Policy Provisions that Raise Ethical Questions or Dilemmas for Care Coordination

Several federal and state policies sometimes raise ethical questions for care coordination in nursing homes. HIPAA regulations on securing PHI and informed consent may sometimes raise ethical questions in dementia care in nursing homes. This is because patients with these illnesses have cognitive decline, with memory impairment and poor comprehension being apparent. The hospital readmission reduction program (HRRP) under the Medicare value-based system may also raise an ethical question in dementia care. This is because dementia is a progressive disease with limited identifiable prognostic trajectory markers. Readmission for these patients is inevitable (Gai & Pachamanova, 2019). The Resident Rights in Nursing Home Act may also raise an ethical question in nursing homes. While this act requires nursing homes (NH) to preserve residents’ rights, some residents may cease eating or taking medications. This may present a specific challenge in preserving these patients’ rights to dietary services and medications.

Implications and Consequences of Specific Policy Provisions

Policies that raise ethical questions have several implications and consequences for nursing homes. They may influence funding to these care institutions, result in damaged reputations, and attract fines to the NH. Breaches in HIPAA regulations and the provision of privacy and informed consent may sometimes cause a care institution to ruin its reputation. Breaches in patient privacy may also attract fines and other legal measures (Moore & Frye, 2019). Non-conformation to the HRRP under Medicare value-based systems may also reduce reimbursements to a care institution, which may reduce its operational efficiency. Nursing homes must,, therefore, conform to these policy provisions to avoid these consequences.

Impact of the Code of Ethics for Nurses on the Coordination and Continuum of Care

The nursing code of ethics outlines ethical codes that guide nursing practice and help them in their clinical decision-making processes. The major ethical provisions of the nursing code of ethics outlined by the American Nursing Association are beneficence, non-maleficence, justice, and autonomy. These provisions may help nurses navigate the ethical challenges raised by various policies during the coordination and continuum of care (Jakobsen et al., 2017). Beneficence requires that they promote the welfare of their patients, while non-maleficence requires that they do no harm to their patients. Lastly, autonomy requires them to allow their patients to make decisions on their treatment. These provisions will enable them to make decisions that are in the best interest of their patients.

Factors Contributing to Health

Several factors contribute to health. These factors are mainly categorized into individuals’ behaviors and characteristics, physical environment, and social and economic environment. The social and economic environment encompasses factors such as income, educational levels, social support networks such as family, and access to health. The context of the physical environment includes factors such as access to clean water and air, safe housing, workplaces, infrastructure, and others. Lastly, individual behaviors and characteristics are factors of self that contribute to diseases and illnesses, such as smoking, excessive alcohol consumption, and health-seeking behavior. All of these factors interplay in various illnesses and human suffering.

Factors Contributing to Health Disparities and Access to Care

Health disparity refers to the identifiable variations in health and healthcare between communities and groups. Several factors contribute to health disparity. Some of these factors include health behaviors, community characteristics, gender, race and ethnicity, poverty, and the physical environment. Access to care is another area that remains a topic of discussion in many American societies. Factors that influence access to care include poverty, geographical proximity to care centers, race and ethnicity, disability status, age, sex, and language spoken. These factors inform an individual’s ability to utilize care services and have been implicated in poor access to care among many American communities.

Social Determinants of Health Identified in Healthy People 2020

Social determinants of health (SDOH) are non-medical factors that influence health outcomes. Healthy People 2020 outlines the social determinants of health grouped into five domains. The first domain is economic stability, which encompasses employment, food insecurity, and others. Education entails access to quality education, enrollment in higher education, and others. Another domain is the social and community context that encompasses social cohesion,