How Financial and Legal Barriers Affect Quality of Care
The quality of care and life of the elderly in any rehabilitation center or nursing home is largely determined by the choice of the rehabilitation center or nursing home that one decides to turn to. And for these institutions to be as good as possible, they need legal and financial stability (among other things).
For such institutions, the most important thing is the care of the users, but unfortunately they have to struggle with costs and regulations, which reduces their resources for quality care. We investigated how exactly these legal and financial entanglements affect the very quality of care, personnel, but also access to services.
Financial Obstacles and Their Impact on Care Quality
Where the finances are, there are problems. And often the other way around.
These care institutions are actually mostly dependent on external sources of financing such as state institutions or private insurance, and financial difficulties are reflected in the quality of care standards.
Underpayment problem
As an example, we can use the most famous American state institutions, Medicare and Medicaid, which should work on their business model.
On the good side, they make up a significant part of the income of many health institutions, i.e. even 96% of hospitals cover half of their costs through them.
There’s always a “but”. This comes in the form of violations that these institutions might have. Such as medicare payment denial in the last 3 years and not covering the full amount of the actual costs of treatment, increases in the debt of hospitals, and more. In 2022, that amount of underpaid costs was a mind-numbing 99.2 (USD) billion.
This sounds like a vicious circle that is very difficult to break out because people still need help and staff does not have enough resources to provide them with quality service. Not to mention how to invest in infrastructure, devices, training, etc.
That means you have to provide help, but you don’t have the resources for quality service. Both sad and funny at the same time.
In such situations, it is most often a “hit” on the staff, whose smaller number leads to a lower quality of service.
The Effects of Low/Late Payments
Over time, if the health sector as a whole pays less than the recommended amount, it becomes problematic given the fact that shortages of medical personnel and proper equipment equates to lower standards of health care, especially in nursing homes and facilities where total care services are needed for the residents.
As inflation goes up, so does the cost of living, and therefore, it’s easy to say that patients are under-delivered with regard to their medical services.
Late payments will (likely) result in the same scenario where staffing will not work to their fullest potential, and the nursing home residents are going to be the ones who’ll bear the brunt of that impact.
Healthcare Regulations and Reimbursement Issues
It is safe to say that there are legal tussles at every stage of life, and the medical field is no exception.
The Complexity of Healthcare Regulations
There is one thing that has no exceptions – adherence to the federal and the state laws. In addition to existing nursing home regulations, there is always an effort to develop a better system that requires much more time and resources to adapt institutions. Their introduction also consumes already hard-to-get funds that could be used to care for elderly and sick patients. All this increases the risk of non-compliance with the regulation due to less resources.
Although it may not seem like it at first, legal procedures also affect the quality of care. Long-lasting appeals for delayed payment burden the already small budgets of institutions. Situations like this especially affect smaller nursing homes or rehabilitation centers because they don’t have the financial reserves to withstand long-term litigation and waiting for compensation.
3 Key Factors Impacting Quality of Care
Of course, the quality of service cannot be at the same level when financial and legal problems appear.
Staffing and Workforce Issues
The first thing that comes to mind is reducing the number of employees. Consequently, a situation arises where the number of patients is more than the available nursing staff, thus limiting the necessary attention per patient.
And since the staff are only human, they cannot be overloaded indefinitely. Then you have the problem of burnout, the possibility of mistakes, and ultimately reduced patient satisfaction.
Some patients need specialized care (physical therapy, special diet, constant care, etc.), and a reduced number of staff members cannot perform this at a high level due to overload.
Access to Medical Resources
We think it is unnecessary to say how many times you have come across outdated equipment in medical facilities. Then you go to some other place and you are delighted. Limited access to resources. Well, that’s the difference that affects the quality of service and patient satisfaction.
Facility Maintenance and Environment
This is just a continuation of the previous item. Inadequate maintenance of facilities and late repairs affect the sanitation and safety of the patient environment.
Conclusion
As we already know – nothing works without financial resources. And so not even in health institutions. Sad, but that’s how it is. And then they are still “squeezed” with legal entanglements and we end up with a rather bad whole system that affects the quality of patient care.
Service providers are forced to make cuts to keep everything functioning as much as possible because patients are priority. Without significant reforms, we are afraid that this ship could sink deeper and deeper, and in the end, all of this affects the patients.
It’s time for a change.