Emergencies often occur at night or during adverse weather conditions. This chapter provides an overview on the importance of integrating six key variables to achieve operational safety in medical emergency transportation systems and how it can be generalized to general acute health care situations for elders. They are the organizational culture, situation awareness, its safety culture, safety management, risk management, and training. In the case of pilots flying medical emergency helicopters, organizational culture may influence the crew’s perception of the critical factors in their immediate environment that informs their situation awareness. Several types of stress factors can exist in the medical emergency transportation environment, as well as in other senior-citizen-focused health care. Health care practitioners must be familiar with the safety regulations that govern the operations of medical emergency systems in their communities or regions.

This section discusses how to use financial information to better control the facility by carefully managing: accounts receivable; patient census reports; third-party payers; Medicare cost reconciliation statements; account write-offs; cash handling; planned bill paying; inventory control; and payroll management techniques. Although accounting processes are similar in every institution, the procedures for managing finances will vary from facility to facility, and so will the best control methods. In financial management, control refers to the development and maintenance of systematic ways to identify problems when they occur to permit the administrator to intervene appropriately. The facility cannot receive money for services rendered until the resident has been billed for them. An appropriate collections policy will depend on the facility's previous experience with its payers. Agreeing to take responsibility for these assets must be confirmed through a legal contract signed by both the facility and the resident or their sponsor.

An administrator’s duties encompass nearly every aspect of managing the facility, from assisting in professional medical staff recruiting to ensuring the efficient operation of the laundry department. The administrator is the one person held accountable for the entire financial operation of the facility. This section explores individual functions, that the bookkeeper primarily records the daily cash transactions of the facility, keeping track of all money going out or coming in. The accountant uses the information compiled by the bookkeeper to generate reports on the facility’s financial standing. The section discusses the steps the administrator takes in strategic business planning for the facility. The administrator is responsible for the effective operation of the nursing facility to its residents and their significant others, to the employees, to the owner(s) or stockholders, and the facility’s governing body. When signs of ineffective financial management become apparent, the administrator is held accountable to each party.