Indiana University of Pennsylvania Jasper Gardens Case Study Discussion

Getting Started

This week’s case study comes from the long-term care delivery system.
Jasper Gardens is a certified nursing home approved to provide skilled
nursing and rehabilitation services to the citizens of Hillsboro County.
This week’s assignment addresses elements from your previous course
work in accounting and finance. It is designed to assess your competence
in financial management and strategic planning. Both of these are
competencies identified by employers and recognized by the American
College of Healthcare Executives (ACHE).

Upon successful completion of the course material, you will be able to:

• Analyze financial information to support a recommendation.
• Design strategies which address complex organizational issues within the healthcare industry.
• Analyze potential impacts of decision making in situations both internal and external.
• Integrate critical analysis to ensure healthcare organizational success.

Resources

• Textbook: The Middleboro Casebook: Healthcare Strategy and Operations
• Website: OCLS

Background Information

Capital City Visiting Nurses Association (VNA) and Hospice has
requested that Jasper Gardens enter into a contractual relationship to
provide inpatient hospice services to Jasper residents. The organization
is able to do this under existing Medicare regulations involving its
skilled nursing facility (SNF). Capital City VNA and Hospice would
provide all staffing and direct patient services in this new unit
located at Jasper Gardens. Jasper Gardens would provide a dedicated
wing, area, or building with private rooms for the patients, meals,
general nursing supervision, and general services (housekeeping, etc.).
They would pay Jasper Gardens a price per patient day to be negotiated.
Jasper Gardens estimates that its direct costs would be approximately
$75 per day for the services they have requested. Its pharmacy service
would provide needed drugs and other durable medical equipment at cost
that would be directly reimbursed to the pharmacy by Capital City VNA
and Hospice. The initial estimate is that Jasper Gardens could add a new
dedicated wing of four to eight private rooms at approximately $180,000
per private room (minimum four).

Note the following additional information:

National studies indicated that approximately 55% of all individuals
who die from cancer enroll in hospice services prior to their death.
Non-cancer enrollees include individuals who died from heart disease
(12%); dementia, including Alzheimer’s disease (11%); lung disease (8%);
stroke (4%); kidney disease (3%); liver disease (2%); HIV/AIDS (0.6%);
and other causes (11%).

On average, enrollees in a Medicare-certified hospice are enrolled
for approximately 68.5 days prior to death. Note that 31% of enrollees
died or were discharged from hospice in seven days or less. Studies also
indicate that most hospice care is “regular care” provided in a
patient’s home based on periodic visits as needed.

Nationally, Medicare-certified patient care days are classified as
routine care (96%), continuous (24/7) home care (1%), inpatient respite
care (1%), and hospital general inpatient care (0.25%). These same
studies indicate that of all patients in a Medicare-certified hospice,
approximately 85%, are covered by Medicare, 4% are covered by private
insurance, and 6% are covered by Medicaid. Currently, the maximum rate
paid by Medicare is $150 per day of routine care, $850 per day for
continuous home care, $160 per day for inpatient respite care, and $650
per day for general inpatient care. Also, the total annual cost per case
cannot exceed $23,000 per hospital enrollee.

Instructions

1. Review the rubric to make sure you understand the criteria for earning your grade.
2. Read “Case 8: Jasper Gardens” in the textbook.
3. Review the material within the Background Information section of this page.
4. You will be developing a case review report to address some highlighted issues.
   1. The data needed for analysis is included in the case study.
      1. You should utilize this data to provide quantitative justification for your conclusions.
   2. There needs to be, where appropriate, analysis of the data that supports your responses.
      1. Short answers to the questions will not be enough.
5. The report should be approximately five to seven pages in length.
   1. It is to include a properly formatted title and reference page.
   2. Be sure to use proper APA formatting for headings and citation of tables and graphs.
6. Address the following questions and provide appropriate quantitative justification to support your conclusions and recommendations:
   1. Should Jasper Gardens agree to enter into this contractual relationship?
   2. How large a unit should they offer?
   3. What price per day should they negotiate with Capital City VNA and Hospice?
   4. What is the general estimate of the positive and negative impacts of this unit on the nursing home?
7. Turn in your case review report to the instructor by using the Assignment submission page by the end of the workshop.