Ethical conflict
Order Instructions:
Responsibilities of Nonprofit Health Care Organizations
In 2006, 59% of the hospitals in the United States were nonprofit. As you read in the Government Accountability Office (GAO) report on nonprofit hospitals, a hospital must provide benefit to the community to maintain this tax-exempt status, but there is some latitude from the Internal Revenue Service and other governmental agencies about what qualifies as community benefit.
In this Discussion, you will analyze the extent to which a nonprofit hospital is legally and ethically responsible to provide community benefit, using the ACHE decision-making model to guide your analysis of the following scenario:
The management team of Memorial Medical Center (MMC) must make a decision regarding the continuation of one of its outpatient clinics. To provide better community service, MMC developed three outpatient clinics throughout a large metropolitan area. Over the past several years, one of the clinics has consistently been a financial loser. The losses have grown even as the costs of maintaining the clinic have increased. A primary reason for the negative financial performance is the high amount of non-reimbursed health care services—the clinic provides needed health care to a low-income part of the metropolitan area.
Several members of the executive management team believe that MMC has no alternative other than closing the clinic. One member of the management team, however, believes that the situation raises ethical concerns and that the executive team needs to seek an ethics-grounded response to the problem. (Nelson, p. 9)
These are the question to answer below. (To prepare for this Discussion):
•Review the GAO report (http://www.gao.gov/new.items/d08880.pdf), paying particular attention to its discussion about criteria for nonprofit status.
•Review the article “An Organizational Ethics Decision-Making Process,” and apply the steps of the decision-making model to this scenario, going into more detailed analysis than is already provided in the article. What options does this hospital have? Clarify your ethical reasoning for each option.
•If you were an administrator at MMC, what decision would you make.
Article to read to answer the question along with your own.
•Article: Nelson, W. A. (2005). An organizational ethics decision-making process. Healthcare Executive, 20(4), 8–14. Retrieved from http://ezp.waldenulibrary.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=17407169&site=ehost-live&scope=site
This reading was assigned in Week 2. Review it with this week’s content in mind. You will be applying the ethical decision-making model in Discussion 1.
•Article: Callendar, A. N., Hastings, D. A., Hemsley, M. C., Morris, L., & Peregrine, M. W. (n.d.). Corporate responsibility and health care quality: A resource for health care boards of directors. Retrieved Nov. 23, 2009, from http://oig.hhs.gov/fraud/docs/complianceguidance/CorporateResponsibilityFinal%209-4-07.pdf(PDF Document)
This article offers guidance to health care organization corporate directors regarding elements of the quality oversight process, including measurement tools and requirements for health care quality and reporting.
•Report: U.S. Government Accountability Office. (2008). Nonprofit hospitals: Variation in standards and guidance limits comparison of how hospitals meet community benefit requirements. Retrieved from http://www.gao.gov/new.items/d08880.pdf (PDF Document)
?”Letter” (pp. 1–40)
ACHE Policy Statement: Ethical Decision Making for Healthcare Executives
http://www.ache.org/policy/decision.cfm
