FINANCIAL MANAGEMENT IN HEALTHCARE SYSTEMS - NURS 725
Fall 2014
Schedule Number
COURSE INFORMATION
Class Days: Mondays
Class Times: 1600-1840
Class Location:TBD
Professor: Jaynelle F. Stichler, DNS, NEA-BC, FACHE, FAAN
Contact Information: jstichler@mail.sdsu.edu
Office Hours Days: By appointment
Office Hours Times (and by appointment): TH
Office Hours Location: AH 3156
Course Overview
COURSE CATALOG DESCRIPTION: This course provides an overview of healthcare economics, develops budgeting
planning and management skills, and culminates in financial analysis skills necessary to facilitate management decision making
or writing business plans or grant proposals.
COURSE OVERVIEW
This course provides the student with an overview of the history of healthcare finance and financial management including
capital and operational budget planning and management; cost and resource allocation and cost-finding; review and analysis
financial reports; and other financial analysis skills such as break-even analysis, cost-benefit analysis and cost-effectiveness
analysis. The course focuses on experiential learning through the examination of real budget examples and applies skills
outlined in each topic with case studies, analysis of financial reports and data tables, and preparation of a final project (such as
a feasibility study, business plan or grant proposal). Evidence-based articles on healthcare financial issues in healthcare will be
critically appraised by the students with implications for management discussed in the classroom and/or in distance education
learning exercises.
COURSE OUTCOMES: Upon completion of this course the student will be able to:
1. Discuss the history of healthcare finance and how it affects policy today
2. Describe the economics of health care that affects nursing
3. Compare and contrast different models of health care payment systems
4. Compare and contrast different types of budgets used in health care organizations
5. Compare and contrast cost and resource allocation and cost-finding methods
6. Demonstrate skills in budget planning, cost-benefit analysis and break even analysis in solving case examples
7. Apply knowledge of financial formula in calculating profit, contribution margins, fixed costs, and revenue/expenses
per unit of service
8. Compare and contrast different financial statements
9. Perform basic financial statement analysis and variance justification
10. Describe the measurement indicators and budgeting of nursing care
11. Explain capital budgeting capital rationing, and capital decision process
12. Prepare a business plan or grant proposal for a case study
Enrollment Information
Prerequisites: Nursing 620
Course Materials
Required for ALL students:
 Textbook: Penner, S. J. (2013). Economics and Financial Management for Nurses and Nurse Leaders, 2 nd. Ed. New
York,NY: Springer Publishing Company. ISBN 978 – 0 – 8261 – 1049 – 7
 financial calculator
 laptop with Excel
Additional readings will be posted in Blackboard
Course Structure and Conduct
1
This course uses a “flipped” classroom process where the student is expected to have completed all assigned readings and
PowerPoint and other audiovisual presentations before the class. The class uses lecture-discussion in seminar format the
classroom and online, critiques, as well as internet searches.
Experiential learning with case studies will be used to amplify learning with hands-on experience in analyzing financial
statements and reports, developing cost-benefit and breakeven analyses, and writing a business plan or grant proposal. Guest
lecturers and student interviews with his/her financial officers and their respective organizations is expected.
The SDSU Blackboard system is used for all standard, supplementary course materials, and all course communication and
grades.
Course Assessment and Grading
Students earn a letter grade for the course based on satisfactory attainment of the course and clinical objectives and classroom
requirements. The grading criteria listed below are dependent upon successful completion of the course requirements.
Unsatisfactory performance in the classroom setting and on required assignments and exams will result in a failing grade for
Nursing 725.
The student's letter grade for the course will be derived as follows:
Class participation
100
Assignments or quizzes
100
Business Plan
100
Midterm examination (1)
100
Final examination (1)
100
Total points possible
500 points
Grades will be assigned as follows if the specified criteria1, 2, 3 are met:
A 93 - 100% (465 – 500 points)
A- 90 - 92% (450 – 460 points)
B+ 87 - 89% (435 – 445 points)
B 83 - 86% (415 – 430 points)
B- 80 - 82% (400 – 410 points)
C+ 77 - 79% (385 – 395 points)
C 73 - 76% (365 – 380 points)
C- 70 - 72% (360 – 350 points)
F
Less than 70% (349 points or less)
In-Class Quizzes
In-class quizzes will be conducted sporadically during class sessions. Full credit will be awarded for correct responses, halfcredit for incorrect responses, and no credit for non-responses. Quizzes will be based on required reading and material covered
during the course.
Exams
Each exam may include questions pertaining to material covered in the required reading, class sessions, as well as financial
calculation exercises. Any student unable to take an exam due to illness/injury or extraordinary circumstances must notify the
course coordinator PRIOR to the exam to be considered for a full-credit make-up exam prior to Finals Week. Such approval will
be at the discretion of the course coordinator and validation of illness/injury/circumstances may be required. Any student who
misses an exam without prior authorization will be allowed to take a make-up exam (which may differ from the original exam &
may differ in format) during Finals Week only, at a time to be specified by the course coordinator. In this instance, only fifty
percent (50%) of the score earned will be granted towards the course grade. Any student who arrives for an exam more than
15 minutes late will not be admitted and will have missed the exam without prior authorization. Students need 3 small red and
white ParSCORE Test Forms for the exams.
During exams, students must leave all parcels, phones, pagers, PDAs, etc. at the front of the room. Students are allowed to
have pencils, erasers, a calculator and one par score form at their desks. Once a test has begun, any student who leaves the
room will not be allowed to continue the test (so please make arrangements to use the bathroom before each exam begins so
that you do not need to leave the classroom during exams). Any student who, in the judgment of the faculty, is cheating during
2
an exam will receive a zero for that test and will be reported to the University Judiciary Committee for further action. It is the
responsibility of the student to avoid any behavior which could give rise to a suspicion of cheating. During test reviews, neither
writing nor recording are allowed.
Other Course Policies
Classroom Participation and Student Behavior
All students are expected to participate in classroom activities and behave in a professional manner. Tardiness is disruptive to
other students and will not be tolerated. Any behavior during class time that may be disruptive to other students, such as
talking or leaving the room unexcused, is unprofessional and will not be tolerated. Cell phones and all other electronic devices
should be turned off or on vibrate mode during class and are not to be used when class is in session. Following a single
warning, grade points may be deducted for any student behavior deemed inappropriate by the course coordinator.
Professional Standards
All students are expected to know and adhere to all standards contained within the School of Nursing Graduate Student
Handbook. All IN725 students are expected to conduct themselves in an ethical and professional manner at all times. The
American Nurses Association Code of Ethics for Nurses and the American Association of Critical Care Nurses (AACN) Standards
for Acute and Critical Care Nursing Practice provide specific guidelines for the professional nurse. The ANA code is included in
this syllabus. The AACN standards can be found at http://www.aacn.org/WD/Practice/Docs/130300Standards_for_Acute_and_Critical_Care_Nursing.pdf. All students are expected to comply with these standards at all times.
Failure to do so may result in course failure.
Academic Dishonesty
As stated in the SON Undergraduate Handbook: “The School of Nursing follows the University policy on academic
dishonesty/student discipline as identified in the San Diego State University General Catalog which states that any student may
be expelled, suspended, placed on probation, or given a lesser sanction for several campus related causes. Such sanction shall
include cheating or plagiarism in connection with an academic program at a campus. The above policy applies to both oncampus and off-campus activities. It includes such off-campus activities as falsifying clinical records or public documents.” See
the SON Undergraduate Handbook for further information and definitions of cheating, plagiarism, and disruptive behavior.
Referral to the Center for Student Rights and Responsibilities will be made as appropriate.
Information Regarding Off-Campus Course Work
This course requires students to participate in field trips, interviews, research or studies that include course work that will be
performed off-campus. Participation in such activities may result in accidents or personal injury. Students participating in the
event are aware of these risks, and agree to hold harmless San Diego State University, the State of California, the Trustees of
the California State University and Colleges and its officers, employees and agents against all claims, demands, suits, judgments,
expenses and costs of any kind on account of their participation in the activities. Students using their own vehicles to transport
other students to such activities should have current automobile insurance.
Disability Accommodations
If you are a student with a disability and believe you will need accommodations for this class, it is your responsibility to contact
Student Disability Services at (619) 594-6473. To avoid any delay in the receipt of your accommodations, you should contact
Student Disability Services as soon as possible. Please note that accommodations are not retroactive, and that accommodations
based upon disability cannot be provided until you have presented your instructor with an accommodation letter from Student
Disability Services. Your cooperation is appreciated.
Patient and Organizational Confidentiality
In accordance with ethical and legal regulations, patient and organizational confidentiality must be maintained at all times.
Students are expected to adhere to all HIPAA privacy laws. No patient name or identifying information related to specific
organizations will be used in class discussions or presentation material prepared by the student. Organizations and employees
will be identified by initials only.
WEEK
1
TOPIC
Economics and healthcare
History of HC Finance;
Introduction to HC Finance,
organizational structures and
ownership
Labor Day
NO CLASS
August
25
Sept 1
Content
Learning
Outcome
1
Assignment
Read: Penner chapters 1
3
WEEK
2
TOPIC
Paying for Health Services
Sept 8
3
Read: Penner chapters 2 & 3
www.commonwealthfund.org/p
ublications/publications_show.h
tm?doc_id=620087. Bending the
curve: options for achieving
savings and improving value in
US healthcare spending.
1
Budgets and budgeting
Profit and loss statements;
income and expense statements;
Managing operating budgets;
variance analyses;
1,2
Financial Statements
Income & Expense Statement
Balance Statement
Cash Flow Statement
8
Online Class
Strategic Planning; operational
planning; budgeting types &
decisions; variance analysis
3, 5, 6
Read: Chapter 6
Sept 29
5
1, 2
Assignment
Measuring nursing care;
productivity issues; measuring
patient acuity’s & relative value
units
Sept 22
5
Basic insurance concepts; HC
payer systems; MCOs; ACO’s;
Reimbursement methods
Learning
Outcome
Budgets and budgeting
Sept 15
4
Content
Read: chapter 4
Supplemental reading on BB
Read: chapter 5
Read: Chapter 12 -page 315-324;
Supplemental reading to be
assigned
Oct 6
Planning & Budgeting
7
Budget & Cost Analysis
Analysis and justification of costs
and budgets; cost benefit
analysis, cost-effectiveness
analysis
6
Read: Chapter 9
Financial & Making a
Business Case
Cost finding, breakeven analysis,
pricing and charging; and other
types of analyses
6
Read: Chapter 8
Mid-Term Exam
Writing a business plan; preparing
a grant proposal
12
Read: Chapter 10 and 11
Oct 13
8
Oct 20
9
Oct 27
10
Nov 3
Proposing new programs
with business planning and
grant proposals
On-line Class
Proposing new programs
with business planning and
grant proposals (continued)
Write business plan and pro
forma for proposed program
case study
Prepare your business plan or
grant proposal
12
Write business plan and pro
forma for proposed program
case study
4
WEEK
11
TOPIC
Planning & Budgeting
Nov 10
12
Nov 24
14
Dec 1
Dec 8
Capital budgeting & other specialpurpose budgets; capital
allocation; capital rationing;
justification for capital; Debt
financing; debt contracts; debt
ratings; equity financing; short &
long term debt; cost of capital
Learning
Outcome
Assignment
3,4,5
Read: Chapter 7
Financial statements &
analyses
Accounting Concepts; Analyzing
Financial Statements; Hospital
wide indicators
6,7
Read: chapter 12
Health policy and ethical
issues related to healthcare
finance
health economics issues; health
policy issues; future trends in
healthcare finance
4,5
Read: chapters 13 and 14
Business Plan presentation
& Class review for the final
exam
All chapters
Nov 17
13
Content
Presentation of Business Plan
Final Exam
5