HCS 451 Health Care Quality Management and Outcomes Analysis Professor Jodi Sapaguh
By Lisa Gresley
August 9, 2010
Substandard quality of health care is duly recognized as a major form of medical crises with potential to jeopardize the functioning and purpose of the American health care system. Whereas on the one hand medical costs of treatment are rising, on the other malpractices and non compliance on the part of medical professionals and institutions compounds the problem and seriously questions the quality of health care being provided to citizens. However, before proceeding further it is important to understand what is exactly meant by the substandard quality of care. The substandard quality of care implies that one or more of the requirements mandatory under the federal regulations 42 CFR 483 .13 involving resident behavior and facility practices, 42CFR .15 involving quality of life or 42CFR 483 .25 regarding quality of care are not complied with leading to actual jeopardy to the resident health or safety or having potential for causing more than minimal harm (HealthCare information, 2007). Any nursing home found with delivering substandard quality of healthcare or carrying significant deficiencies in its healthcare treatment plans would be required to immediately address the issue. The following personal experience presents an example of injuries from utilization control healthcare delivered resulting in grievous and permanent injuries to the patient. The problem here is about Lois Battles, my grandmother, who was diagnosed with Leriche's syndrome, which is a vascular occlusion. Upon diagnosis, her doctor recommended surgery where a part of an artery was to be replaced with a Teflon graft. The program providing medical care to Lois was California's medical assistance program, Medi-Cal that was responsible for controlling costs and authorizing treatment. As such, the approval and authorization from state was a...