Easy work management

Unit 8 Assignment

Jordan Paltani

Purdue Global University

HS410: Organization and Management for Health Care

R. Todd Kane

08/29/2018

Unit 8 Assignment

“You are the finance manager in a long term care facility that is struggling to remain solvent. The facility’s administrator has hired a consultant to work with you to increase Medicaid reimbursement. The consultant recommends that you be more “liberal” in coding the severity of residents’ needs to justify greater reimbursement. The consultant tells you, “everybody does it” and, “it’s an undetectable way to boost revenue”.

You believe this approach is somewhere between inappropriate and illegal. You know the consultant is being paid on a commission and is an old college buddy of the facility administrator. You also recognize that your facility could soon go out of business and leave you without a job.”

Ethical Challenges

My ethical challenges would include what I personally feel is right and what is wrong along with what I think would be of best interest for the facility and its employees/residents. Being more “liberal” in coding the severity of residents’ needs to justify greater reimbursement can be known as falsifying information which is illegal and can cost me my license in the end. Being told “everybody does it” and, “it’s an undetectable way to boost revenue” is unethical but also illegal. In the end I am trying to help everyone out and do it both ethically while being completely honest.

Options

I have a few options to consider in this situation. First off, I could decide against being more “liberal” in coding the severity of residents’ needs. Being more “liberal” in coding the severity of residents’ needs would ultimately put the facility at risk for being closed down along with the staff members of the facility losing their jobs or even licensures. My second option would be to be more “liberal” in coding the severity of residents’ needs to increase Medicaid reimbursement. This would ultimately save the facility from shutting down. This is unethical to me along with being illegal. If the state were to find out that documentation was being falsified or altered, the facility would shut down, everyone would lose their jobs, some may go to jail, pay fines, or lose their medical licensures all together. My last option would be to carefully spend time and review the facilities financial needs by having a meeting to discuss an honest way of proceeding with this situation.

Course of Action

My course of action will be to schedule a meeting with the director of each department to see what can further be done to avoid being shut down. We will look at all the finances coming in and going out and see what can be done. I would never falsify any information as this puts too many employees’ licensures in stake along with their jobs. Ethically, it would look better on everyone if the facility was shut down due to actual “lack of funds” rather than employees falsifying information. In conclusion it is my job to uphold the ethical code as a medical professional for this facility.

References