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WGU NURS 2650 D223 Healthcare Policy and Economics - UKM1 – Performance Assessment 1

A. Healthcare Organization Selection

A1. Selected Healthcare Organization

The healthcare organization chosen for this analysis is Saint Mary’s Regional Medical Center, located in Russellville, Arkansas, as listed on the American Hospital Directory (AHD, 2024).

A2. Significance of the Chosen Healthcare Organization

Saint Mary’s Regional Medical Center holds personal significance as it is my hometown hospital. I have worked as a nurse at this facility and continue to receive medical care here. Additionally, I recently underwent surgery at this hospital, reinforcing my connection to this organization.

A3. Type of Facility

Saint Mary’s Regional Medical Center is classified as a short-term acute care hospital and is designated as a Level III Trauma Center (AHD, 2024). The facility provides various medical services, including:

  • Acute care
  • Surgical services
  • Women’s health services
  • Interventional cardiology
  • Rehabilitation services
  • Oncology and radiation treatments within its cancer center (AHD, 2024).

A3a. Type of Control

Saint Mary’s Regional Medical Center operates as a proprietary, for-profit hospital and is owned by LifePoint Health, a corporate healthcare organization (AHD, 2024).

A4. Hospital’s Overall Star Rating

According to the Centers for Medicare and Medicaid Services (CMS) Care Compare website, Saint Mary’s Regional Medical Center has an overall 2-star rating. The CMS star rating is based on five key performance categories:

  1. Mortality
  2. Safety of Care
  3. Readmission Rates
  4. Patient Experience
  5. Timely and Effective Care (CMS, 2024).

A4a. Additional Source of Clinical Quality Data

Saint Mary’s Regional Medical Center is accredited by The Joint Commission, an independent organization recognized for establishing high standards in patient care and clinical outcomes (The Joint Commission, 2024). This accreditation signifies the hospital’s commitment to meeting quality and safety standards in healthcare delivery.

A5. Ethical Considerations in Hospital Operations

As a corporate-owned, for-profit hospital, Saint Mary’s Regional Medical Center prioritizes financial sustainability while maintaining ethical responsibilities in healthcare delivery.

Russellville, Arkansas, has a rural, low-income population, making it common for patients to lack health insurance or adequate financial resources. Despite financial constraints, the hospital is committed to providing care to all patients, regardless of their ability to pay.

An example of ethical decision-making occurred while I was working as a nurse at this facility. A tragic event unfolded in which a man opened fire on a family, resulting in multiple fatalities. The shooter was shot by a bystander and subsequently transported to our emergency department. Despite the criminal nature of his actions, hospital staff provided life-saving medical treatment, stabilizing him before he was transferred to surgery and intensive care. This situation reinforced the principle that all patients, regardless of personal circumstances, are entitled to medical care.

A6. The Nurse’s Role in Value-Based Care (VBC)

Nurses play a vital role in value-based care (VBC), which ties hospital reimbursement to quality outcomes rather than service volume. The effectiveness of nursing interventions directly impacts patient safety metrics and hospital financial performance.

Healthcare organizations monitor quality indicators such as Catheter-Associated Urinary Tract Infections (CAUTIs) and Central Line-Associated Bloodstream Infections (CLABSIs). Facilities with higher infection rates face financial penalties under VBC reimbursement models (Cleveland et al., 2019).

Nurses play a key role in:

  • Implementing evidence-based infection control practices to prevent CAUTIs and CLABSIs.
  • Conducting comprehensive patient assessments to detect early signs of complications.
  • Educating patients on infection prevention and self-care measures to support recovery (Cleveland et al., 2019).

By adhering to best practices in infection prevention, nurses contribute to reducing healthcare costs, improving patient safety, and enhancing overall hospital performance.

A7. Organizational Change to Improve VBC Delivery

Hospital readmissions present a significant challenge nationwide. According to the CMS Care Compare website, Saint Mary’s Regional Medical Center has a 14.7% readmission rate, with Chronic Obstructive Pulmonary Disease (COPD) patients being among the most frequently readmitted (CMS, 2024).

To reduce COPD-related hospital readmissions, a structured outpatient COPD management program could be introduced. This initiative would include:

  • Comprehensive patient education on medication adherence and symptom management.
  • Regular follow-up visits to monitor disease progression and adjust treatment as needed.
  • Collaboration with insurance providers to ensure cost-effective treatment options.
  • Providing medication samples and assisting with financial resources for patients in need (CMS, 2024).

By implementing this preventive care strategy, Saint Mary’s could effectively reduce readmissions, improve patient outcomes, and align with value-based care objectives.

B. Financial Comparison of Healthcare Organizations

Saint Mary’s Regional Medical Center is a for-profit, corporate-owned hospital, while Baptist Health Medical Center in Conway, AR, is a voluntary, nonprofit hospital. The key financial differences between for-profit and nonprofit hospitals include:

  • For-profit hospitals pay taxes and can generate capital through investor contributions.
  • Nonprofit hospitals are tax-exempt and must reinvest profits into community health programs (Zare & Gabow, 2023).

B1. Alignment with Value-Based Care

Baptist Health Medical Center aligns more effectively with value-based care (VBC) due to its nonprofit status. The Affordable Care Act (ACA) mandates that nonprofit hospitals conduct community health needs assessments (CHNAs) to identify and address local health disparities (Rapfogel & Gee, 2021). This ensures that hospital services prioritize community health needs, reinforcing patient-centered care principles.

B2. Equitable, Patient-Centered Care

Baptist Health Medical Center is better positioned to provide equitable, patient-centered care because its nonprofit status requires it to demonstrate tangible community benefits (Rapfogel & Gee, 2021). These requirements promote broader access to healthcare services, particularly for underserved populations, through charity care programs and preventive health initiatives.

References

Cleveland, K. A., Motter, T., & Smith, Y. (2019). The evolving role of nurses in value-based care. Nursing Administration Quarterly, 43(1), 25-32. https://doi.org/10.1097/NAQ.0000000000000342

CMS. (2024). Hospital compare. Centers for Medicare & Medicaid Services. Retrieved from https://www.medicare.gov/care-compare

Rapfogel, N., & Gee, E. (2021). Addressing healthcare inequities in nonprofit hospitals. Center for American Progress.

The Joint Commission. (2024). Accreditation and certification. Retrieved from https://www.jointcommission.org

Zare, H., & Gabow, P. (2023). For-profit versus nonprofit hospitals: Financial implications. Health Affairs, 42(2), 50-60.

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