Hospitals and Long-Term Facilities

Hospitals can be defined as a facility that sick or injured persons are given medical treatment. Whereas long-term facilities provide rehabilitative, restorative, or continuous care to persons whom need help with day-to-day activities. Throughout this paper, the difference between non-profit and for-profit hospital will be described, as well as three major trends that have occurred within the hospital sector. Three examples that describe and differentiate the roles of hospitals and nursing homes in providing long-term care will also be evaluated.

In addition, the current state of long-term care policy in the United States will be critiqued. Describe the differences between nonprofit and for profit hospitals. Most nonprofit hospitals were developed for charity and usually through religious orders. However, with a dramatic rise in health care costs since the 1980s, hospitals have increasingly converted to for-profit enterprises (Layne). During the 1980s, the increased health care costs were due to inflation, and new technologies threatening the survival of nonprofit hospitals.

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Their soul mission was providing health care without regard to a patient’s ability to pay. Employers and government, which bear most of the expense for health care in the U. S. , pressured medical providers to decrease costs. Hospitals shorten stays, emphasize outpatient services, and become more efficient by collaborating with other health services to provide care (Layne). Nonprofit hospitals accept everyone; they do not refuse treatment and offer many community-based health programs. For-profit hospitals represent a corporate model of health care, which seeks profit first.

For-profit hospitals enjoy higher capital, which in return allows them to purchase the latest medical technologies and create state-of-the-art facilities. For-profit health care providers claim they are able to provide better care at lower cost due to their focus on efficiency. However, critics say for-profit hospitals are successful because they tend serve affluent, insured patients and focus on highly lucrative specialties such as cardiology and elective surgery; they avoid typically unprofitable areas such as emergency care, which often is used by poor patients for their basic health needs (Layne).

Further, for-profit hospitals’ focus on efficiency has raised questions of whether cost-cutting impacts consumers’ health. Both nonprofit and for-profit hospitals provide similar services, each faces demands to cut health care costs. For-profit hospitals have a duty to investors in paying dividends and taking the company in an approved direction. Nonprofit hospitals seek to promote community health organizations such as free community health clinics and acute-care centers (Layne).

Since for-profit hospitals seek to maximize profits, first it is likely that these less than profitable community programs will not continue as for-profit hospitals continue to buy out nonprofits (Layne). Describe at least three major trends that have occurred within the hospital sector. Multiple trends have occurred within the hospital sectors. One major trend is large hospitals being more prevalent within the East due to the timely trend of building smaller rather than larger facilities. Over the past 25 years, a large number of small hospitals especially in the urban areas have closed because of financial and competitive pressures.

The lack of operating a small number of hospital beds also lead to the closing of facilities. Specifying the optimal side of a hospital is particularly difficult given the complexity of services offered on an inpatient basis (Williams, ; Torrens, 2008). Another major trend as reflected from the table in the textbook is the decrease in the number of hospital beds from 1. 5 million to fewer than 1 million since 1975. A combination of closures and reductions for operating licensed beds within the hospital still open was reflected in this trend.

Due to the size of large hospitals, there is a disproportionate share of knowing the total number of hospital beds. About 70 percent of the nation’s hospital beds are in nonprofit facilities (Williams, ; Torrens, 2008). By combining technological innovation and the financial pressures of payers, there has been an increase for medical care rendered at ambulatory facilities. As well as shortening the length of stay at hospitals for patients with similar diagnosis as other patients who have been admitted to the hospital.

The impact of these trends is to yield a much higher intensity or complexity of care for hospitalized patients (Williams, ; Torrens, 2008). Despite the shorter stays, closing of hospitals, and the reduction in the number of beds the occupancy rates are still declining. On a nightly average only two-thirds of the hospital beds are occupied. This trend is shown in every category of hospital ownership. Give three examples that describe and differentiate the roles of hospitals and nursing homes in providing long-term care.

Long-term care is defined as health, mental health, residential or social support provided to a person with functional disabilities on an informal or formal basis over an extended period of time with the goal of maximizing the person’s independence (Williams, ; Torrens, 2008). Hospitals provide care for patients with acute problems, emergencies, chronic disease, and long-term health problems. Psychiatric, rehabilitation, chronic disease and orthopedics are all examples of long-term care offered with a hospital setting. Normally the length of stay is 23 days or longer.

There are also out patient services offered by hospitals to treat long-term care such as rehabilitation, mental health counseling, and out patient surgery. The type of care offered by hospitals has developed over time from focusing on acute care to promoting health with disease management and health education programs. The average length of stay within a hospital is 4 to 5 days for adults under age 65 and 6 days for adults 65 and over. Most hospital admissions are due to heart problems; cancer, mental illness, stroke and respiratory conditions just to name a few.

Medicare and private insurance are the primary payer for hospital services, with individuals paying relatively little out-of-pocket (Williams, ; Torrens, 2008). Medicare, government health programs, and private insurers spend a large amount of their expense’s on hospital services. Extended inpatient care also referred to as “nursing facilities” or “nursing homes”, provides inpatient care for individuals who are sick or cant function alone to accomplish day to day activities that need to be within a health care facility.

The type of care that they need is ongoing and they do not need the constant care or technology as an individual in the hospital. Specialty facilities range from subacute units in hospitals to intermediate care facilities for the mentally retarded or developmentally disabled to psychiatric hospitals caring for the severely mentally ill on an indefinite basis (Williams, ; Torrens, 2008). Payments to nursing care facilities are made by Medicaid whom pays 47 percent and the residents or their families who pay about one-third.

Over the years the odds of being admitted into a nursing facility has increased while the length of stay has decreased. This action reflects a trend of nursing facilities becoming more advanced to operate as a temporally short-term facility of care rather than a permanent place of care. Joint Commission accredits both hospitals and nursing facilities and both have non-profit and for-profit facilities. Critique the current state of long-term care policy in the United States. The United Sates does not focus on just one set public policy for long-term care however there are multiple policies at the federal, state, and local levels.

The Social Security Act of 1935, Americans with Disabilities Act of 1990 and National Caregiver Support Act of 2000 are all examples of federal polices for long-term care. The four major thrusts of legislation are direct payment for services like Medicare, regulations like the Balanced Budget Acts of 1997 and 1999, creation of resources such as Hill-Burton or Health Manpower Act, and direct provision of service like the Veterans Affairs. Public policy approach to date has produced the fragmented long-term-care delivery system that currently exists in the United States (Williams, ; Torrens, 2008).

The increase in the number of people who will need care due to chronic disease or and multigeneration caregiver will stress the system. Primarily state governments usually handle long-term care, and they have determined the impact of fragmentation on the quality of care provided as well as what it will cost the government. Some states have organized their own systems to streamline long-term care deliveries like Wisconsin who has a system that unites health, social services, and mental health programs. The current and future shortage of health care providers will be another factor challenged by long-term care.

Efforts to achieve coordination through government programs will likely continue, more so at the local level and not the national level. As for the future individuals and their families will still be responsible for maintaining the constant long-term care needed. The hospital industry has experienced some bumpy transitions over the years and will continue to face many more in the future. Due to the change in the economy, markets, and the cost of health care, some hospitals had to switch to for-profit vs. non-profit to remain open.

Through all the transitions, hospitals have still been able to provide top-notch care for their patients. Several trends have presented themselves within the hospital sector from building smaller facilities verses large to the occupancy of patient beds being utilized. Even tough hospitals and nursing homes are different facilities that offer different types of care the services available to for those with long-term disabilities and chronic conditions has developed drastically over the years. United States is not prepared to support or provide its citizens with affordable efficient and effective long-term care.

Families are contentiously struggling on a daily basis to develop a plan that will allow them to have heath care for their entire family without having to take away from their daily needs or monthly household necessities. References Layne, E. (n. d. ). Nonprofit vs. for profit hospitals. Retrieved from http://www. ehow. com/facts_5607717_nonprof it-vs_-profit-hospitals. html Williams, S. J. , ; Torrens, P. R. . (2008). Introduction to health services:2010 custom edition(7th ed. ). New York: Cengage Delmar Learning.

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