Problem state and research question - Writing
Post your topic, problem statement, and a minimum of two research questions, based on your problem statement, which will guide your Doctoral Study research.I need a new problem statement and two research questions. It must be related to the topic ( The effect of Patient-Driven payment model (PDPM) on quality care in nursing homes. ddha8246_week7_prospectus.docx Unformatted Attachment Preview The effect of Patient-Driven payment model (PDPM) on quality care in nursing homes Walden University Week 7 Assignment: Revised Doctoral Study Prospectus The effect of Patient-Driven payment model (PDPM) on quality care in nursing homes. Prepared By: Charmaine Maestrado The effect of Patient-Driven payment model (PDPM) on quality care in nursing homes Problem Statement The world’s population is rapidly aging and the number of elderly people is increasing daily( Manav, Yeşilot, Demirci,& Öztunç, 2018). 1.4 million Americans are living in a nursing home. Unfortunately, thousands of them are evicted against their wishes simply because of their eligibility status.It is a troubling trend statewide as the senior population is growing , nursing home facilities are closing down.The primary contributor of these closures is the low Medicaid reimbursement rate(s). Majority of the nursing homes are run by large corporate chains that operate multiple facilities throughout the country.It is illegal to discriminate against residents’ based on payment source. Medicare and Medicaid subsidize different amounts. Medicare pays more. However , Medicare is not for long term purposes since it will only cover certain days. Medicare only covers short-term rehabilitation: up to 20 days for 100\% after that you have to pay for the copayment. As of 2017, long term Ombudsman received more than 10,000 complaints about nursing home discharged and transfers. Minimizing our costs as a business is always a challenge . Staffing plays a huge part in nursing home operational costs. If we do not have enough resources to remain in business. We are most likely going to cut our staff and this is going to impact the care and services we provide to our patients. The new payment model , the patient-driven payment model (PDPM) is expected to align reimbursement with shift from volume to value.This study will identify the significant gap between the funding and the actual cost to providing the care as well as the impact on staffing levels in the nursing homes. The effect of Patient-Driven payment model (PDPM) on quality care in nursing homes Purpose of the study The purpose of this study is to examine the impact of the new payment model on quality of care in nursing homes. Hettich and Pivec (2018) noted that Under the RUG-IVpayment system, SNFs are paid at a constant per diem rate, regardless of the length of a resident’s stay, unless the resident is reclassified into a different group during the stay . It has been three months since we started the new case-mix model titled the Patient-Driven Payment Model (PDPM) and replaced the Resourced Utilization Groups or the RUGs model. Significance of this study In healthcare, quality is a measure of success. We cannot improve what we cannot measure. The resident’s health outcome will tell us how we are doing. The study will help us determine how effective the new model is and identify the impact of it in rehabilitation services and the overall well being of the resident(s). The goal of Patient-Driven Payment Model is to provide patientcentered care that treats the resident as a whole instead of reimbursing nursing facilities primarily for rehabilitation services.The PDPM focuses on clinically relevant factor rather than codes and other characteristics as the basis for patient classification. It will focus on critical conditions ,patient diagnosis, comorbidity and history of the most recent hospital stays for reimbursement rates. Rehabilitation services will take a lesser role in reimbursement and PDPM will affect Part A but not Medicare Advantage patients. Background The keywords searched were online doctoral program completion, Elsevier, Emerald insight and CINAHL Plus. The effect of Patient-Driven payment model (PDPM) on quality care in nursing homes 1. Babbie, E. (2017). Briefly discussed the importance of deductive theory and social change. 2. Elliot, A. E., & Barsness, S. (2016). Explained how Medicaid reimbursement started and importance of staff engagement. 3. Hettich, D., & Pivec, A. (2018). Provided information about Prospective payment system which is under the previous model system. Briefly explained the purpose of PatientDriven Payment Model (PDPM). 4. Howard,L. (2014). Provided information about the role of the government in reimbursing skilled nursing facilities. 5. Manay,A. Yesilot,S. ,Demirci,P. & Öztunç (2018). Provided information about the cognitive function and quality of life of elderly people living in a nursing home. 6. Moick, S., Simon, J., & Hiesmayr, M. (2019). Nutrition care quality indicators in hospitals and nursing homes: A systematic literature review and critical appraisal of current evidence. Clinical Nutrition https://doiorg.ezp.waldenulibrary.org/10.1016/j.clnu.2019.07.025 Framework I will be using Donabedian Framework and Andersen Behavioural Model. According to the concept of Donabedian, quality of care is a multidimensional construct. In his framework he distinguishes between structure, process and outcome indicators that all affect quality of care (Moick,Simon, & Hiesmayr 2019. I believe this can help me explore both clinical and leadership aspect in healthcare . Evidence -based practice from previous scholars will be applied. The effect of Patient-Driven payment model (PDPM) on quality care in nursing homes Under Andersen Model, I can do cost utilization. It can also let me identify important factors such as measuring quality indicators. We want to be effective and cost-efficient.Since the payment model just started, it may be too early to distinguish the impact of it but we will see a combination of extensive services with non therapy ancillary services and with nursing services to deliver a case mix that finally reimburses the facility for what the services they actually provide. Our per diem rate should be budget neutral where Rehabilitation therapy will no longer drives payment. Patient characteristics and MDS coding will drive reimbursement . Research Question(s) RQ–Quantitative: What is the impact of Patient-Driven Payment Model on workforce and reimbursement rate? H01- 90\% of post acute care are billed to rehabilitation services. The RUGs payment rates are certainly not dependent on the clinical conditions except for depression as part of the rehabilitation case-mix. As far as reimbursement , physical therapy (PT) and occupational therapy (OT) reimbursement rates will decline by 2\% every week after the 20th day of stay. Non-therapy Ancillary services will decline by 66\% after the 3rd day of stay. We can be able to use our pharmacist to help us optimize drug therapy early in a resident’s day instead of having the pharmacist quarterly for drug regimen review . We can provide admission medication review to help us identify the barriers and adverse effects, medication errors upon transition and transfer and to assure that the new admission has a successful stay in our facility while we maximize the payment rate for them. Annual federal and state government expenditures for the provision of nursing home care services through the Medicaid program now exceed US$48 billion. Elderly recipients account for The effect of Patient-Driven payment model (PDPM) on quality care in nursing homes nearly three-fourths of the total costs of nursing home care, and nursing home care services comprise 15\% of the total Medicaid program spending ( Howard 2014).We are in the crisis situation. The biggest fear that we might face is that , providers will be forced to close particularly those facilities in the rural or smaller communities who have a higher percentage rate of Medicaid. H1- A study showed that each additional hour of therapy received per week was associated with a 3.1 percentage point increase in the likelihood a SNF resident was discharged home. Nature of this study There is growing tension in long-term care based on an increasing focus on quality of life and resident experience juxtaposed with reimbursement models shifting to an emphasis on quality of care and measurable outcomes (Elliot & Barsness, 2016). This will be a quantitative research, we will focus on data and metrics. Collecting and gathering consistent , valid and measurable data is necessary in/ for this study. Organizations need to look at their financial planning systems , staff management practices and ensure that those approaches will align with their business strategies. The overall purpose of PDPM is to lower costs, improve patient outcomes , augment revenue sources and optimize the reimbursement that facility is due. I think that PDPM will open new opportunities for new admission and effective disease management. Secondary Data Types and Sources of Information Secondary data will be accessed from an online doctoral program. I will also be using previous data and studies used by Centers of Medicare and Medicaid to look at factors such as RUGS IV, PPS model, mix case model and implications of cost analysis for rate setting. The rehabilitation department will play a significant role in this study. The effect of Patient-Driven payment model (PDPM) on quality care in nursing homes Implications Long term care organizations need to change their business approaches and strategies because of the new payment model. The development of PDPM did not take outcomes when determining therapy groups or payment. At this time, it is difficult to determine how the changes will affect the bottom lines since we just started it. The sources may be also limited since everything is highly regulated. The effect of Patient-Driven payment model (PDPM) on quality care in nursing homes References Babbie, E. (2017). Basics of social research (7th ed.). Boston, MA: Cengage Learning. CohenMiller, A. S., & Pate, P. E. (2019). A Model for Developing Interdisciplinary Research Theoretical Frameworks. Qualitative Report, 24(6), 1211–1226. Retrieved from https://searchebscohostcom.ezp.waldenulibrary.org/login.aspx?direct=true&db=a9h&AN=136871953&site=edslive&scope=site Elliot, A. E., & Barsness, S. (2016). What’s in Your Bundle? Building a Communication Map of Relational Coordination Practices to Engage Staff in Individualizing Care. Seniors Housing & Care Journal, 24(1), 3–19. Retrieved from https://search-ebscohostcom.ezp.waldenulibrary.org/login.aspx?direct=true&db=a9h&AN=120614537&site=edslive&scope=site Hettich, D., & Pivec, A. (2018). Payment System to Change for Skilled Nursing Facilities: CMS’s Patient-driven Payment Model revamps PPS for SNFs. (cover story). Dennis Barry’s Reimbursement Advisor, 34(3), 1–12. Howard, L. L. 1. larryhoward@fullerton. ed. (2014). Does Government Oversight Improve Access to Nursing Home Care? Longitudinal Evidence From US Counties. Inquiry (00469580), 51, 1–12. https://doi-org.ezp.waldenulibrary.org/10.1177/0046958014561634 Lo, T. K. T., Parkinson, L., Cunich, M., & Byles, J. (2016). Factors associated with the health care cost in older Australian women with arthritis: an application of the Andersen’s Behavioural Model of Health Services Use. Public Health, 134, 64–71. https://doiorg.ezp.waldenulibrary.org/10.1016/j.puhe.2015.11.018 Manav, A. İ., Yeşilot, S. B., Demirci, P. Y., & Öztunç, G. (2018). An evaluation of cognitive function, depression, and quality of life of elderly people living in a nursing home. Journal of The effect of Patient-Driven payment model (PDPM) on quality care in nursing homes Psychiatric Nursing / Psikiyatri Hemsireleri Dernegi, 9(3), 153–160. https://doiorg.ezp.waldenulibrary.org/10.14744/phd.2018.26817 Shirey, M. R. (2013). Strategic Leadership for Organizational Change. Lewin’s Theory of Planned Change as a Strategic Resource. Journal of Nursing Administration, 43(2), 69–72. https://doi-org.ezp.waldenulibrary.org/10.1097/NNA.0b013e31827f20a9 ... Purchase answer to see full attachment
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Your assignment may be more than 5 paragraphs but not less. INSTRUCTIONS:  To access the FNU Online Library for journals and articles you can go the FNU library link here:  https://www.fnu.edu/library/ In order to n that draws upon the theoretical reading to explain and contextualize the design choices. Be sure to directly quote or paraphrase the reading ce to the vaccine. Your campaign must educate and inform the audience on the benefits but also create for safe and open dialogue. A key metric of your campaign will be the direct increase in numbers.  Key outcomes: The approach that you take must be clear Mechanical Engineering Organic chemistry Geometry nment Topic You will need to pick one topic for your project (5 pts) Literature search You will need to perform a literature search for your topic Geophysics you been involved with a company doing a redesign of business processes Communication on Customer Relations. 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Throughout your nurse practitioner program Vignette Understanding Gender Fluidity Providing Inclusive Quality Care Affirming Clinical Encounters Conclusion References Nurse Practitioner Knowledge Mechanics and word limit is unit as a guide only. The assessment may be re-attempted on two further occasions (maximum three attempts in total). All assessments must be resubmitted 3 days within receiving your unsatisfactory grade. You must clearly indicate “Re-su Trigonometry Article writing Other 5. June 29 After the components sending to the manufacturing house 1. In 1972 the Furman v. Georgia case resulted in a decision that would put action into motion. Furman was originally sentenced to death because of a murder he committed in Georgia but the court debated whether or not this was a violation of his 8th amend One of the first conflicts that would need to be investigated would be whether the human service professional followed the responsibility to client ethical standard.  While developing a relationship with client it is important to clarify that if danger or Ethical behavior is a critical topic in the workplace because the impact of it can make or break a business No matter which type of health care organization With a direct sale During the pandemic Computers are being used to monitor the spread of outbreaks in different areas of the world and with this record 3. Furman v. Georgia is a U.S Supreme Court case that resolves around the Eighth Amendments ban on cruel and unsual punishment in death penalty cases. The Furman v. Georgia case was based on Furman being convicted of murder in Georgia. 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The greatest obstacle From a similar but larger point of view 4 In order to get the entire family to come back for another session I would suggest coming in on a day the restaurant is not open When seeking to identify a patient’s health condition After viewing the you tube videos on prayer Your paper must be at least two pages in length (not counting the title and reference pages) The word assimilate is negative to me. I believe everyone should learn about a country that they are going to live in. It doesnt mean that they have to believe that everything in America is better than where they came from. It means that they care enough Data collection Single Subject Chris is a social worker in a geriatric case management program located in a midsize Northeastern town. She has an MSW and is part of a team of case managers that likes to continuously improve on its practice. The team is currently using an I would start off with Linda on repeating her options for the child and going over what she is feeling with each option.  I would want to find out what she is afraid of.  I would avoid asking her any “why” questions because I want her to be in the here an Summarize the advantages and disadvantages of using an Internet site as means of collecting data for psychological research (Comp 2.1) 25.0\% Summarization of the advantages and disadvantages of using an Internet site as means of collecting data for psych Identify the type of research used in a chosen study Compose a 1 Optics effect relationship becomes more difficult—as the researcher cannot enact total control of another person even in an experimental environment. Social workers serve clients in highly complex real-world environments. 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