Ethical and Policy Factors in Care Coordination

Ethical and Policy Factors in Care Coordination

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Ethical and Policy Factors in Care Coordination

Nursing homes do very vital roles, particularly in the way they give accommodation together with health services for those who are not able to get homebased care and do not have to move to a hospital. A nursing home in some scenarios tend to pay considerable attention to caring for particular conditions, such as physical or learning disabilities. Nonetheless, service providers in the nursing homes need to adhere to existing ethical and policy structures that guide health care delivery in nearly all aspects and levels (Pratt et al., 2017). Being conversant with the relevant ethical and policy directives presents an opportunity to act in a way that impacts positively on those receiving care and attention.

Government policies affect the coordination of care in health facilities significantly. Such policies determine how the caregivers attend to their clients with the primary objective being to give the best and most effective care (Maddox et al., 2019). The government policies exist to ensure that the nursing home does not violate any of the patient’s rights, and that caregivers do only what is good for their clients’ well-being (Maddox et al., 2019). All facilities need to adhere to government policies because other than ensuring that patients receive the best attention, such adherence helps to avoid legal confrontations that could affect smooth flow of operations at the facility.

Nursing homes while conducting their operations need to about by existing governmental policies that determine how such facilities and employees in such firms ought to conduct their operations. For instance, such institutions need to abide by the terms of Medicaid that offers health coverage to many Americans, encompassing eligible elderly people, pregnant women, low-income adults, and minors (Birk, 2016). Operators in nursing homes, therefore, must offer services those who enjoy this form of health cover without discrimination whatsoever. Another policy that impacts on the operation of nursing homes is the Healthcare Quality Improvement Act (HCQIA) of 1986 that urge health facility to identify whether certain factors could impede caregivers against providing appropriate care (Birk, 2016). Consequently, operators in nursing homes should take time to understand the requirements of the various policies that impact their operations.

Nonetheless, health workers in nursing homes are obliged to adhere to other existing policies that determine health practices across the country. For instance, the facility must follow the directives of the Hospital Readmissions Reduction Program (HRRP), which is a value-based buying plan that urges health facilities to advance communication and coordination of care to adequately incorporate clients and health workers in discharge initiatives, and consequently minimize preventable readmissions (Birk, 2016). Also important is to abide by the provisions of Medicare, which is destined to offer health cover to the elderly, often people who are 65 years and older (Birk, 2016). A fundamental fact is that such adherence makes it possible to offer the needed intervention. More fundamentally, practitioners in nursing homes must abide by the requirements of HIPAA of 1996, which pursues to offer direction in four key areas. One of the areas that HIPAA covers is the need to safeguard the confidentiality of public health information, while ensuring that patient personal data is not put into inappropriate use (Cohen & Mello, 2018). The requirement is similar to HIPAA’s next directive, which is to offer needed protection for electronic records. In addition, HIPAA urges health facilities to embrace administrative functions that facilitate care delivery (Cohen & Mello, 2018). Also important is that HIPAA directs caregivers to consider any form of health cover that clients present (Cohen & Mello, 2018). All these regulations are essential and nursing homes have no alternative but to follow the specific provisions. Consequently, it is imperative to find time to familiarize with such provisions to ensure that individual practitioners and the firm as a whole act in the most appropriate manner that is not likely to generate controversy.

Various policy requirements exist at various levels that cause moral anxieties or problems of care coordination. HIPAA is an example of a policy that has ethical effect, because it urges caregivers to avoid all forms of inappropriate use of patient data terming this unethical (Cohen & Mello, 2018). Consequently and based on this regulation, health workers have an obligation to ensure that they access and use patient personal information only when it is necessary, and that the retrieval process happens with the client’s consent, unless when directed by law (Cohen & Mello, 2018). The other policy that generates ethical concern is the Death with Dignity Act of 1994 that permit physicians to help terminal patients who may not recover from their condition to facilitate the dying process (Maddox et al., 2019). The regulation has continued to generate much ethical concerns with various parties calling for increased clarification on the policy to avoid ethical violations.

The primary implication of the policy provisions is that they help to ensure that a nursing home or any other health facility for that matter conduct their activities in accordance with existing structures. The policies guide individual practitioners to do what is right and acceptable and to boldly castigate what is inappropriate and likely to harm patient outcomes. For example, adhering to HIPAA provides an opportunity to respect patient privacy, which is vital when handling patients (Cohen & Mello, 2018). The patient is likely to become more committed to the health care process and the entire mitigation process when they feel that the interveners care for their well-being. Thus, the existing policies have significant impact on health facilities and individual service providers.

Evidence exists to show that the existing policies impact significantly on how individual practitioners and the entire firm respond to their duties. For example, various patients have initiated litigations against certain health facilities for violating their privacy rights as provided for in HIPAA (Cohen & Mello, 2018). Such facilities are liable for the violation, which suggest that service providers are bound to abide by existing policies. Therefore, it is imperative to acknowledge that those groups and individual health workers who do not follow existing policies and confine their operations in light of these provisions are likely to experience disruptions or opposition that could possible affect their performance in one way or the other.

The code of ethics for nurses play fundamental roles in facilitating coordination and continuum of care. The code urge nurses to do what is right and to handle their operations in a way that is not likely to generate controversy (Breen et al., 2008). Moreover, the code of ethics serves as a reminder to nurses that they have an obligation to their patients to ensure that they do what is right to improve the well-being of those receiving care (Breen et al., 2008). More fundamentally, the code of ethics helps to achieve patient satisfaction, which significantly determines coordination and continuum of care.

Various social factors regulate how people reach health care, some of which are stated in Healthy People 2020. Some of the factors that result in health disparities encompass poor quality of care, poverty or financial instability, improper environmental conditions, restricted personal aid that makes it difficult to access the needed support. Healthy People 2020 identifies some of the social determinants of health that influence how people access health care and attention. The determinant according to Healthy People 2020 fall into four factors – environmental, economic, social, and personal. Lack of financial stability is an example of an economic factor that Healthy People 2020 identifies as determining how people reach health care services (U.S. Department of Health and Human Services, 2014). In terms of environmental factors, lack of health facilities or absence of competent health practitioners are some of the issues that determine how a person or community access health care.


The study describes the various factors that could impact the operations of a nursing home. The paper pays considerable attention on the need for nursing homes to abide by ethical and policy frameworks that guide the operations of health workers. It emerges that individual practitioners and the organization in its entirety have an obligation to adhere to existing structures to avoid confrontations or dissatisfaction. Otherwise, health facilities that choose to defy existing structures may encounter substantial opposition and it is likely that patients will not achieve satisfaction. Thus, service providers in nursing homes should take time and familiarize with existing regulations to avoid inappropriate eventualities.


Birk, H. (2016). United States national healthcare policies 2015: An analysis with implications for the future of medicine. Cureus, 8(1), doi:10.7759/cureus.451

Cohen, G., & Mello, M. (2018). HIPAA and protecting health information in the 21st century. JAMA, 320(3), 231-232. doi:10.1001/jama.2018.5630

Breen, G., Loyal, M., Littleton, V., Seblega, B., & Paek, S. (2008). An ethical analysis of contemporary healthcare practices and issues. Online Journal of Health Ethics, 5(2),

Maddox, K., Bauchner, H., & Fontanarosa, P. (2019). US health policy—2020 and beyond. JAMA, 321(17), 1670-1672. doi:10.1001/jama.2019.3451

Pratt, B., Paul, A., Hyder, A., & Ali, J. (2017). Ethics of health policy and systems research: A scoping review of the literature. Health Policy and Planning, 32(6), 890-910.

U.S. Department of Health and Human Services. (2014). Healthy People 2030. Retrieved from

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