evalObjectType=5&userId=4901&groupId=0&rubricId=6574&d2l_b… 1/4 Close Print RubricSUO Discussion Rubric (80 Points) - Version 1.2 Course: MHA6060-Health Law and Ethics SU01 Response No Submission 0 points Emerging (F-D: 1-27) 27 points Satisfactory (C: 28- 31) 31 points Proficient (B: 32-35) 35 points Exemplary (A: 36-40) 40 points Criterion Score Quality of Initial Posting / 40No initial posting exists to evaluate. The information provided is inaccurate, not focused on the assignment’s topic, and/or does not answer the question(s) fully. Response demonstrates incomplete understanding of the topic and/or inadequate preparation. The information provided is accurate, giving a basic understanding of the topic(s) covered. A basic understanding is when you are able to describe the terms and concepts covered. Despite this basic understanding, initial posting may not include complete development of all aspects of the assignment. The information provided is accurate, displaying a good understanding of the topic(s) covered. A good understanding is when you are able to explain the terms and topics covered. Initial posting demonstrates sincere reflection and addresses most aspects of the assignment, although all concepts may not be fully developed. The information provided is accurate, providing an in- depth, well thought-out understanding of the topic(s) covered. An in- depth understanding provides an analysis of the information, synthesizing what is learned from the course/assigned readings. Participation No Submission 0 points Emerging (F-D: 1-13) 13 points Satisfactory (C: 14- 16) 16 points Proficient (B: 17-18) 18 points Exemplary (A: 19-20) 20 points Criterion Score 8/30/2021 Rubric Assessment - MHA6060-Health Law and Ethics SU01 - South University https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=80786&evalObjectId=402680&evalObjectType=5&userId=4901&groupId=0&rubricId=6574&d2l_b… 2/4 Participation No Submission 0 points Emerging (F-D: 1-13) 13 points Satisfactory (C: 14- 16) 16 points Proficient (B: 17-18) 18 points Exemplary (A: 19-20) 20 points Criterion Score Participation in Discussion / 20No responses to other classmates were posted in this discussion forum. May include one or more of the following: *Comments to only one other student's post. *Comments are not substantive, such as just one line or saying, “Good job” or “I agree. *Comments are off topic. Comments to two or more classmates’ initial posts but only on one day of the week. Comments are substantive, meaning they reflect and expand on what the other student wrote. Comments to two or more classmates’ initial posts on more than one day. Comments are substantive, meaning they reflect and expand on what the other student wrote. Comments to two or more classmates’ initial posts and to the instructor's comment (if applicable) on two or more days. Responses demonstrate an analysis of peers’ comments, building on previous posts. Comments extend and deepen meaningful conversation and may include a follow- up question. Writing No Submission 0 points Emerging (F-D: 1-13) 13 points Satisfaction (C: 14- 16) 16 points Proficient (B: 17-18) 18 points Exemplary (A: 19-20) 20 points Criterion Score 8/30/2021 Rubric Assessment - MHA6060-Health Law and Ethics SU01 - South University https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=80786&evalObjectId=402680&evalObjectType=5&userId=4901&groupId=0&rubricId=6574&d2l_b… 3/4 Total / 80 Writing No Submission 0 points Emerging (F-D: 1-13) 13 points Satisfaction (C: 14- 16) 16 points Proficient (B: 17-18) 18 points Exemplary (A: 19-20) 20 points Criterion Score Writing Mechanics (Spelling, Grammar, Citation Style) and Information Literacy / 20No postings for which to evaluate language and grammar exist. Numerous issues in any of the following: grammar, mechanics, spelling, use of slang, and incomplete or missing citations and references. If required for the assignment, did not use course, text, and/or outside readings (where relevant) to support work. Some spelling, grammatical, and/or structural errors are present. Some errors in formatting citations and references are present. If required for the assignment, utilizes sources to support work for initial post but not comments to other students. Sources include course/text readings but outside sources (when relevant) include non- academic/authoritative, such as Wikis and .com resources. Minor errors in grammar, mechanics, or spelling in the initial posting are present. Minor errors in formatting citations and references may exist. If required for the assignment, utilizes sources to support work for both the initial post and some of the comments to other students. Sources include course and text readings as well as outside sources (when relevant) that are academic and authoritative (e.g., journal articles, other text books, .gov Web sites, professional organization Web sites, cases, statutes, or administrative rules). Minor to no errors exist in grammar, mechanics, or spelling in both the initial post and comments to others. Formatting of citations and references is correct. If required for the assignment, utilizes sources to support work for both the initial post and the comments to other students. Sources include course and text readings as well as outside sources (when relevant) that are academic and authoritative (e.g., journal articles, other text books, .gov Web sites, professional organization Web sites, cases, statutes, or administrative rules). 8/30/2021 Rubric Assessment - MHA6060-Health Law and Ethics SU01 - South University https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=80786&evalObjectId=402680&evalObjectType=5&userId=4901&groupId=0&rubricId=6574&d2l_b… 4/4 Overall Score No Submission 0 points minimum There was no submission for this assignment. Emerging (F to D Range) 1 point minimum Satisfactory progress has not been met on the competencies for this assignment. Satisfactory (C Range) 56 points minimum Satisfactory progress has been achieved on the competencies for this assignment. Proficient (B Range) 64 points minimum Proficiency has been achieved on the competencies for this assignment. Exemplary (A Range) 72 points minimum The competencies for this assignment have been mastered. 8/30/2021 Rubric Assessment - MHA6060-Health Law and Ethics SU01 - South University https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=80786&evalObjectId=411451&evalObjectType=1&userId=4901&viewTypeId=3&rubricId=248270&… 1/3 Close Print RubricSU MHA6060 Week 3 Project Rubric Course: MHA6060-Health Law and Ethics SU01 Criteria No Submission 0 points Emerging (F through D Range) (1–41) 41 points Satisfactory (C Range) (42–47) 47 points Proficient (B Range) (48–53) 53 points Exemplary (A Range) (54–60) 60 points Criterion Score Includes all assignment components and meets graduate level critical thinking. A purpose statement is identified for the response. / 60Student did not submit assignment. Work minimally meets assignment expectations. No purpose statement is provided. Assignment meets some expectations with minimal depth and breath. Purpose statement is vague. Assignment meets most of expectations with all components being addressed in good depth and breadth. Purpose statement is present and appropriate for the assignment. Assignment meets all expectations with exceptional depth and breath. A comprehensive purpose statement delineates all requirements of the assignment. Criteria No Submission 0 points Emerging (F through D Range) (1–37) 37 points Satisfactory (C Range) (38–43) 43 points Proficient (B Range) (44–48) 48 points Exemplary (A Range) (49–55) 55 points Criterion Score Integrates and understands assignments concepts and topics. / 55Student did not submit assignment. Shows some degree of understanding of assignment concepts. Demonstrates a clear understanding of assignment concepts. Demonstrates the ability to evaluate and apply key assignment concepts. Demonstrates the ability to evaluate, apply and integrate key assignment concepts. Criteria No Submission 0 points Emerging (F through D Range) (1–34) 34 points Satisfactory (C Range) (35–39) 39 points Proficient (B Range) (40–44) 44 points Exemplary (A Range) (45–50) 50 points Criterion Score 8/30/2021 Rubric Assessment - MHA6060-Health Law and Ethics SU01 - South University https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=80786&evalObjectId=411451&evalObjectType=1&userId=4901&viewTypeId=3&rubricId=248270&… 2/3 Total / 175 Criteria No Submission 0 points Emerging (F through D Range) (1–34) 34 points Satisfactory (C Range) (35–39) 39 points Proficient (B Range) (40–44) 44 points Exemplary (A Range) (45–50) 50 points Criterion Score Synthesizes, analyses, and evaluates resources to apply concepts in the assignment. / 50Student did not submit assignment. Does not interpret, apply, and synthesize concepts and strategies. Summarizes information gleaned from sources to support major points, but does not synthesize. Provides minimal justification to support major topics. Uses one credible resource in the assignment. Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Uses a minimum of two credible resources in the assignment. Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Uses three credible resources for the assignment, including at least one scholarly peer-reviewed resource. Criteria No Submission 0 points Emerging (F through D Range) (1–6) 6 points Satisfactory (C Range) 7 points Proficient (B Range) 8 points Exemplary (A Range) (9–10) 10 points Criterion Score Uses correct spelling, grammar, and professional vocabulary. Provides credible resources using correct APA format. / 10Student did not submit assignment. Contains many (≥5) grammar, spelling, punctuation and APA errors that interfere with the reader’s understanding. Contains a few (3–4) grammar, spelling, punctuation and APA errors. Uses correct grammar, spelling, and punctuation with no errors. Contains a few (1–2) APA format errors. Uses correct grammar, spelling, and punctuation with no errors. Uses correct APA format with no errors. 8/30/2021 Rubric Assessment - MHA6060-Health Law and Ethics SU01 - South University https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_results.d2l?ou=80786&evalObjectId=411451&evalObjectType=1&userId=4901&viewTypeId=3&rubricId=248270&… 3/3 Overall Score No Submission 0 points minimum Emerging (F through D Range) 1 point minimum Satisfactory (C Range) 122 points minimum Proficient (B Range) 140 points minimum Exemplary (A Range) 157 points minimum