Reference no: EM131335052

The first imprtant thing is submited to me at the time ..

Ineed In each questions of causes the answer content this following concepts and ides should be organized :

1- which law is applying and how it applied? (giving a background a bout the law ) .

2- who is labile?

3- Cause analysis ?(Intentional tort include the type, or unintentional tort include (duty-breach of duty- damages - result)

4- How to prevent recurrence?

5- If the law that given in the questions is not relevant to the cause. Why?

In Both Questions (A-B) you chose the causes that I listed in the attachment form the syllabus or from the link that posted down ..

In the Question A , Chose the causes that have more ethical issue then law validations .

In Questions B, Chose the causes that have more law validations then ethical issue

Listed of causes that we disicussed them in the class:

1. https://chelmsfordhospital.blogspot.com/p/our-views.html

2. Hurricane Katrina & Memorial Medical Center

QUESTION A.

In the context of this course and citing at least (3) actual cases presented in class (you may cite more and are not limited to those discussed in class) and applying the ethical, legal, and financial considerations, would the United States be better off with true universal health care coverage for all and a single payer system? Why or why not?

QUESTION B

Citing at least (3) actual cases presented in class (you may cite more and are not limited to those discussed in class) and applying the laws and regulations discussed in your book, please prepare a comprehensive and thoughtful analysis and response to one of the following:

• "More Regulation in healthcare is needed and why"

• "Less Regulation in healthcare is needed and why"

Please include in your analyses a thorough discussion of the legal and regulatory issues and theories of liability (except negligence) and whether you agree with the outcomes, and the detailed types of changes or reforms that should be implemented, if any.

QUESTION C

INSTRUCTIONS: Please type your response to the following case and organize it in a way to include and address your scope of responsibilities and the areas of concern, as assigned below.

CASE:

You are hired as the new regional compliance director for a Fortune 500 multi-facility integrated healthcare system (aka "HOSPITAL") to lead their corporate compliance program. You current have a staff of six and have been informed that as part of the company's efficiency and optimization mandates, you are expected to reduce your departmental staff by 30% within your first 12 months. In addition, you immediately receive a request from your executive leadership to review and approve from a legal, compliance and ethical perspective the following:

"Due to our increasing intrinsic health care costs, decreasing profit margins, significant reductions in Medicare reimbursement rates, and the high cost of life continuity and chronic care measures, effective January 1, 2017, Hospital will implement the following program. Hospital will establish a fund to help defray patient expenses incurred due to a stay in the hospital. Hospital, as part of its' goodwill and community outreach measures will require each current female employee of Hospital to contribute 5% of their salary to that fund which Hospital will match at 100%. Male employees will be required to contribute 7% of their salaries to address the fact that men are generally paid more than women. Any employee requests to be exempted from the forced contribution based on financial hardship will be considered on a case by case basis only. The funds will be applied selectively by Hospital to patients deemed by the Hospital Board to be most deserving. In addition, each non-emergency patient shall sign a release prior to admission allowing the hospital to use their photographic images and treatment information for fund-raising purposes to help defray cost to the hospital to the extent that their individual costs of care are not met by their insurance and/or the patient's out of pocket payments.

This may include broadcasting the images on video monitors throughout hospital where you can make donations similar to a telethon, selling of photos of newborns to advertising agencies, community messages showing individuals suffering the effects of smoking, drug use, and for religious purposes such as the promotion of abstinence and warnings against teenage pregnancy. If the patient refuses to sign the release, they will not be admitted. The hospital shall be fully transparent in terms of patient care costs; and provide each patient with an estimated cost of care (including a menu of basic treatment plan services and a la carte options prior to admission so that the patient may select their appropriate level of care. The patient will receive a daily invoice accounting of the hospital services provided each day thereafter (not unlike the hotel invoice placed under your door on the day of checkout.) Patients admitted under emergency conditions will be required to sign the release as soon as their condition is deemed by hospital physician to be medically stable."

QUESTION D

In your fifth week in this capacity, you receive the following written complaint:

"My name is Mervat Bronwyn. I am a long-term employee currently on disciplinary action and need your help. I believe I am being retaliated against for my reporting of the following ethical, legal, and compliance concerns to our leadership:

1. Starting last year, HOSPITAL has been offering financial incentives to participate in an annual employee blueprint for wellness heath screen. Though the stated purpose is to encourage healthy employee eating and lifestyle, HOSPITAL has been collecting and analyzing detailed employee health data to (1) identify and ultimately terminate employees with chronic health care conditions and (2) outsource departments with greater than average healthcare utilization. HOSPITAL has also been strategically reducing the work schedule for all hourly workers to get them to 39 hours per week or less; and has recently announced the elimination of all previously vested health and retirement benefits for all workers employed by HOSPITAL effective 1/1/2017.

2. One of our contracted ER physicians, Dr. James Reap, and one of our in-house pathologists, Dr. Alda Hyde are harvesting hearts, lungs, and kidneys from ER patients who expire on the table and pronounced dead for sale to an international organ broker for sale on the black market. Reap and Hyde receive 80K per heart, 60K for kidneys, and 40 K for lungs. Many of the ER patients are homeless and have no family and those that do are never aware that their loved one's organs have been removed. All organs are tested for disease and tissue matching, cryogenically preserved to prevent deterioration, and are immediately picked up by broker's courier and transported via private jet to broker's overseas distribution center. Reap and Hyde donate 75% of the funds they receive to the Sisters of Mercy, an approved 501 c Catholic charities organization that engages in many philanthropic endeavors throughout the community including free daycare, Montessori schools, homeless shelters, after school programs for low income families, etc. The other 10% goes to a charitable funeral home owned and run by Reaps'sister, Ruby Reap, for burial and cremation fees open to the public via application. 15% of the funds are donated anonymously back to the hospital.

3. HOSPITAL is giving financial incentives to staff employed at Los Angeles homeless shelters to deliver homeless patients by ambulance to HOSPITAL. HOSPITAL provides the homeless patients a hot meal in the cafeteria and has each patient sign a consent form for medical treatment as well as an advanced directive. HOSPITAL does not all the homeless patients to leave the cafeteria until they complete and sign the forms. HOSPITAL then bills Medicaid for a variety of medical services allegedly rendered to the homeless patients, many of which are not medically necessary. When the homeless patient dies at a shelter, HOSPITAL will send an ambulance to collect the body so that HOSPITAL may harvest and repurpose the organs to other patients for transplant.

4. Bristol, a pregnant 15-year-old uninsured patient with suspicious bruising on her face, neck and upper torso appeared at the HOSPITAL emergency room with her boyfriend and appeared to have labor-type symptoms. Admitting clerk, Derek, told Bristol to seek care instead at the free health clinic outside of town. While en-route to that clinic, Bristol's car is struck by a drunk driver, Joe. Bristol dies from the injuries shortly after giving birth to a baby boy who is now on artificial life support at our HOSPITAL due to a permanent brain damage. Bristol's boyfriend claims that the baby was fathered by Bristol's stepfather who is now insisting on taking the baby off the life support.

5. HOSPITAL has opened several new facilities in affluent areas in the past year while at the same time closing an even larger number in lower income areas - leaving some communities without reasonable access to medical care. All existing locations appear to be understaffed with long wait times in the ER -- and we even had a patient bleed to death while waiting to be seen. Female nurses have complained they are forced to work uncompensated overtime and almost always at a lower pay rate than their male counterparts. Older employee's jobs are always the first ones cut; and when a job vacancy is posted for any position, everyone knows that only the "young and healthy" need apply.

6. Arthur Andersen, M.D., is a surgeon on HOSPITAL staff who performs medical procedures for which he is neither competent nor properly credentialed. At least one patient died, and others were seriously injured, and no formal action was ever taken, because the HOSPITAL and the state licensing boards are in cahoots and protect their own. I know that a previous facility had restricted Arthur's physician's privileges as a result of a high-complication rate on his surgical procedures.

7. HOSPITAL recently implemented an integrated Electronic Medical System (EMR ). All physicians, employees, temporary workers, and others with hospital privileges can access all patient medical records anytime through the interface. A cardiology patient recently filed a complaint with the Office of Civil Rights claiming that here privacy rights were violated because the cardiologist was aware that the HIV positive patient had also recently been treated for Syphillis. HOSPITAL also just rolled out a new "zero tolerance"social media policy stating that any employee using social media (facebook, linked in, twitter, etc.) may not identify "HOSPITAL"as their employer in any way shape or form or be subject to immediate termination and loss of benefits.

8. Patients with Alzheimer's disease sit unsupervised inside a small room of HOSPITAL's adult psychological care facility watching the movie "Forrest Gump" every day. Each time the patients sit in front of the TV watching it, the facility submits private insurance claims for providing "group therapy." Some of the "therapists" have never been trained to provide those services and are under the supervision of a part-time doctor, Suzanne Speedy, M.D., who comes in two days a week to review treatment files and sign claim forms. The facility is being renovated with unattended hazardous equipment laying around, and patient treatment files and forms are currently housed on an open magazine shelf in the lobby.

9. Michelle Mengala is an allergy doctor and researcher on HOSPITAL staff providing an experimental treatment not yet approved by government healthcare plans or other insurance companies. Patients are handed a bag of syringes filled with antigens and told to inject themselves in their homes. HOSPITAL bills Medicare for each patient self-injection as an office visit. Because the treatment is not covered by insurance, Dr. Mengala instructs her staff to code it as some other treatment that is covered.

Please help! I feel I am going to lose my job because of exposing these issues."

ASSIGNMENT for Question D: Analyze and evaluate the organizational risks of Mervat's allegations, citing actual cases and laws in your analysis and argument. Discuss your specific course of action, step-by step, and explain how it integrates into your overall comprehensive strategy for your new function. Explain the ethical dilemmas, if any, in addition to legal and compliance concerns.