In reading the Case Study below (Scale2) concerning an Assisted Living Facility

Question

In reading the Case Study below (Scale2) concerning an Assisted Living Facility implementing new technology, can you help identify at least six specific business rules using the following criteria:

- Identify the specific regulations or guidance justifying the rule (you may need to look up specific examples regarding safety rules in assisted living facilities)

- Specific business owners who are responsible for enforcing or clarifying the rules

- Who told you so (exactly what part of the Scale2 case study that lead you to believe that there was a business rule)

- If the rule ever expires and when

- If the rule is valid only during specific times (e.g., summer)

- Jurisdiction where the rule applies (state, county, etc.)

- Preconditions that trigger the rule

- Post-conditions after the rule is invoked.

Healthy Air, Healthy Water, Healthy People

A safe and healthy environment supported by connected devices/sensors, or the Internet of Things (IoT) is now well within the reach of many people. However, too often new technologies do not benefit those who need them most: elderly, infirmed and vulnerable residents who are unable to afford this level of protection. The public sector already plays a critical role in protecting the most vulnerable around us, and can now do it more effectively and efficiently with IoT.

Note about the Scale2 Project

Scale2 is a real project being developed for real users in an assisted living facility that is sponsored by a county government. The residents of the facility receive rent subsidies on a sliding scale; the facility is intended for use by those county residents who need financial and other supports to be able to live on their own. An assisted living facility offers fewer clinical services than a nursing home. Residents do not receive regular nursing care from the assisted living center staff – there are no medical personnel on the premises. If needed, they may hire their own caregivers who may stay with them to provide needed support for daily living (e.g., bathing, getting meals, etc.). Residents who need skilled nursing care must move to a nursing home.

Scale2 will not capture or retain any health care information on its own. Instead, it will provide a list of personal health records credentials for each consenting resident. During a medical emergency, Scale2 will seamlessly provide these credentials to the authorized emergency medical technologist for a view only access to a limited set of health care data (including current diagnoses, current medications, known allergies and most recent vital signs (if available). Access will be audited for accountability and no one will be able to access any of the clinical data outside of a declared medical emergency.

Scale2 User Profiles

Hector

It’s the evening of June 3rd and Hector is home alone in apartment 3B. Hector loves to bake. He’s expecting his grandchildren to visit in the morning and decides to prepare some pastries the night before. He preheats the oven and begins to prepare the ingredients when he realizes that he does not have everything he needs. He leaves to walk to the corner store and get the extra ingredients. He remembers to turn off the stove but a faulty pilot light results in a free flow of natural gas into his apartment. He’s not around to smell the gas. However, the sensor in his apartment detects higher levels of the gas within minutes and sends him an alert to his phone. Normally Hector would have remembered to bring his phone, but this time it was left at home. After getting no response from Hector, the system alerts Bob the building supervisor via his cell phone. Bob gets the message, confirms that he can respond and is in the apartment within minutes. He shuts off the gas to the stove, opens a couple windows, and shortly after Hector gets home. Hector decides to take his grandkids out for breakfast in the morning instead.

Sally

On June 4th Sally wakes up promptly at 6:00am in her home, apartment 3F. She gets out of bed, lifting herself into her wheelchair. She begins to prepare her coffee and as it brews she takes her morning shower. As she turns on the water the flow sensor in her shower head activates a small sensor that monitors abnormal vibrations in the shower, in other words, falls. She hoped this feature would never be needed, but today it was. As Sally reaches for something, she slips from her seat and hits her head, rendering her unconscious. The sensors detect the fall and a small red button in the shower lights up. Sally does not respond after a ten second delay and as a result, the sensor cuts off the water as a precaution. The second level of response is then initiated. Due to her disability, Sally lives in an independent living facility with a building supervisor available on call. The Bob the building supervisor receives an alert on his cell phone that there is a possible problem in apartment 3F. The alert asks for confirmation of his ability to respond. This morning he happens to several apartments away fixing a broken stove and is able to be in her apartment within a minute. Bob finds Sally and calls 911. She regains consciousness shortly after the paramedics arrive and is taken to a local hospital for evaluation.

Irma

Irma beats her 6:30am alarm, again. Her body clock wakes her up at 6:29am in her home, apartment 2A. She turns off the alarm and heads to the medicine cabinet in her bathroom. She checks her blood glucose. Her fasting blood glucose is 139 mg/dl and it appears to be in the proper range. The reading registers in the systems that helps monitor her vitals. As she cooks her breakfast she is reminded to check her blood pressure. It is 104/68. She sits down to rest for a moment and begins to drift off. She wakes up in a room full of smoke. She stands up as the smoke alarm in her apartment begins to go off. She is incapacitated by the smoke and falls to the floor. This alarm does more than just blink and make sound. It sends a signal to two people: her and Bob the building manager. She does not respond within the set time and neither is Bob, who is busy attending to a Sally two floors away. The alert system the alarm is connected to then sends an alert to the fire department. At the same time the system alerts all of the building residents with a targeted alert. “A possible fire event has been detected in the building. Please evacuate via the nearest emergency exit.” The fire department arrives several minutes later, much sooner than they would have if not for the automated alert. Many residents have already left the building. They locate Irma and an ambulance transports her to a local hospital. The fire department puts out what amounts to a small kitchen fire, but could have been much worse.

Chuck

Chuck, a chronically ill patient with congestive heart failure, has also been ill with pneumonia lately. His only family members live many hours away and a home health aide has been hired to check on him every couple of days. He is taking medication and has several medical devices in his apartment to help manage his congestive heart failure. These include a respirator, a pulse-ox device (for measuring heart rate and oxygen saturation), a blood pressure device and a single-lead ECG machine. These are integrated into the HomeICE personalized medical device interface[1]. HomeICE provides access to his current and previous medical device readings on a dashboard that runs on a web browser in a tablet or on a personal computer. HomeICE may be accessed by Chuck and by those he has authorized (his home health aide, his family members and his clinical care team (nurse and physician) at MoCo Medical Center.

On this morning, June 4th, the home health aide arrives to check on Chuck and make sure that he is taking his medication but finds that there has been a small fire and no one is being allowed to enter the building. She leaves Chuck a message that she will return either later in the day or the next day. It does not register with her that the air in his home, apartment 3H might be affected by the smoke from the fire and she is also unaware of a small gas leak in a nearby apartment the night before. Chuck sleeps through the alerts and when awoken by the commotion from fire trucks he decides he should try to leave. As he slowly gets dressed it becomes harder and harder for him to breath. He sits back down and tries to gather his strength and breath. Suddenly the phone rings. The air quality sensors in his apartment have detected higher than normal levels of natural gas and particulates in the air. The system has alerted him, his home health aide, building supervisor and family by automatically placing them on a conference call. Chuck is too weak to reach his phone and the supervisor is preoccupied with the events in the building but the aide and his family answer. The aide lets the family know she was unable to get into the building that morning and the family realizes that Chuck is not responding. They log into his HomeICE dashboard and realize that his vital signs have deteriorated since that morning.

The system asks the family if they would like to be connected with emergency dispatch. The 911 operator joins the call and they inform the dispatcher of the situation and Chuck’s health condition. The 911 operator radios to the firefighters on the scene and they find Chuck in apartment 3H barely conscious. The building supervisor shows them the HomeICE dashboard and they bring the tablet with them in the ambulance to the MoCo emergency room, where his aide meets him.

Julien

Julien is an Alzheimer’s patient living his wife, Celeste, in apartment 1E. Celeste woke at 6:00am and began her morning routine before Julien rose for the day. Realizing that they’d run out of coffee yesterday, Celeste put on her shoes and left for the coffee shop to get beans. Before she left, she activated a bracelet Julien wears with a radio transmitter that can relay his location in the building, or transmit a signal for triangulation if he’s outside of it.

While she was out, the fire alarm sounded and the building was evacuated, Julien along with everyone else. He was able to leave the apartment with the other evacuees; the bracelet recognized that he was leaving the building and activated the out-of-building tracker. Once outside, he looked around, not recognizing his new surroundings.

Confused, Julien wandered around the corner in hopes of finding a familiar place or a familiar face.

By the time Celeste had navigated the morning crowd at the coffee shop, returned with her beans, and walked back to the senior living facility, the fire was contained and residents were evacuated. She’d received a text message while she was out, alerting her that Julien had left the building with his bracelet on, but hadn’t seen it in line at the coffee shop--she kept her phone in her purse and hadn’t felt or heard it in the bustle. She quickly scanned the milling crowd for Julien, becoming more and more alarmed when she couldn’t find him. Celeste hurriedly rooted through her purse, which had a text waiting, asking if she wanted to publish the radio transmitter identifier to the police and issue a Silver Alert for Julien.

‘YES’

The response kicked off an alert to Bob, asking if he knew where Julien was. Bob couldn’t answer his text, occupied with other events in his building. Ten minutes after Bob’s lack of response, the service issued a Silver Alert to the local police department, along with the unique identity of the radio bracelet. Each police cruiser in the district receives the Silver Alert update, including the last known location of Julien, his senior living facility. Two cruisers diverted along the roads leading away from his apartment, both looking for Julien and gathering signal data. Soon, they collected enough data to triangulate his position to within a block--the converged on that area and found him wandering across the street. Guiding him gently into the cruiser, the police returned him to Celeste before any real harm was done.

Firefighter Steve

Firefighter Steve is a battalion chief at station 17. Station 17 is a joint fire and EMS service station. A midsized senior assisted living facility is located in his area. Shortly after 6:50am on June 4th a call comes in regarding a possible fire at the senior assisted living facility in apartment 2A, where Irma Johnson lives alone with her cat. His crew had already been to the building earlier in the morning after a resident had fallen in the shower and his ambulance crew was transporting the patient to the hospital. He requests assistance from the closest ambulance. Both an ambulance and a fire truck are dispatched to the facility. En route Steve pulls up the preplans of the building. The building is equipped will cell phone detection sensors that can be activated in an emergency. It is also equipped with atmospheric sensors in each dwelling. Steve can see that residents appear to be evacuating the building by the movement of phones towards exits. He sees that the phone in apartment 2A is not moving. He can tell that the temperature in 2A is elevated with significant amounts of smoke. None of the other units have elevated temperatures and only slightly elevated amounts of smoke. Steve feels confident that there is in fact a small fire in the apartment but that for the moment it is contained. He is also able to see that one of the two nearby fire hydrants has very low pressure, so he positions his trucks to use the hydrant with proper pressure. He arrives on the scene, sends his men directly to apartment 2A where they promptly evacuate Irma and put out the small fire in the kitchen. While on the scene Steve gets a radio call that there may be a resident in distress in apartment 3H. Bob the building supervisor is working with first responders and provides remote access to the unit. When Bob requests emergency access he is notified of an “isolation request” put in place by the resident to ensure his infection doesn’t spread. Bob alerts first responders so that they can take the appropriate precautions.

EMS Tech Sumiko

EMS Tech Sumiko and her crew were the closest unit when the call came in for assistance. En route they get word that there may be a resident by the name of Irma Johnson in distress in apartment 2A. When they arrive, first responders enter Irma’s apartment where they immediately retrieve her HomeICE monitoring device. They assume she has suffered from smoke inhalation but they are immediately given access to her HomeICE dashboard and see that she is diabetic and had a normal blood glucose level approximately 30 minutes earlier. So they hold off on an insulin injection until they can check her levels further. Irma is admitted to a local hospital where she will be monitored for several days. In the meantime, she grants her neighbor access to her apartment from her cell phone so that her cat can be fed.

Bob the Building Supervisor

In the aftermath of a very hectic day at the apartment complex, Bob gets some well deserved rest but continues to monitor the health of his building. A June heat wave is causing air quality issues and the lingering smell of smoke has caused many residents to leave their windows open. Indoor and outdoor air quality sensors detect some lingering problems with particulates in the air and dangerous ozone levels outside. Given the high number of respiratory issues in his building some residents are relocated temporarily and extra fans are distributed to residents. Small LED indicators inside the apartment of each resident with a respiratory concern light up either red, yellow or green depending on the air quality factors outside the building.

Non-Event Use Cases (Not Driven by Emergency Response)

Bob the Building Supervisor

One of Bob’s duties is keeping the residents comfortable and balancing that with keeping HVAC costs under control. By gathering temperature data and HVAC run time data from various areas of the facility, including individual rooms, and common areas Bob can more rapidly detect problems with the building HVAC system. Using smart building algorithms Bob can better manage energy efficiency and participate in energy demand response events. Using additional air quality sensors throughout the building Bob can also monitor levels of dust, mold and pollen to help identify optimal times for air filter changes or modifications to the HVAC.

Thank you

[1] HomeICE is an open source-based clinical dashboard using the MD PNP architecture. See http://www.mdpnp.org/MD_PnP_Program___OpenICE.html

Explanation / Answer

Business Policies and Procedures:

Arrangements are expansive articulations, received by a business, that set out what the business remains for and what its objectives are. Systems are normally actualized to backing every approach disclosing how to apply the strategy to the business' clients, representatives and items, and the guidelines important to take after the arrangement. Illustrations of territories where organizations normally establish arrangements are morals, HR, bookkeeping and client administration.

Morals:

Morals strategies address issues, for example, genuineness, decency, respectability and admiration. For instance, the long-standing morals approach with respect to trustworthiness established at Levi Strauss and Co. as cited by Inc.com peruses: "Genuineness: We won't say things that are false. We will never intentionally misdirect. We will be as real to life as could be expected under the circumstances, straightforwardly and openly sharing data, as suitable to the relationship."

HR:

Approaches forced in the range of HR location issues, for example, contracting and end, advantages, advancement and pay increment and order. For instance, a run of the mill HR arrangement tending to enlisting may read: New contracts might be liable to a three month trial period amid which job is 'freely.

Client Service:

Client administration arrangements address issues, for example, representative demeanor toward clients. A specimen arrangement managing client relations .All workers manage our clients No matter what your position, each representative effects the client somehow. Workers are reminded to advance the organization pretty much as they would speak to their families. This implies being agreeable and obliging on the business property, while going by our stores, driving our vehicles on streets and interstates and in day by day collaborations. All things considered, you never know who knows the individual you are conversing with Other ways workers can upgrade client connections are to answer telephones before three rings, exchange office calls effectively, complete on guarantees, give overhauls if vital, welcome stroll in clients or simply grin and make proper acquaintance. Regarding different as you hope to be dealt with goes far in client administration connections."

Bookkeeping:

Bookkeeping strategies manage how cash is taken care of in the organization, both the spending and the recording of inflow and out-stream. A case of a run of the mill bookkeeping arrangement in regards to receipt of blessings to an association may read: "Endowments of stock, securities, original copies, workmanship and collectibles are recorded and such data is straightforwardly accessible to officers, investors and representatives as with some other corporate resource."

Organization Policies and Procedures:

Organization strategies and methods build up the standards of behavior inside of an association illustrating the obligations of both workers and managers. Organization approaches and techniques are set up to ensure the privileges of specialists and the business hobbies of bosses. Contingent upon the requirements of the association, different strategies and methods build up principles in regards to worker conduct, participation, clothing regulation, security and different territories identified with the terms and states of vocation.

Worker Conduct:

A worker conduct approach sets up the obligations and obligations every representative must stick to as a state of livelihood. Conduct approaches are set up as a rule for suitable representative conduct, and they layout things, for example, appropriate clothing regulation, work environment wellbeing techniques, badgering arrangements and strategies with respect to PC and Internet use. Such strategies additionally diagram the methodology managers might use to train wrong conduct, including notices or representative end.

Square with Opportunity:

Square with circumstance laws are guidelines that advance reasonable treatment in the working environment. Most associations execute measure up to circumstance arrangements hostile to separation and governmental policy regarding minorities in society approaches, for instance to support fair conduct inside of the work environment. These strategies dishearten wrong conduct from representatives, directors and self employed entities concerning the race, sex, sexual introduction or religious and social convictions of someone else inside of the association.

Participation and Time Off:

Participation approaches set principles and rules encompassing worker adherence to work routines. Participation arrangements characterize how workers might plan time off or advise bosses of a nonappearance or late entry. This strategy additionally puts forward the results for neglecting to hold fast to a timetable. For instance, managers might permit just a specific number of unlucky deficiencies inside of a predefined time period. The participation approach examines the disciplinary activity workers face on the off chance that they miss a greater number of days than the organization permits.

Substance Abuse:

Numerous organizations have substance misuse arrangements that deny the utilization of medications, liquor and tobacco items amid work hours, on organization property or amid organization capacities. These approaches frequently diagram smoking systems workers must take after if permitted to smoke on business premises. Substance misuse strategies likewise examine the testing techniques for suspected medication and liquor misuse.

Work environment approaches and Procedures:

Administration Support:

It is urgent to have senior administration support for the execution or alteration of an arrangement, particularly where strategies identify with worker conduct. The underwriting and displaying of the conduct by senior directors and managers will urge staff to consider the strategies important. While administration support for an approach is an imperative initial step before effectively looking for worker input on a proposed strategy, the thought for the arrangement and some of its points of interest might actually originate from staff.

Counsel with staff:

Include staff in creating and actualizing work environment arrangements to advance more grounded mindfulness, comprehension and responsibility for result. Staff contribution likewise decides how and when the strategies may apply, and can help with distinguishing conceivable inadvertent results of the approach.

Characterize the terms of the strategy:

Be unequivocal. Characterize key terms utilized as a part of the approach toward the starting with the goal that workers comprehend what is implied. The arrangement ought to clarify what is adequate and inadmissible conduct in the working environment. You might wish to incorporate particular samples to outline issue ranges or unsatisfactory sorts of practices.

Email approach:

Utilizing the association's PC assets to search out, access or send any material of a hostile, profane or defamatory nature is denied and might bring about disciplinary activity.

Put the strategies in composing and expose them To be successful, arrangements should be promoted and gave to all current and new workers. This incorporates easygoing, low maintenance and full-time representatives and those on maternity leave or vocation breaks.

Approaches ought to be composed in plain English and effectively comprehended by all representatives. Consider making an interpretation of the approaches into the fitting dialects for representatives whose first dialect is not English.Ensure all staff comprehend what the arrangements mean. Disclose how to consent to the approaches and the ramifications of not agreeing.

Preparing and normal referral:

The approaches might be disclosed to staff through data and instructional meetings, at workforce gatherings and amid actuation sessions for new staff. They ought to likewise be emphasized and talked about with staff routinely at workforce conferences to guarantee they stay pertinent.

Duplicates of arrangements ought to be effectively available. Duplicates might be kept in envelopes in a focal area or staff regions, in staff manuals and accessible on the association's intranet framework.

Execution

It is essential that arrangements are connected reliably all through the association. A rupture of an arrangement ought to be managed quickly and as indicated by the techniques set out in the strategy. The result of the rupture ought to additionally suit the seriousness of the break whether it be a notice, disciplinary activity or release.

Assess and survey

Survey arrangements frequently to guarantee they are present and in accordance with any progressions inside of the association. Where arrangements are essentially transformed they ought to be re-issued to all staff and the progressions disclosed to them to guarantee they comprehend the association's new headings. These progressions should also be widely publicised.

Rules:

Most business exercises fall inside inadequate for which no expert ability is set as a condition for perfomance of the movement. The rules depict methods for getting all authorizations required for directing a business action, including all structures and applications.

The business arranging specialists at Business Resource Software, Inc. have composed various articles tending to parts of the creation, examination and documentation of your business and advertising techniques.

Dupont Chart:

Shows the relationship between key proportions and parts of a business.

Vital Marketing Plan:

This article addresses systems for valuing, circulation, advancement, publicizing and market division. Elements, for example, market infiltration, piece of the overall industry, net revenues, spending plans, money related investigation, capital venture, government activities, demographic changes, rising innovation and social patterns are likewise tended to.

Issues Influencing Price:

This article addresses an assortment of elements that ought to be considered while building up a cost for your item or administration. These incorporate evaluating techniques, the effect of your endeavor goals, the impacts of rivalry, the impact of the prospect's observation, qualities of your item or administration, your venture assets and ecological impacts.

Market Segmentation:

A business sector is made out of numerous purchaser bunches. These can be ordered by their requirements. Every class has one of a kind qualities that impact the choice to purchase.

Wage Statement:

A portrayal of the Income Statement, otherwise called the P&L Statement. It is a projection of your income and costs.

Income Statement:

A portrayal of the Cash Flow Statement. It anticipates if and when you will require a mixture of working capital.

Monetary record:

A portrayal of the Balance Sheet. It demonstrates the advantages, liabilities and money related strength of your business.

Money related Ratios:

Speculators utilize an assortment of proportions to assess your monetary projections. It is further bolstering your good fortune to comprehend the all the more normally utilized

regulation:

Guideline taking into account and intended to do a particular bit of enactment, for example, for the security of environment . Regulations are upheld as a rule by an administrative office shaped or ordered to complete the reason or procurements of an enactment. Additionally called administrative prerequisite.

Ecological Regulations

Ecological regulations can affect a business whenever. Whether you deliver items that could possibly hurt the earth, are occupied with agrarian cultivating, or need to discard toxins or unsafe or non-perilous waste – you should consent to the law. Organizations affected by fiascos, for example, flooding or fire, are additionally required to execute tidy up arrangements to dodge contaminations entering and harming the biological community.

Regulation of Financial Contracts :

In the event that you are directing business exchanges outside of your state, for example, obtaining cash, renting gear, building up contracts and offering products, you have to conform to the Uniform Commercial Code (UCC). UCC comprises of uniform principles organizing and streamlining the offer of merchandise and other business exchanges all through the United States.

Business exchanges frequently happen crosswise over state lines. Merchandise, for instance, might be made in one state, conveyed in another and sold to a client in a third state. Saving money and credit exchanges frequently happen between monetary organizations in one state and clients in another state.

Working environment Safety and Health Law:

As a little entrepreneur, furnishing laborers with a protected and sound working environment is basic to the wellbeing of your representatives and the achievement of your business yet it is additionally the law.

Under the Occupational Safety and Health Act businesses must give a working environment free from perceived dangers that cause, or are prone to bring about, death or genuine physical damage to your representatives.

Discover the Workplace Health and Safety Requirements that Apply to orderly manual for pinpoint which OSHA prerequisites apply to your work environment and in what manner can consent.

Demand an On-Site Consultation Service – Get free exhortation from prepared state government staff at your work environment.

State-Specific Requirements Some states do work their own occupation wellbeing and wellbeing programs. Check here to see which states have OSHA-endorsed plans and the gauges they command.

Preparing and Educational Programs – Take point of preference of a wide choice of instructional classes and instructive projects offered by the Occupational Safety and Health Administration for businesses.

Remote Workers and Employee Eligibility:

As you get ready to contract workers, make sure that you see all laws and regulations about representative qualification. Specifically, the Immigration and Nationality Act (INA) represents movement and citizenship in the United States. The INA is particularly vital to little entrepreneurs since it addresses vocation qualification, occupation check and non-separation. This aide gives a review of these procurements and help on the most proficient method to agree to the INA.

Worker Eligibility Verification

Government law requires you, as a business, to check a worker's qualification to work Within three days of enlisting another representative, you should complete an Employment Eligibility Verification Form, usually alluded This requires inspecting adequate types of the worker's documentation to affirm his or her citizenship or qualification to work in the United States. You can just demand documentation indicated on the structure. Managers who request different sorts of documentation not recorded on the structure might be liable to separation discrimination lawsuits.

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