Ethical and Policy Factors in Care Coordination

Ethical and Policy Factors in Care Coordination

Presentation Script


Patients and health care providers benefit immensely from care coordination. However, care coordination outcomes depend on many factors, including ethical and policy issues, patient concerns, and the practices used in routine care. A nursing home is a valuable community resource for providing custodial care and assistance with activities of daily living for older adults. Its members need to understand how care coordination works and the role of government policies in care coordination. The purpose of this presentation is to explain the connection between government policies and coordination of care, how policy provisions raise ethical dilemmas, and the impacts of the code of ethics for nurses on care coordination and continuum.

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Care Coordination in a Nursing Home

Before examining the connection between government policies and care coordination, it is crucial to explore what care coordination in a nursing home entails. At the basic level, care coordination is primarily about organizing patient care activities to ensure that patients and deserving populations receive health care services when needed. Sharing information is at the core of a coordinated practice as different health care providers work together and exchange crucial patient data for decision-making. At a broader level, supporting communities and health care organizations with information, regulation, and resources is part of coordinated care. The primary goal is to achieve safer and more effective care while preventing duplication of services and malpractices that risk patient health.

Government Policies and Coordination of Care

Government policies demonstrate how the government influences health care provision. Broadly, health policies are primarily about decisions, goals, and actions that determine how health care providers administer care. Health care policies also influence access to care, such as policies promoting insurance coverage. Most government-based policies include legal and safety regulations. A suitable example is the Affordable Care Act (ACA). They also include protocols guiding health care delivery to patients and specific populations. Like other organizations, nursing homes cannot work without policies. Understanding policies and adhering to policy recommendations ensures that health care providers provide the best care to patients while avoiding legal and ethical implications.

Specific Policy Affecting the Nursing Home

Medicare & Medicaid

A nursing home usually includes older adults, and it is important to reflect more on government policies that focus on this unique population. The first government-related health care policy is Medicare. Medicare is a federal insurance program for older adults and younger people with disabilities (Congressional Research Services, 2019). To understand it better, it is crucial to compare it with Medicaid, which primarily targets low-income families. It aims to provide access to free or low-cost health care coverage. Both policies expand insurance coverage to unique populations, particularly the disadvantaged populations. More insurance coverage implies more access to care, reducing the illness burden while improving people’s productivity.


The other important policy affecting the nursing home is the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Like other community health organizations, health care practitioners exchange massive data regarding patients’ health to foster shared decision-making. Information exchange is usually electronic, posing significant risks to patient safety and care coordination. HIPAA addresses the use and disclosure of protected health information (Cohen & Mello, 2018). Through HIPAA, health care practitioners must ensure confidentiality and integrity of patient data. The data must also be safeguarded against threats related to unauthorized access, sharing, and malicious use. The patient also retains the right of ownership of their health information.

Policy Provisions Raising Ethical Questions

Common Ethical Concerns

Ethics is an integral part of today’s health practice. Community organizations and other facilities providing patient care must ensure that all procedures adhere to ethical recommendations. Common ethical concerns dominating national, state, and local provisions include excluding some populations in the coordinated practice. For instance, Medicare and Medicaid target specific populations. The other ethical concern is how to offer the best possible practice without exposing health care providers to legal and ethical consequences. For instance, the use of technology increases the possibility of leaking patient information to unauthorized users. Local provisions such as smoking cessation laws interfere with people’s right of choice.

Medicare-Medicaid and Ethical Concerns

Despite their commitment to promote access to care, particularly to vulnerable groups, Medicare and Medicaid provisions raise ethical questions for care coordination. For better care coordination, health care professionals and patients should link up through programs characterized by fairness and equal distribution of the available resources. However, as Williams and Cooper (2019) posited, Medicaid can only be justifiable from an economic dimension. It guarantees some populations the right to basic health care and long-term care, which should be extended to all populations. Williams and Cooper (2019) further claimed that Medicare is yet to address racial and ethnic disparities. It demonstrates inequities in health coverage, which should be addressed to make it more effective.

HIPAA and Medical Ethics

Breaching HIPAA regulations has severe ethical and legal implications. It is crucial to examine some of the concern areas and ensure compliance at the nursing home. The first concern is how to use protected health information and guarantee patient autonomy. Cohen and Mello (2018) advised health care providers to remember that patients have the absolute right to their PHI upon request. To ensure non-maleficence, health care professionals should always handle PHI as HIPAA stipulates. Nurse leaders should also consider organizing training programs for nurses to improve their knowledge of HIPAA compliance. A just practice applies the same privacy and security standards for each patient’s PHI.

Code of Ethics for Nurses and Care Coordination

Understanding the Code of Ethics

Another crucial area for care coordination is the code of ethics for nurses. Butts and Rich (2019) defined a code of ethics as standards that guide health care professionals’ conduct. In this case, despite being close to each other and knowing each other for a long time, nurses must always act professionally. The code of ethics keeps nurses free from ethical concerns since it provides a reference for exceptional conduct. It determines a nurse’s limits as far as conduct and everyday interaction are concerned. In care coordination and continuum, nurses must always act to benefit patients. Adhering to the code of ethics is imperative to ensure nurses act professionally to meet the desired health outcomes.


Health, Health Disparities, and Access

Whether working in a nursing home or other organization, nurses will always meet patients whose problems and vulnerabilities differ profoundly. To serve them diligently and advise them appropriately, nurses must be conversant with factors contributing to health, disparities, and access to services. The leading causes include social determinants of health, including poverty, health literacy, and economic stability (Office of Disease Prevention and Health Promotion, 2022). Other factors include community features, environmental conditions, and health behaviors. For instance, physical inactivity and excessive alcohol assumption are typical behaviors among older people (Gil-Salcedo, 2020). Understanding the causes of health variations would enable nurses to interact with patients more professionally as they provide them with the care they deserve.


This presentation explored the influence of government policies related to health and how they affect care coordination. The main observation is that the government plays an influential role in care coordination through policies. Most government policies are support programs, regulations, and laws, such as Medicare, Medicaid, and HIPAA. The other important discussion area was the impact of the code of ethics for nurses. Regardless of their practice level, nurses should ensure that their conduct matches the expected professional and ethical standards. A code of ethics guides behavior. The last section was the factors contributing to health, health disparities, and access to services. Social determinants of health are the leading causes of disparities.



Butts, J. B., & Rich, K. L. (2019). Nursing ethics: Across the curriculum and into practice. Jones & Bartlett Learning.

Cohen, I. G., & Mello, M. M. (2018). HIPAA and protecting health information in the 21st century. Jama320(3), 231-232. doi:10.1001/jama.2018.5630

Congressional Research Services. (2019). Medicaid eligibility: Older adults and individuals with disabilities. CRS Report.

Gil-Salcedo, A., Dugravot, A., Fayosse, A., Dumurgier, J., Bouillon, K., Schnitzler, A., … & Sabia, S. (2020). Healthy behaviors at age 50 years and frailty at older ages in a 20-year follow-up of the UK Whitehall II cohort: A longitudinal study. PLoS medicine17(7), e1003147.

Office of Disease Prevention and Health Promotion. (2022). Social determinants of health.

Williams, D. R., & Cooper, L. A. (2019). Reducing racial inequities in health: using what we already know to take action. International Journal of Environmental Research and Public Health16(4), 606.


Select a community organization or group that you feel would be interested in learning about ethical and policy issues that affect the coordination of care. Then, develop and record a 10-12-slide, 20-minute presentation, with audio, intended for that audience. Create a detailed narrative script or speakers notes for your presentation, 4-5 pages in length.

For this assessment:
• Choose the community organization or support group that you plan to address.
• Develop a PowerPoint with typed speaker notes (the script for your voice recording) and audio voice-over recording, intended for that audience. Video is not required.
Note: PowerPoint has a feature to type the speaker notes directly into the presentation. You are encouraged to use that feature or you may choose to submit a separate document. See Microsoft Office Software for technical support about the use of PowerPoint, including voice recording and speaker notes.
For this assessment, develop your presentation slides and speaker notes, then record your presentation. You are not required to deliver your presentation to an actual audience.
Presentation Format and Length
You may use PowerPoint (recommended) or other suitable presentation software to create your slides and add your voice over. If you elect to use an application other than PowerPoint, check with your faculty to avoid potential file compatibility issues.
Be sure that your slide deck includes the following slides:
• Title slide.
o Presentation title.
o Your name.
o Date.
o Course number and title.
• References (at the end of your presentation).
Your slide deck should consist of 10-12 slides, not including a title and references slide with typed speaker notes and audio voice over. Your presentation should not exceed 20 minutes.
Create a detailed narrative script for your presentation, approximately 4-5 pages in length.
Supporting Evidence
Cite 3-5 credible sources from peer-reviewed journals or professional industry publications to support your presentation. Include your source citations on a references page appended to your narrative script.

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