ACA insurance subsidies in limbo after federal courts issue conflicting rulings
Government subsidies paid to patients who bought health insurance through the federal exchange are invalid, according to a ruling Tuesday by a federal appeals court in Washington, D.C.
Meanwhile, a federal appeals court in Richmond, Virginia, upheld the legality of the subsidies, according to a report in the New York Times.
Elimination of the subsidies would be a major blow to the Affordable Care Act (ACA) and to millions of patients from 36 states who purchased insurance from the federal exchange and could see their premiums rise drastically as a result. The ruling does not impact exchange customers in the state-run exchanges.
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Preventing workplace violence in the healthcare industry
One of the biggest challenges faced by security directors today is mitigating the risks posed by workplace violence, which materializes itself in many forms including intimidation, verbal abuse, battery, sexual assault, and in some cases homicides.
Bryan Warren, director of corporate security for Carolinas Healthcare System, joined SIW on Thursday for a webinar on workplace violence in the healthcare industry. According to Warren, workplace violence in the healthcare industry is unique in that the majority of incidents are not employee-on-employee, but rather patient or another visitor against hospital staff.
“Hospitals, if anything, are unpredictable,” he said. “Let’s face it; no one comes to a hospital because they want to.”
There are also several factors, according to Warren, that contribute to making healthcare facilities more prone to workplace violence, which include an increased number of homeless and psychiatric patients, long wait times and overcrowding, forensic patients (criminal suspects and others brought in by authorities, etc.), and emotions of people who are already on edge. In addition to ER and behavioral health units, Warren said that a hospital’s labor and pediatric departments can also be especially vulnerable, considering the emotional state of a parent who has received word about the diagnosis of their child.
In an effort to better protect against workplace violence, the Joint Commission recommends that hospitals work with their security departments to audit the facility’s risk for violence; take additional security measures in the emergency department especially if it is located in an area with a high crime rate or gang activity; identify strengths and weaknesses and make improvements to the facility’s violence prevention program; require staff members undergo training on responding to patients and family members who are agitated and potentially violent; and encourage employees and other staff members to report any violent activity of the perceived threat of violence.
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Bill to Tighten Hospital Security Clears California Legislative Panel
A California legislative committee gave preliminary approval Tuesday to a bill that would tighten security at hospitals and increase their requirements for reporting violent acts to the state.
The bill given the nod by the Assembly Committee on Health was sponsored by Assembly woman Mary Hayashi and the California Nurses Assn., which claims that nurses are facing an epidemic of violence in hospitals. It follows the death last October of Cynthia Palomata, a nurse who was bludgeoned at a medical facility at a jail in Martinez in Northern California.
The California Hospital Assn. opposes the proposed law. In a letter and testimony, the association warned that the law would put increased burdens on hospitals “without evidence that they will provide … benefits.” Opponents say hospitals are already required to report violence against hospital employees to local police, the Division of Occupational Safety and Health and the state Department of Public Health.
But Kelly Green of the nurses association said that only serious injuries and deaths must be reported now. The proposed law would also require hospitals to report all assaults and batteries on employees and patients.
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