Patients who do not return home directly from the hospital are transferred to a lower level of care. Transitional care


Patients who do not return home directly from the hospital are transferred to a lower level of care. Transitional care can take place in many different types of health care settings, such as a skilled nursing facility, long-term care facility, or subacute unit specializing in rehabilitation therapy, wound care, IV therapy, and/ or postacute cardiac care. There are various staff arrangements based on the focus of care, but generally there is a registered nurse (RN) in charge, who may only work the day shift with the assistance of licensed practical nurses (LPNs) and certified nursing assistants (CNAs), and a medical director who may visit the facility daily (or 2-3 days per week) but who is on call for emergencies. This specific transitional care unit consists of a 35-bed unit located within a 300-bed skilled nursing facility and is generally close to the patient’s home. There are RNs (staff) on duty 24/7 with a physician or nurse practitioner 7 days per week. The facility is a nonprofit, community-affiliated organization with a community board of directors that oversees the operations of the facility. The facility has a strong history of delivering quality services and high patient satisfaction. The facility is known for the implementation of the latest electronic medical record (EMR) technology. It has a five-star rating from the Department of Health and Commission on Medicare and Medicaid (CMS) with The Joint Commission Certification. You have just been notified of a situation that has occurred in the facility. A patient was admitted to the transitional care unit and was assessed by both nursing staff and physical therapy staff in order to develop a plan of care for the patient to return home. It was initially anticipated that following IV therapy the patient would be discharged home in 5 days (this is the standard stay, including the staffing ratios, in the operational budget). However, the patient developed an infection and has to have an additional 6 days of antibiotic fluids, which increases his stay from 5 to 11 days. As the administrator, you now need to evaluate the financial impact to your organization, keeping in mind that the insurance is only paying 50% of the IV therapy and only 35% of the extension of stay beyond the original authorization.

Put yourself in Kaila’s shoes. As a new CEO of an organization, you have recognized that designation of power has been an issue in the past. As a result, this is creating obstacles for you and your vision. Create a plan of action in an essay format of 300 to 500 words that you would use to regain control of the organization and employees, while still moving forward with a specific vision. In the plan, include:

  1. How will you differentiate the daily duties between your roles as a manager and a leader? Provide clear separation of duties. 
  2. What are the sources of power within the organization and how does it determine the organizational structure? 
  3. Discuss how you will address the management issues present with the existing staff as well as the CFO and CIO.
  4. Discuss a leadership style you will use to move the organization into a plan that will implement a shared network.

Solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines if needed.

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