A handful of studies have used industrial engineering methods to determine if Medicare or aged patients receive a differential amount of nursing when compared to non-Medicare patients, for example, Jacobs ; Thompson, et al. An identical hospital located in a low wage area was paid Hospital expansion analysis expansion of units for patients needing more intensive care should reduce the demand for nursing care in routine care units.
Historically, CMS has attempted to offset the financial losses of treating uninsured individuals, such as reimbursing hospitals that treat a greater portion of Medicaid and uninsured individuals Disproportionate Share Hospital DSH payments.
The relevant hypothesis is a test of the nursing resource consumption by age, over all patients, and without regard to DRG and length of stay. The economic rationale behind the MRND payment was, basically, that aged patients were believed to require more nursing care, even for the routine activities, and that nursing salary payments should be assessed according to the nursing resources consumed by the Medicare beneficiary.
This study tests this hypothesis while attempting to hold constant the influences of other factors such as local area wages, hospital size, occupancy rate, type of control, and geographic region. Models are designed to explain a significant amount of the variation in RNS. The reimbursement model specified here searches for the existence of a Medicare routine nursing differential in the context of the Section routine cost limits.
Prologue The Medicare routine nursing salary cost differential MRND was born out of the elimination of the Medicare 2-percent bonus and out of a study of 55 hospitals showing that patients 65 years of age and over appeared to use more nursing care than younger patients. Census data, and data from Health Resources Statistics, Other non-Medicare payers also had good reason to reduce their payment for nursing salary costs.
This study presents the most comprehensive tests so far: One may hypothesize that patients belonging to the excluded age category——generally come to the hospital with more serious ailments demanding closer attention by the nursing staff.
Under this assumption, if no MRND were paid and the quality of care and technical efficiency remained the same, total hospital nursing salary costs probably would not have changed. Further, during the time the MRND had been paid, more and more hospitals began or expanded special care units, where the more seriously ill patients may be treated.
In the other direction, older patients have longer lengths of stay and the last stages of recovery may require nursing services well below those of an average patient. This was to the extent that accounting systems could determine the appropriate Medicare beneficiary resource consumption.
In, and limits which restricted Medicare reimbursement of hospital routine costs per patient day were published in the Federal Register. Beforethe 8.A Statistical Analysis of the Medicare Hospital Routine Nursing Salary Cost Differential.
This expansion of units for patients needing more intensive care should reduce the demand for nursing care in routine care units. The per diem inpatient routine nursing salary costs (RNS) to which the differential applied included “gross salaries and.
State regulators are asking Boston Children’s Hospital to show that its planned $1 billion campus expansion won’t undercut their efforts to restrain growth in.
Case Study 1: The Case for Open Heart Surgery at Cabarrus Memorial Hospital- Chemplavil Brief Introduction: Cabarrus Memorial Hospital (CMH) is a large, public hospital located in North Carolina, that prides itself in cultivating a never wavering commitment to its community.
Having first opened in.
Sacramento Region Health Care Partnership SWOT Analysis The following Strength, Weaknesses, Opportunities and Threats (SWOT) analysis has Expansion in newly insured under ACA Threats hospital and clinic collaboratives).
Using the case study Shouldice Hospital Limited (by James Heskett, Harvard Business School case, no. ) please help with these questions: 1. Of these alternatives, which one (if any) do you recommend and why?
What are. Hospital expansion is an opportunity to serve community healthcare needs, offer expanded services and improve your hospital’s bottom line.