Please review the draft for grammar, transitioning, corrections and addressing the goals. I'm stuck on explaining my ideas on how it relates to finance and ?financial leadership assessment. This is course basic healthcare finance. This is what I need to address for the assignment.?
Assuming the role of a director at an adult day center ?prepare a financial leadership assessment addressing key concepts and principles essential to effective financial practices and operations of a healthcare entity. Examine how financial health would be managed including: a) financial challenges you would expect to face,
b) how you would monitor and address these challenges,
c) key financial information you would want access to, and
d) how you would manage the financial health of the organization.?
e) describe and explain how 3rd party Payer requirements and reimbursements and Medicare and Medicaid standards for managed care;
f) and include a plan for auditing practices to ensure regulatory compliance.
Paper should be minimum of five pages in length and use APA.
According to Guthrie and Koster (2016) healthcare is going through a transformation
stage. Impacted are not just providers, clients or patients and insurance company. There are more
stakeholders including internal and external stakeholders. As a new administrator to an adult day
center, I will discuss about the adult day care business, the financial challenges, how to monitor
changes and address the financial health of the organization.
Adult day care is used to relieve the caregiver?s duties for the day while ensuring that the
care recipient will still receive the proper care in a safe, friendly environment. These centers
usually operate during normal business hours, five days a week. Some centers also offer
additional services during evenings and weekends. There are more than 4,600 adult day services
centers across the U.S. ? a 35% increase since 2002. (Metlife Study, 2010).
The internal stakeholders are the Board of Directors, director, staffs and eligible
participants. In Minnesota, in order to be a director in adult day center: have two years in health
or social services or be a licensed practical nurse and or four years of volunteer service with
supervision and administration. All staff that works in the adult day center must go through a
detail orientation including: background checks, vulnerable adults, abuse prevention, safety
procedures and more. It?s highly recommended to contract a nurse once or twice week to come
check on participant?s vitals and health maintenance. Along with a lawyer for legal consultations.
The external stakeholders are: payers such as Medicaid Home and Community-based
Waiver Services (HCBS) waivers (Minnesota Department of Human Services, 2016) and private
pay participants, legislatures that creates a yearly budgets for the home and community based
services, Minnesota Department of Human which takes care of licensures of adult day centers,
individual counties which provides the nurse assessments, adult protection, medical providers,
social workers and therapist who can advocate and write support letters, families, and vendors
who may supply the adult day with food, cleaning supplies and additional equipment?s. All these stakeholders are important for the adult day director and staff to collaborate and
maintain a good business connections. That way if the adult day run into issues, these external
stakeholder can be of resources to them. According to the Melife (2010) report the financial
challenge for adult day center is funding and financial concerns. It is covered through federal
Medicaid governed by the Department of Health and Human Services and part by individual
state Medicaid program. Adult day services are covered through waiver programs and or private
pay also. The financial concerns are adult day center are just breaking even with their operating
cost and trying to maintain their current participants. There are more adult day center opening
competing for more services and activities. Thus, participants will leave their current day center
to another one due to other benefits such as garden plots or prizes for their participants.
People who are still on a waiting list to get on to waiver services sometimes struggle to
understand how waiver services works and how to obtain the services. For the low income
population and people with disabilities, this is how reimbursements of Medicaid will work. In
order for participants to access adult day programs. Family, participant or service providers can
make a county referral over the phone. Once an intake has been completed, the county has thirty
days to come out and complete a personal care assistant and or waiver assessment. Though the
time line is thirty days, certain metropolitan counties are back logged. In Ramsey County, there
is a waiting list of over 700 people. There is not enough slots available for the amount of people
applying for waiver services, and not enough nurse assessors. Once the nurse assessor meets with
the participant to assess the needs of the individual. Even after the assessments are completed,
some participants may not be eligible since the participants are not at the nursing level of care.
There are some ways to monitor and address these financial changes. I would
management the adult day service in a team management style, which Singh?s states ?that leader rate high on both person orientation and task orientation.? Workers are important in assuring that
the task gets completed and residents are person-centered. I would be the manager that walks
around talking to staffs and participants. Similar to my supervisor whom uses the team approach
and walks around. I feel that it motivates me doing the best that I can. Our manger makes sure
our team and other staffs knows that she is there for us. Whether to listen to member?s current
case, or health concern, help with consultations and her door is open throughout the day.
I don?t think my team management style would change regardless of which environment I
end up. By gathering as much information as I can, I can prevent future problems rising to bigger
issues. Listening to staff and residents I can get a better feel of what happens outside of meetings
with management and how the morale is in the work place. By taking time to listen to few direct
internal stakeholders, I can understand people better; know who they are, what they do, and the
issues they face and listen to their ideas of improvements. Then reflect on what I have learn and
try to improve the system. The times that I may need to step out of my role would be when there
is an audit from a regulatory agency or an outbreak that occurred onsite.
There are benefits by using the team management style. It can strengthen relationship and
create an environment of trust. It will increase my knowledge of the department and area of
responsibility. Also, it will enhance the level of quality of communication between staff and
As the director, I would have to review centers? last fiscal data to review financial
statements and monitor revenue, expenses and net income. Complete an analysis of cost to run
the center per participant per day such as: total cost per participant day, direct labor,
transportation, payment methods, and food. Then check where the break-even point. By finding
out the unit cost per day, I can see how I can decrease other cost, and increase revenue.
Another area to review is our current programs and see if it?s possible to add new
programs or additional services to enhance the adult day environment. To increase more revenue,
research into further funding in Medicare and other grants. According to Medicare (Medicare, 2016) Programs of All-Inclusive Care for the Elderly (PACE) provides financial coverage for adult day for
participants who qualify. Also, local backing from the Older Americans Act and the Social Services Block
grants. Another alternative funding to look into for people who cannot get on a waiver are sliding
fee scale based on the income of the participant. It?s for the participants that doesn?t quite qualify for the
Waiver services, and does not meet the financial services.
The auditing practices to ensure regulatory compliances for adult day services in the state of
Minnesota goes through the Minnesota Department of Health and Human Services. Per the state licensure
requirements (Minnesota Department of Health and Human Services, 2016) the facility, food, beverage
and lodging must be licensed, and staff must have completed training requirements. All participants must
have a care plan available with additional documentation of socialization, activities, nutrition service and
supervision to safety. For internal evaluations, I would complete annual evaluations, have participants and
family complete satisfaction surveys, and care plan audits with the staff. References:
Anderson, K. A., Dabelko-Schoeny, H., & Johnson, T. D. (2013). The state of adult day services:
Findings and implications from the MetLife National Study of Adult Day Services.
Journal of Applied Gerontology, 32(6), 729-748. doi:10.1177/0733464812447284
Baker, J. J., & Baker, R.W. (2014). Health Care Finance: Basic Tools for Nonfinancial
Managers, 4th Edition, Sudbury, MA: Jones & Barlett Publishers.
Brown, Bobbi. (2016) Top7 Financial Healthcare Trends and Challenges for 2016. Health
Catalyst. Retrieved from
https://www.healthcatalyst.com/7-Financial-Healthcare-Trends-Challenges-2016 Hilsenrath, P., Eakin, C., & Fischer, K. (2015). Price-Transparency and Cost Accounting:
Challenges for Health Care Organizations in the Consumer-Driven Era. Inquiry
(00469580), 521-5. doi:10.1177/0046958015574981llenges-2016
Centers for Medicare and Medicaid Services. (2008). Quick facts about programs of all-inclusive
care for the elderly (PACE) (CMS Publication No. 11341). Retrieved
Mosquera, Mary, (2014). 5 challenges facing health systems. Healthcare Finance. Retrieved from
Singh, Douglas (2014) Effective Management of Long Term Care Facilities. Sudbury, MA: Jones
Guthrie, M., & Koster, J. (2016). A NEW ECOLOGY IN HEALTH CARE. Physician Leadership
Journal, 3(5), 12-16. Minnesota Department of Human Services. (2016).
Retrieved from https://mn.gov/dhs/people-we-serve/people-with-disabilities/services/homecommunity/programs-and-services/hcbs-waivers.jsp
U.S. Department of Health and Human Services (Office of Disability, Aging and Long-Term
Care Policy). (2006). Adult day services: A key community service for older
adults. Washington, DC: Author. Retrieved
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