Length & Format: 8-10 slide PowerPoint presentation with voice over.

Role: Director of Community Care and Outreach

Audience: Internal, hospital leadership team(s)

Topic: Financing Charity Care

Scenario: You have worked for ABC Hospital for several years. Recently, you were promoted to be the Director of Community Care and Outreach. In this role, you are responsible for increasing the hospital’s presence in the community, reaching new patients, and ensuring patients receive effective and coordinated care. You are aware of ABC Hospital’s current issue with charity care: there is no defined policy for who can write off an account, and no defined standards for what qualifies a patient to receive charity care. The billing department has reported multiple complaints due to the lack of a policy, and frustrations from both providers and patients. Your presentation will address how to appropriately utilize the charity care resource of financing.

• Review the resource within Topic 3: Principles and Practices Board Sample 501c(3) Hospital Charity Care and Financial Assistance Policy and Procedures (Links to an external site.). (HFMA, n.d.)
• Prepare an 8-10 slide PowerPoint presentation, with voiceover. Assume fictional information to develop your content. Address the following points in your presentation:
• Why ABC Hospital needs and uses charity care
• Patient demographics and percent of hospital patient population receiving charity care in the last fiscal year (fictional data).
• Define the issues that have contributed to poor management of the charity care provision.
• Propose a new way to move forward, providing effective care to patients, utilizing charity care properly. What is different about this approach, then what was happening previously?
• Using bullet points, clearly define a minimum of three benefits of your plan for moving forward. These benefits should be focused on the financial health of ABC hospital, while balancing the needs of your patient population. These points will be the cornerstone for future development of a policy on charity care.
• APA style should be followed throughout. A title and reference slide are required. Please include a minimum of three scholarly sources.

Wellness visits are an important part of pediatric primary care. During these visits, patient growth and development are assessed. As an advanced practice nurse who performs these assessments, you must be able to distinguish between normal and abnormal growth and development to recognize red flags. While some patients may not meet milestones due to differences in rates of development, abnormal development might also be a red flag of an underlying problem. In this Discussion, you examine the following case studies and consider potential developmental red flags:

Case Study 1

A mother brings in her 16-month-old, Brittany, for treatment of an acute illness. During the history, the mother reports that her mother-in-law is concerned about the toddler’s development. Further questioning reveals the following:

• Brittany was a term infant born vaginally with no intrapartum complications. Birth weight was 8 pounds 1 ounce and current weight is 26 pounds 9 ounces.
• She was breastfed until 12 months of age and now drinks 24 ounces of whole milk and eats table foods daily.
• Physical milestones are as follows: Rolled front to back at 6 months, developed pincer grasp at 11 months, crawled at 8 months, and began cruising at 10 months. She does not walk independently.
• Social development includes mimicking adult behavior, four-word vocabulary (mama, dada, baba, and no), follows one-step commands, and quiets easily when comforted.

Case Study 2:

You see a 30-month-old named Brian for a well-child visit. His mother reports the following development:

• Physical: Walks independently, runs, able to climb stairs alternating feet, makes a tower of nine cubes, and is able to button his pants.
• Social: Follows one-step commands, uses one-word sentences, and has a vocabulary of approximately six words. He is resistant to nighttime and feeding routines, he has marked temper tantrums, and Mom states he does not calm when she tries to comfort him.

Case Study 3

Jose is a 36-month-old who presents for a preschool evaluation. His father reports the following development:

• Physical: Walks, runs, and jumps independently, walks up stairs alternating feet, pedals a three-wheeler, scribbles, copies circles and squares, and is able to balance on one foot for 2 to 3 seconds.
• Social: Recognizes three colors; speech is 75% understandable; uses three- to four-word sentences; talks about friends, favorite activities, and family; frequently engages in imitative play; has an imaginary friend; does stutter on occasion when excited or when intent on getting something said. Will typically repeat the first word in a sentence three to four times, but does not repeat syllables or consonants. This happens three to four times a week.

To prepare:

• Review this week’s media presentations, as well as “Developmental Management of Infants” and “Developmental Management of Toddlers and Preschoolers” in the Burns et al. text.
• Think about how physical, social, and cognitive development vary during infancy, toddlerhood, and the preschool years. Reflect on normal versus abnormal growth and development and consider the decision-making process of identifying and managing red flags of abnormal development.
• Select one of the three case studies provided. Reflect on the patient information included in the case study and consider any developmental red flags.
• Reflect on standardized screening tools, clinical guidelines, and management strategies that would be used to assess and manage the patient in your selected case study.

By Day 3

Post an explanation of any developmental red flags that presented in the case study you selected based on the stages of normal physical, social, and cognitive development for infants, toddlers, and preschoolers. Explain how you differentiated between normal and abnormal growth and development for this patient and identify which standardized screening tools, clinical guidelines, and management strategies you might use to assess and manage this patient and why.