Health Care Facilities
Javier Espinales, CST
Health Care Facilities
• Traditionally hospitals provided all the care
• Since the 1990’s you now have facilities;
– Wellness care and education
– Home health care
– Follow up care
Health Care Facilities
• All surgeries use to be in one building
• There were few specialty hospitals
• You now have ;
– Traditional OR’s
– Free standing ambulatory
– Surgical facilities
– Free standing specialty centers
– Dr’s offices and clinics
– L&D units
Health Care Facilities
• Several types of hospitals;
– Nonprofit (Not-for-profit)
– Proprietary (For profit)
– Tax supported
Health Care Facilities
• Nonprofit (Not-for-profit) – acute-care hospitals – nontaxable
• Owned by
– Community
– Church
– Other organization
• Profits put back into maintenance and improvements
• Can be supported by tax revenues
Health Care Facilities
• Proprietary (for profit) – investor-owned hospitals
– Owned and operated individual or corporation
– Profits returned to investors
– Profits are taxable
Health Care Facilities
• Surgeries can be performed in more than one setting in the hospital
– Traditional OR’s
– Outpatient surgery
– L&D
– Pediatric surgery
Health Care Facilities
• Free standing ambulatory surgical facility – separate from a hospital
• HMO – Health Maintenance Organization
– Insurer
– Provider of medical services
• Clinics – for specific procedures
• Vets provide surgical services
Hospital Organization
Hospital Organization
• Surgeon’s
– Medical doctors
– Doctors of Osteopathy
– Podiatry
• Board certified in their specialty
Hospital Organization
– RN’s
• GN – Graduate Nurses
• LPN/PVN – Licensed practical /vocational nurses
• ADN - Associate Degree Nurse
• BSN – Bachelor’s Science Nursing
• Master’s and PhD’s
• CNOR
• CRNFA
Hospital Organization
• Anesthesia staff
– Anesthesiologists – MD’s/DO
– Anesthetists – nurses CRNA
– Anesthesiologist assistant – AA
– Anesthesia technician
• PA’s – Physician Assistants – role usually as a surgical assistant
Hospital Organization
• Other personnel working in the OR
– X-ray tech
– Perfussionist
– Cell saver tech
– Bioelectrical tech
– Lab tech
– Ortho tech
– Ophthalmic tech
– Dental tech
Hospital Departments and Interdepartmental Communication
• Direct Patient Care Departments
– Nursing Care Units
– Diagnostic Imaging
– Medical Laboratory
– Pharmacy
– Physical/Occupational Therapy
Hospital Departments and Interdepartmental Communication
• Indirect Patient Care Department
– Administration
– Maintenance
– Biomedical
– Housekeeping
– Food Service
– Purchasing/Central Services
– Medical Records
Financial Considerations and Reimbursement
• Surgery is expensive
• Some surgeons provide free care
• Insurances – designate contractual relationship and mutual benefit that exist when one party or entity agrees to pay another for a specific loss or condition.
Financial Considerations and Reimbursement
• Most health care coverage are provided by HMO’s or PPO’s (Preferred Provider Organization)
– All seek to control cost through contractual arrangements
– Limit payments to agreed-on amounts
Financial Considerations and Reimbursement
• Medicare – administered by the Fed. Gov. Through the Centers for Medicare and Medicaid Services (CMS)
– Reimbursements to hospitals and physicians
– 65 y/o & older qualify
– People eligible for Social Security disability payments for at least 2 years
– Certain workers & families who require kidney dialysis or transplantation
Financial Considerations and Reimbursement
• Medicaid is a government assistance funded jointly by Fed. Gov. and State Gov.

• Provide for low-income persons who can not afford medical insurance

• Surgical Technologist and other staff personnel must control cost
Organization Related to Hospitals, Health Care, and Surgical Services
• Governmental
– Dept. of Health and Human Services (DHHS)
• Public Health Services (PHS)
• Centers for Medicaid & Medicare Services formally known as Health Care Financing Administration (HCFA)
• Social Security Administration (SSA)
• World Health Organization (WHO) UN division
Organization Related to Hospitals, Health Care, and Surgical Services
– Various state, county, and city department groups

• Private Volunteer Agencies
– American Cancer Society
– American Diabetes Association
– American Heart Association
– American Red Cross
Organization Related to Hospitals, Health Care, and Surgical Services
• Accrediting Agencies
– Joint Commission on Accreditation of Healthcare Organizations (JCAHO) – An independent, nonprofit national organization
Organization Related to Hospitals, Health Care, and Surgical Services
• Professional Associations
– American College of Surgeons (ACS) – dedicated to improvement of surgical care by elevating standards of surgical education and pratices
– Association of Surgical Technologist (AST)
– Association of Operating Room Nurses (AORN)