A nurse is teaching the staff about health care reimbursement. Which information should the nurse include?
a. Sentinel events help determine reimbursement issues for health care.
b. Home health, long-term care, and hospital nurses' documentation can affect reimbursement for health care.
c. A clinical information system must be installed by 2014 to obtain health care reimbursement.
d. HIPAA is the basis for establishing reimbursement for health care.
ANS: B
Nurses' documentation practices in home health, long-term care, and hospitals can determine reimbursement for health care. Sentinel events do not determine reimbursement. About 60% of the worst types of medical errors, called sentinel events (involving death or severe physical/psychological injury), relate to communication problems that often arise during telephone reports. A clinical information system (CIS) does not have to be installed by 2014 to obtain reimbursement. CIS programs include monitoring systems; order entry systems; and laboratory, radiology, and pharmacy systems. Diagnosis-related groups (DRGs) are the basis for establishing reimbursement for patient care, not HIPAA. Legislation to protect patient privacy regarding health information is the Health Insurance Portability and Accountability Act (HIPAA).
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