Ethical and Policy Challenges Affecting Nursing Home Care Coordination

This report delves into the complex ethical and policy issues that significantly impact the coordination of care within nursing homes. It begins by establishing the importance of nursing homes as critical healthcare environments requiring diligent attention and evidence-based practices. The report then explores the relationship between governmental policies, such as Medicare and Medicaid, and their effects on the health and safety of nursing home residents, highlighting how these policies can influence the social determinants of health. It examines ethical questions raised by these policies, including insurance coverage and access to care, particularly for uninsured individuals. The report further analyzes the implications of these policies, the impact of the code of ethics for nurses, and the factors contributing to health disparities and access to services. Key ethical and policy issues, such as professional autonomy, involvement boundaries, and scholarly communication strategies for patient-centered care are also discussed, providing a comprehensive overview of the challenges and considerations in nursing home care.

Ethical and policy issues
that affect the
coordination of care for
nursing homes Name
Date
Course number

Introduction
 Nursing homes are critical health partitioning
intexts tat require adequate attention, knowledge
and evidence based practices to meet the
expectation of the government policies and
promote safe community in coordination of care.
 Continuum of care in nursing homes is usually from
the independent living t he skilled care in nursing.
The services that are progressively offered by the
concerned health body and practitioner teams allow
the residents in a nursing home to get whatever
level of care they would want to get and whenever
they need.

How governmental policies relate to
health and/or safety of the nursing
homes affect coordination of care
 According to National Center for Health Statistics
(US.2016) coordination of care is practice program that
aim at supporting implementation of the government's
policies.
 The government policies may impact the health of
citizens positively or negatively (Artigas & Hinton,
2018), this could be through influence of the social
determinants of health. Changes in social policy like
education, housing and even security may cause a
shift in pubic health specialty.

Examples of policies affecting
nursing homes
 Medicare-insurance programs that covers health
acre for he elderly and those with end stage renal
disease.
 Medicaid- Public insurance programs covering
health care for the poor.
 Nursing home reform act
 Health insurance portability and Accountability Act

National and state policy provision that
raise ethical questions for care coordination
 The affordable care act care- the Obama care had a lot
of issues regrading the insurance cover. Millions of
people were not able to renew their existing , non
fictional and non conforming insurance policies (Arnold
& Boggs, 2019)
 Uninsured residents have no easy access to the private
offices of the physicians. They seek care from the safety
net providers because they are uninsured
 The policies provides that there should be insurance
policy for the elderly unfortunately there are elderly
people who are still not insured and suffer relentlessly in
the nursing homes.

Implications of the policies
 Medicare has helped a great deal in providing the necessary
attention that the disabled and those with end stage renal
disease. It has positively contributed to the well being of the
beneficiaries.
 Medicaid has helped in taking care of the elderly especially
those who are beyond a productive age.
 However, it is also unfortunate that those without insurance
policy have no option when they are denied access to the
private physicians (Holroyd-Leduc et al., 2016)

Evidence to support the conclusions
 According to National Center for Health Statistics
(2016), there has been a significant increase and
improvement of health among the elderly and the
disabled now that they have no ability to support
themselves. There is recordable improvement in the
sector of health. However, Artigas and Hinton
(2018) observes that uninsured residents in the
nursing homes have relatively poor access to health
and this a gap is created in health coverage in
heath care and lifestyles tat are unhealthy.

Impact of code of ethics for nurses
on the coordination and continuum
 Code of ethics enhances professionality among nurses
in the nursing homes.
 Professionalism means that nurses re able to treat
patients in the nursing home with absolute dignity,
keep their information confidential and walk with them
throughout the journey of illnesses.
 Code of ethics has enhanced proper values, beliefs
and practices among the nurses so that the nurses
provide comprehensive and holistic care that
promotes health care in nursing homes.

Factors that contribute to health,
health disparities, and access to
services
According to Arnold and Boggs, the following factors are likely to
contribute to health disparities and access to health care
 Development of disease or an illness
 Ability to get ad utilize healthcare
 Health and healthcare outcomes
Social determinants
 Education status
 Race and ethnicity
 Insurance status
 Poverty

Key ethical and policy issues
affecting the coordination and
continuum of care Professional autonomy and loyalty: the given loyalty to whom
and what. Decision overruling, obligation and trust to report in
nursing home set up (Holroyd-Leduc et al., 2016)
 The involvement boundaries: private and professional provision
of health care, the care nurse and the accessibility of the nursing
home and physicians (Holroyd-Leduc et al., 2016)
 Holroyd-Leduc et al. (2016) observes that nursing homes are
sometime faced with a lot of challenges that some of the policies
applicable to healthcare don’t get to the ground. They add tat
sometimes, the health professionals choose to go against the
code of ethics at the expense of the ailing individuals.

Scholarly communication strategies
to lead patient-centered care
 According to Blackstone, Beukelman and Yorkston,
2015), of the essential communication strategies that
are required for patient-centered care is electing the
agenda of the patient having open ended questions,
particularly early on and taking care not to interrupt
the patient and constantly engaging in a focused active
listening.
 It also includes understanding the perspectives of the
patient especially those that entails exploration of the
ideas, feelings, concerns, feelings and experiences
regarding the effect of illnesses.

References
National Center for Health Statistics (US. (2016). Health, United States,
2015: with special feature on racial and ethnic health disparities.
Artigas, S., & Hinton, E. (2018). Beyond health care: the role of social
determinants in promoting health and health equity. Health, 20, 1-10.
Arnold, E. C., & Boggs, K. U. (2019). Interpersonal Relationships E-Book:
Professional Communication Skills for Nurses. Elsevier Health
Sciences.
Holroyd-Leduc, J., Resin, J., Ashley, L., Barwich, D., Elliott, J., Huras, P., ... &
Pullman, D. (2016). Giving voice to older adults living with frailty and
their family caregivers: engagement of older adults living with frailty
in research, health care decision making, and in health
policy. Research Involvement and Engagement, 2(1), 23.

Cont’
Blackstone, S. W., Beukelman, D. R., & Yorkston, K. M.
(2015). Patient-provider communication: Roles
for speech-language pathologists and other
health care professionals. Plural Publishing.