FINAL PAPER

Module 1 – 3 Golden Age Hospital

DeMario J. Stackhouse

MHA – 599

Dr. Tina Evans

Trident University International

Background

Currently, the Mission Viejo municipality has a larger population of approximately 500,000 people according to the latest census of 2012. The total population comprises of 48.5% males and 51.5 % female. The county has two main healthcare facilities that provide services to the community of radius of approximately 10-miles. The Mission Hospital Regional Foundation Centre acts as a communal ship due to its functions. Besides, the mission health Centre is prominent to partner with other facilities such as CHOC Children’s (Burgess, Shaw & Kellas, 2011). The two healthcare facilities provide services to a total of nine municipalities at Viejo. These municipalities are San Juan Capistrano, Aliso Viejo, Laguna Niguel, Lake Forest, Laguna Hills, Laguna Woods, Mission Viejo, Ladera, and Rancho Santa Margarita. The county has communities and homes which comprises of the aging population and retired persons of fifty-five years and above.

Common senior medical situations

The makeup of the Golden Age Hospital in the Mission Viejo and its surroundings is useful because it provides quality healthcare services to infected people and the old. Many common health situations affect the old age in the municipality. These most common health conditions include heart attack conditions, lungs problems, and coronary diseases, which has been reported in places like Aliso Viejo and Laguna Hills (Collins, Connor, Mott & Hickey, 2015). Currently, dealing with these common healthcare conditions is challenging because there are no enough health facilities that can provide all needed services to the public. In most cases, senior medical situations need special attention which should be addressed with more care. Therefore, there is need for an extra wing at the Golden Age Hospital that should be specifically responsible to handle senior medical conditions only.

Major Medical Institutions

The senior healthcare institution in the municipality is the two hospitals located in Viejo that primarily provide acute healthcare services and respite healthcare services to the elderly. These healthcare services are susceptible; thus, it can allow caregivers to attend to other daily routines.

Market Research and Segmentation

Targeting and location of Golden Age Hospital

According to the current situation in the city, there is a need for more wing of the facility to prove healthcare services to the aging population that requires more attention. The development and modernization of more extensions in the facility will help to provide supplementary services to the two existing hospitals to deliver excellence healthcare services to old people. Statistically, in the nine counties, around 17.5 % of the total population is fifty-five years of age assuming the average age is 77 years (Havers & Evans, 2010). The latter implies that approximately 77,000 people out of the aggregate population are susceptible to various medical situations. According to the 2016 report, the aging population in the nine municipalities is increasing daily, thus creating the need for extra wings to help to provide supplementary health care services to the aging population.

Additionally, there is a need for an extra wing in the city is due to the increase in common medical conditions that need more attention and facilities. Another reason for the high demand for another facility is due to the rising number of medical conditions in the city which need critical care by building another wing. The aging population can be segmented based on demographic, psychographic, income, and community.

Demographic reasoning

The average income distribution of the people in Mission Viejo region is quite high even though the demographic situations is not favorable. Generally, Mission Viejo is located in an industrialized nation where a lot of demographic configuration had taken place. The latter implies that birth-rate is relatively slower, while longevity rises (Havers & Evans, 2010). Typically, it is fair if the continuation and birth-rate move concurrently to establish a balanced input versus output in the society. Nevertheless, this seems to be challenging, and the governments feel unable to control it due to the rapid increase in the aging population among the locals. As such, an extra wing that will be specifically targeting the aging population will help to solve the problem because it will provide more Medical care to a larger group of the aging population.

Physical specialized health care services

The formation of the Golden Age Hospital will be a scene of success not only to the aging population but also to other patients who has some severe health care conditions. Currently, the younger age is well catered for, but the middle age and the aging population are the ones facing problems that should be attended to ensure equality in health care delivery within the municipality (Havers & Evans, 2010). As such, the primary issues that should be handled well is finding specialized health care practitioners to treat common diseases among the aging population.

The Golden Age Hospital is set to act as one of the branches of the Mission Group that will be primarily significant is attending to the aging population to offer essential health care services that will enable them to live longer. Some of the sensitive services that the facility should offer are like oncology and Cardiology, resilience service, and occupational services (Stoichiţă, 2012). Consequently, this will lead to high innovation and technological levels to find ways of handling critical health issues. Also, there will be a need for engagement of qualified professionals to use advanced technical components in the Golden Age Hospital to provide quality health care services.

Medical Centre Services Preferences

Besides the establishment of another wing is the formation of the Golden Age Hospital which will reduce cases of older people staying at home to seek for health care services from community health workers who do not offer standard care services. As such, this will create a need for more health care professionals, skilled, trained home caregivers, and knowledgeable individual to provide healthcare services (Rogers, 2014). Additionally, trained health care professionals are presently working in unsafe environments. Therefore, it is crucial to have partners to ensure that health care services providers work on safe and conducive environments. The latter will help to ensure that quality health care services are provided to all people regardless of the age factor.

On the other hand, home healthcare services delivery in developed nations should be standard health care services to the targeted group of people. However, the use of home care services to provide services leads to overall loss on the nation’s Gross Domestic Product that needed human labor in different sectors (Rogers, 2014). But the Golden Age Hospital was recommendable and useful to offer quality services.

Recommendation

According to the current condition, the establishment of a new part of the GAH is likely to solve the main problems facing the city. As such, there is a need for the formation of the GAH to help in solving both fundamental and critical health care services.

Conclusively, the setting up of a new health care facility branded as the GAH to incorporate the organizational ideal to provide quality healthcare services.

Case 1 Survey.

Item #	A To be filled by the student	B Results - To be filled by the Instructor
	Survey item	On a scale of 1-10, where: 10= very much needed, and 1 = not needed
1	Is a special GAH Medical Centre needed?	9
2	Is a specialized community clinic needed in Addition to the GAH?	8
3	Is palliative care needed?	They’re not sure what this means --- (9) Hospice
4	Is a speech therapy service needed?	4
5	Is Physical Therapy needed?	9 with OT
6	Is cardiology needed?	9
7	Are you in need of a neurology services?	8
8	Would a podiatry clinic help you?	7
9	Is a doctor who specializes in diabetes need?	6 Endocrinology
10	Is counselling needed to help cope with bad news?	4
11	Are chiropractor services needed?	Not an inpatient service
12	Are oncology services needed?	5
13	Are orthopaedic services needed?	9
14	Are Geriatric services needed?	9

Shared services and function shared between the GAH and the community clinic

There are many health care services that the two facilities will provide in common. First, the facilities will provide essential health care services, such as outpatient services and in-patient services. These services are provided to all ages, regardless of social classes. Besides, the two facilities provide laboratory services such as x-ray, radiotherapy, and blood test, among other laboratory services (Burns & Muller, 2018).

Organizational relationship between structure blocks

The GAH will have a hierarchical organizational structure with different level of management. Each level within the organization will have a health professional who is mandated to assume their roles with professionalism to increase the standards of health care services offered to patients (Bieberstein, Bose, Walker & Lynch, 2015). As such, the top management will engage in strategic planning and creation of policies that will improve efficiency in the facility. Besides, there will be a division of tasks to help in the smooth running of activities at different levels within the facility. For instance, doctors, clinicians, and nurses will have distinct roles to promote efficiency and services delivery.

Furthermore, the GAH will have a chart to clearly outline the organizational structure and roles of healthcare professionals to provide a road map for smooth running of activities (Burgess, Shaw & Kellas, 2011). The chart will also display horizontal linkages between health professionals between different levels in the organization to facilitate smooth coordination. On the other hand, delegation and execution of duties within the facility will be based on the ability to offer quality health care services to patients. However, a chain of command will have to prevail to ensure that all health care professional adhere to internal controls.

Integration of services of physicians within the GAH

Since the facility will mainly provide health care services to the aging population, it is necessary to integrate functions of physicians to help in providing quality services to the aging population to improve quality of life in the city. Integration of services will help to offer health care service to many patients within a short period.

Management aspects

Generally, the management aspect plays an essential role in enhancing the smooth flow of activities. Similarly, to help the GAH to achieve its goals and objectives, there is a need to borrow the ideas of management aspect to help running activities within the facilities (Burgess et al. 2011). As such, management theories will be adopted to create a clear channel on how to run the activities of the hospital. In doing so, specialization and division of labor will be encouraged to ensure health care professionals are assigned duties in their areas of expertise to improve efficiency.

Organizational forms

The GAH will have a conventional hierarchy organizational form. In this form, the division of labor and specialization will be encouraged to improve the quality health care services offered to patients (Burgess et al. 2011). The facility will comprise of the top management, which includes the Chief Executive Officer, Chief Administrative Officer, Human Resources Managers, and medical officers, among other health care professionals. In this organizational form, there will be specialization and division of labor amongst doctors, nurses, clinicians, and laboratory technicians.

The mission statement of the GAH

Typically, a mission statement plays an essential role in an organization by establishing objectives of an institution and how to achieve. Similarly, the Golden Age Hospital has a clear mission statement that will help it to achieve its goals. Since that facility seeks at solving a health problem in the city, it will concentrate on meeting the needs of the locals to improve the quality of life in the city. Below is the primary mission statement of the GAH:

i. To meet all health care needs of the aging population by offering special considerations to treat diseases affecting the elderly.

ii. To enhance the mental health of vulnerable people by creating easy access to health care services to all groups of people.

iii. To provide access to all medical services by all patients regardless of social classes and level of income.

iv. Reinforce health care projects and programs to help in help in empowering activities that aim at improving the quality of health care within the municipality.

Recommended hospital size

Currently, the rate of health care needs for the aging population is rising steadily. As such, the facility should be sized to accommodate all patients who will be visiting the facility to seek medical services. Therefore, the GAH should have a minimum number of 550 beds to accommodate many patients at once.

The organizational structure of Mission Hospital

Proposed Organizational structure of the Golden Age Hospital

The Golden Age Hospital will have the same organizational structure because it will be mainly constructed to provide supplementary services to the Mission hospital.

Main services to offer at the Golden Age Hospital

According to the finding from the survey, the aging population is affected most with health care conditions, that differ from those of any other age group. Specifically, heart, lungs, neurology, joints and even cancer reside at a higher risk percentage for our target market. Considering the needs of our patients, GAH has decided to offer services such as knee replacements, sleep studies, cardiology services to include heart surgery, hip replacements, Physical Therapy, and Appendectomies. The selection of these services to offer came as a conclusion of the demands of our local area. During the second phase of development, GAH wanted to ensure we selected services that could maximize the use of the facility for our patients. Additionally, the facility will allocate a small portion to also offer out-patient services to patients, for the small percentage possessing uncommon needs, based off the geographical location.

Physician-hospital integration

Various activities will be performed in the facilities to provide quality health care services to patients. In doing so, some health care program will be installed to help in providing quality services. However, such services programs must conform to professional requirements to ensure that the quality of health care services offered to patients meets the minimum health standards (Burgess et al. 2011). The facility will set health targets to achieve through establishing social and health care frameworks to help in the provision of standard health services. Even though the facility aims at improving the quality of health care services, the cost of offering those services will be affordable to all classes of people to encourage more patient to access quality health services regardless of the income levels.

For GAH to achieve this, the management will incorporate all functions of the facility to reduce operation cost to charge a reasonable price for their services.

Conclusively, the GAH should appropriately work on its mission, objectives, and goals to ensure it provides quality health care services to patient particularly the aging population who are more in need to health services in the city. Doing so will help to improve the quality of life amongst different groups in the city.

Finance and Budgeting

The construction of the Golden Age Hospital will require a reasonable amount of money to ensure that the facility constructed meet the standards stipulated in the layout. For instance, to build a 550-bed capacity organization, the management of the facility should have a budget of close to $ 800 million. The amount will be used to construct primary supporting that will help to provide quality health care services to the targeted groups (Young, & Kroth, 2018). The amount will also be enough to purchase all medical equipment that will be used to offer need-specific services to the aging population. As such, it is appropriate for the sponsor of the project to avail all financial requirements needed to finish the construction project.

Even though the state will procure most of the health care equipment, legal procurement procedures should be followed. Doing so will help to ensure that all equipment purchased are of standard and are capable of offering quality health care services to the targeted group. As such, since the state is making all purchases on its own, people assigned to budget and procure that equipment should know to ensure they purchase useful items (Young, & Kroth, 2018). Purchasing of the right equipment will help to provide quality health care services to patients. Also, while making procurement activities, technological concepts should be considered to ensure that procured equipment does not become obsolete quickly with changes and advancement in technology.

Since most of the clients who will be served within the facility will be 65 years of age and above, Federal Medicare health insurance will provide majority of the financial resources needed for these patients. Intuitively, there is a need to know how Medicare health coverage will be handled to ensure that all patients have access all health care services. Also, the Golden Age Hospital should have competent financial professionals to manage funds properly, based off previous organizational structures established.

Furthermore, the amounts will be considerate and enough to run all operations of the facility's activities. The facility will maintain this by ensuring that all governments' contributions are disbursed in time, and all payments from individual patients are collected in time. Moreover, the management of the GAH should make reasonable financial projections to ensuring operating costs do not exceed the total income that will result in losses.

Medicare Prospective Payment System

The process in which the facility will be reimbursed by the government, will be done based on the predefined amounts and not according to the cost incurred when treating a patient, a process also known as Prospective Payment System. This process has been around since October of 1983, when it was first introduced to the Federal Government. It came about as a way to stop healthcare facilities from doing things, solely for financial gain. This process is to drive providers to deliver efficient care without overusing the services. Through this means of reimbursement, an amount will be set based off service, and even duration of stay(when applicable), and that is the amount the GAH will see for delivered service. In doing so, the government should ensure that reimbursement is done in time to facilitate the smooth running of all the facility's operations (Bieberstein, Bose, Walker & Lynch, 2015). Also, this will help to avail enough financial resources for the facility to enable it to run its activities well.

The reimbursement amounts made by the government should be enough to enable the facility to offer quality services, while maintaining the mission of the process. Consequently, this will generate enough financial resources that will allow the facility to make some expansion to increase services delivery (Burgess, Shaw & Kellas, 2011). Based off the financial analysis of services provided, an estimated $18 million would be generated as income for the organization. This is a very efficient amount, given this will be the third branch of the hospital. Another security element to add is that it is from Medicare. The disbursement of all government's financial supports and incentives should be made at the beginning of every year. The latter will allow for proper planning and allocation of resources to all departments to facilitate for running all organization's activities to ensure the smooth running of operations.

The General Age Hospital Project

A To be filled by the student	B To be filled by the student	C Filled by Instructor	D To be filled by the student	E Filled by Instructor	F To be filled by the student
Service / Treatment	Estimated Medicare reimbursement to GAH. (each 10 to 60 thousands of dollars)	Projected number of procedures/treatments performed annually	Total income B*C	GAH projected performance relative to federal standards	GAH projected annual gain (or loss). D – D*E
Treatment ABC	$10,000	75	$750,000	80%	$150,000 (do not add this line to total)
Knee replacement	$50,000	200	$10,000,000	80%	$2,000,000
Physical Therapy	$17,000	150	$2,550,000	90%	$255,000
Heart surgery	$60,000	50	$3,000,000	120%	-$600,000
Sleep Study	$11,000	100	$1,100,000	100%	$0
Appendectomy	$21,000	60	$1,260,000	75%	$315,000
Hip Replacement	$49,000	75	$3,675,000	85%	$551,250
Miscellaneous expenses	$10,000	25	$250,000	%250	-$375, 000 (minus)
Total			$18,910,000		$346,250

Interpretation

The net loss illustrates that the hospital is likely to incur more profit than expenses in the first year of operation. It is projected that GAH will generate $18 million in revenue from the services provided. Additionally, financial analyses also show that the hospital should expect a gain of $346,250. This is not as profitable as GAH would like to see. As such, there is a need to implement suitable measures to sustain current expenses or minimize future expenses for the facility (Burns & Muller, 2018). This will ensure continued growth and increased profit, in the years to come. For example, the organization must strive to ensure that the “performance relative to federal standards” is at a percentage in which, the services are profitable. When that percentage is too high or extremely close to 100%, there is no chance in seeing a profitable gain. Currently, with the levels staying where they are, a profitable mission would be a challenging one.

Conclusion

Conclusively, the results obtained from the calculations show that the Golden Age Hospital will incur a minimal profit from the services offered, due to the percentage of performance relative to federal standards, being too close to 100% or over. The main reason why the facility is likely to cause financial damages is due to the unforeseen circumstances that can’t be controlled, only corrected. Therefore, the management of the GAH, project committee, and stakeholders should identify appropriate measures, ones in which would make all services profitable. Putting appropriate measures in place will ensure that the Golden Age Hospital has enough financial resources to run its activities and still make profit.

Recommendations

According to the above results, the GAH is likely to make minor losses in the first year of operation. Therefore, it is appropriate for the management, and the stakeholders of the project to consider the following recommendations to minimize or avoid making massive losses in the futures:

i. Increase the charges of services that require more resources and advanced technology to offer. For instance, the management needs to increase costs on surgical services such as cardiology, which require more attention and resources to provide to patients. In doing so, the facility will be able to generate enough financial resources that will be enough to run all its operations as well as making reasonable profits.

ii. The management of the Golden Age Hospital should set a limit on the number of services offered to specialized services to reduce expenses. This will ensure the facility maintain foresight and balance of the services provided and demands of the community.

iii. The facility should apply for enough government support and incentives to help to generate income that will enable it to offer quality health care services to all patients. Besides, using for government incentives and support will help the Golden Age Hospital to provide all health care services need by patients.

iv. Lastly, the Golden Age Hospital should reduce its annual miscellaneous expenses. The latter will help in reducing the total costs for the facility and thus, will help in enabling the Golden Age Hospital to offer quality services to its clients. An audit shall be performed annually, to possibly reduce this expense in the future.

References

Bieberstein, N., Bose, S., Walker, L., & Lynch, A. (2015). Impact of service-oriented architecture on enterprise systems, organizational structures, and individuals. IBM systems journal, 44(4), 691-708.

Burgess, C., Shaw, C. & Kellas, J. (2011). Health & social care. Harlow: Heinemann.

Burns, L. R., & Muller, R. W. (2018). Hospital‐Physician Collaboration: Landscape of Economic Integration and Impact on Clinical Integration. Milbank Quarterly, 86(3), 375-434.

Collins, A., Connor, J. A., Mott, S., & Hickey, P. (January 01, 2015). Using Data to Drive Improvement and Build the Science of Nursing.

Havers, R., & Evans, R. (2010). The golden age of rock 'n' roll. New York, N.Y: Chartwell Books.

Rogers, N. (2014). Polio wars: Sister Elizabeth Kenny and the golden age of American Medicine. Oxford: Oxford University Press.

Stoichiţă, V. I. (2012). Visionary experience in the golden age of Spanish art. London: Reaktion Books.

Young, K. M., & Kroth, P. J. (2018). Sultz & Young's health care USA: Understanding its organization and delivery.

CEO

Human Resources Manager

Chief Medical Officer

Chief Administrative Officer

Lab technicians

Clinicians

Nurses

Chief Executive Officer

Human Resources Manager

Chief Medical Officer

Chief Administrative Officer

Lab technicians

Clinicians

Nurses