HCA 439 - Management Challenges in Long Term Care

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COLLEGE OF HEALTH AND HUMAN SERVICES
California State University, Long Beach
Health Care Administration Department
HCA 439 Management Challenges in Long-Term Care
Spring 2014 Syllabus
Instructor: Rebecca Perley, M.H.A., N.H.A.
Campus Phone: (562) 985-5694
E-mail: rebecca.perley@csulb.edu
Campus Office Hours: Monday, 9:00 – 10:00 am
Office Location: FOA 007
Course Number: 17188
Section Number: 1
Class Meets: Monday, 4:00 – 6:45pm
Class Room: HHS1-201
Additional Contact Information:
HCA Dept. Administrative Coordinator:
Deby McGill, dmcgill@csulb.edu
Office Location: HHS2-118
Tel. 562/985-5694; fax 562/985-5886
Course/Catalog Description
Functions and essential skills to manage LTC organizations and facilities: Institutional arrangements;
Patient/family/community relations; workforce management; marketing; reimbursement. (Lecture)
Letter grade only (A-F).
**Instructor reserves the right to alter or change the syllabus and/or assignments based on class needs .
Changes in the syllabus will be announced in class, via email and on the BeachBoard. It is a student’s
responsibility to remain updated on course changes.
Course Outcomes, Competencies, and Assessments.
The Health Care Administration Department has adopted a competency-based curriculum, based on the
American College of Health Care Executives (ACHE) Competencies Assessment Tool and the Healthcare
Leadership Alliance (HLA) Competency Directory. This course is designed to develop competencies in the
domains of Professionalism, Knowledge of the Healthcare Environment, Business Knowledge & Skills
(Financial Management, Human Resource Management), Communication and Relationship Management and
Leadership. The chart below describes course outcomes and how they will be met and measured.
Learning Objective
Domain
Competency
Identify the principal clients and
stakeholders of Skilled Nursing Facilities
Professionalism
Patients’ rights and
responsibilities
Identify the major state, federal and
regulatory agencies for LTC
organizations, and the statutory sources of
their authority.
Knowledge of the
Healthcare
Environment
Governmental,
regulatory,
professional, and
accreditation agencies
(e.g., CMS; JCAHO;
NCQA) related to
healthcare delivery
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Activities (A1) ,
Assignments (A2) &
Assessments (A3)
A1 – Field Trip, A1
– Guest
Presentation, A2 –
Research Paper, A3Exams
A1 – Field Trip,
A2- Research Paper,
A3- Exams
Learning Objective
Domain
Competency
Activities (A1) ,
Assignments (A2) &
Assessments (A3)
Differentiate between principal LTC
coverage including financing and payment
systems currently in use, including both
public and private payers.
Discuss physicians and other allied health
professionals’ roles and practice
Business Knowledge
& Skills: Financial
Management
Reimbursement
methodologies and
ramifications
A1- Guest
Presentation, A3Exams
Knowledge of the
Healthcare
Environment
Illustrate how support staff (e.g. nursing,
housekeeping, dietary) affect quality
assurance, quality of care and quality of
life.
Business Knowledge
& Skills: Human
Resource
Management
Nursing, physicians,
and allied health
professionals' roles
and practice
The varying work
environments in which
staff work
Discuss the role of the administrator in
overseeing the clinical, social, therapeutic
activity and facility management
functions of LTC organizations.
Communication and
Relationship
Management
Labor relations
strategies
Develop recommendations to improve the
LTC workplace through the application of
effective leadership, management
practices and culture change.
Leadership
Leadership
styles/techniques
A1- Guest
Presentation, A1 –
Field Trip, A3 Exams
A1- Movie
Presentation, A2Case Study
Presentation, A2 –
Research Paper, A3Exams
A1- Guest
Presentation, A2Case Study
Presentation, A3Exams
A1- Guest
Presentation, A2Case Study
Presentation, A3Exams
Text(s) and other course materials
 Required: Singh, Douglas. A. (2010). Effective Management of Long-Term Care Facilities. Sudbury,
Second Edition, MA: Jones & Bartlett Publishers. (Course text is on reserve in the library under instructor
and course name)
 Articles supplied by instructor, posted on BeachBoard and/or distributed in class.* (*If you miss a class
lecture it is your responsibility to procure materials distributed.)
 APA manual (6th Edition) is in the library under general reference
Student Assignments and Grading
1. Research Paper (60 pts)
A. Undergraduate (439) students: Select a Long-Term Care management challenge and research “best
practices” to address it within the U.S. healthcare system. Use a minimum of six (6) reference sources
from the course text and eight (8) references from professional literature (journals, articles,
documentaries etc.) Total paper: 13 pages.
B. Graduate (539) students: Select three (3) Long-Term Care management challenges and research “best
practices” to address it within the U.S. healthcare system. Use a minimum of ten (10) reference sources
from the course text and fifteen (15) references from professional literature (journals, articles,
documentaries etc.) Total paper: 17 pages.
The following must be followed for organization and formatting of your paper (439 and 539 students):
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A. Title page (1 page)
B. Abstract (1 Page) A three quarter to one-page summary of your thesis.
C. Outline (1 Page) Must be in correct outline form with aligned main headings and sub-headings. The
outline may serve as your Table of Contents.
D. Body of the paper (439 students: 10 pages, 539 students: 14 pages)
1. Clearly state what you are trying to prove. Include pertinent introductory information and the
Thesis Statement on the first page.
2. Detailed analysis of topic
3. Integration of original thought throughout analysis of topic
4. Use correct APA documentation throughout the paper with authors’ names, book or periodical
titles, and pages. Also, cite electronic sources.
5. You may use a movie as a starting point for your discussion of health issues affecting a minority
culture or a special needs/socially different group.
6. Optional: Table of figures, graphs, illustrations, photo-copied material.
7. Optional: survey results or interviews.
8. Last part of the paper –restate the thesis with a strong conclusion.
E. Formatting and References: APA Style. Page numbers/subheadings included on each page. Typed,
double space, 12 Font, normal margins.
439 students: 6 references from the text, 8 references from professional literature
539 students: 10 references from the text, 15 references from professional literature
F. Writing: Content, depth of analysis, original thought throughout paper, correct grammar, sentence
structure, spelling and syntax.
Use the drop box created on BeachBoard for submission.
Points will be deducted if the above format is not followed.
IMPORTANT: Plagiarism is a violation of Academic Ethics. All work not completely your own must be
documented.
2. Case Study and Team Presentation (60 pts)
Each group will prepare a case study on a topic to be approved by the instructor and present the information to
the class using a variety of visual and verbal methods.
A. A typed outline, with aligned main headings and sub-headings, must be submitted through the drop box
per the deadline in the syllabus. Included in your outline should be 6 research references. 4 references
must be from industry related publications and up to 2 may be from personal experiences.
B. You must clearly illustrate how your topic is affected by the current U.S. healthcare system.
C. You are responsible for facilitating a class discussion and creating a unique experience for the students
to learn about the case study.
D. A graduate student will lead each team.
E. Each team member must present information on the topic.
F. All team members will receive the same grade.
G. If a team is dissatisfied with a member(s) participation then the team must notify the instructor one
week prior to presentation day. An evaluation of each team member (including him/herself) will then
be submitted to the instructor on the day of presentation. Each team member will receive an individual
grade to be determined by the instructor. This is only necessary if member(s) of the group are unhappy
with another member(s) completion of team duties.
H. Presentation time: 20 minutes (including question and answer period)
I. Grading is based on clarity of presentation, the degree of class involvement your presentation
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encourages, cooperation with team mates and beginning/ending your presentation on time.
J. All presentation equipment is to be provided by the team (e.g. laptop, flash drive etc.) If a VGA cable
and/or audio cable is needed 72 hours advance notice to the instructor must be given. Apple devices
require special adaptors which cannot be provided by the instructor. It is the student’s responsibility to
determine if the audio/visual department has such adaptors available for use.
You will have time in class for team work sessions and consultations with the instructor.
3. Attendance, Preparation and Participation
Attendance
You are expected to engage with the material, ask questions, respond with answers and participate fully in each
class session. In order to do this you need to be in class. Students who attend class show their commitment to
learning! There will be an attendance roster that you must sign each session.
There will be no makeup opportunities for unexcused absences. Unexcused absences will impact a student’s
participation grade through the loss of opportunity to make up points for in class exercises. Students with
excused absences per university policy should contact the professor within 3 days of absence to receive a
makeup assignment. All make up assignments are due within 2 weeks of absence date and late submissions will
not be accepted.
The university policy defines excused absences as 1) illness or injury to the student; 2) death, injury, or serious
illness of an immediate family member or the like; 3) religious reasons (California Education Code section
89320); 4) jury duty or government obligation; 5) University sanctioned or approved activities (examples
include: artistic performances, forensics presentations, participation in research conferences, intercollegiate
athletic activities, student government, required class field trips, etc.) (CSULB Catalogue, 2010). To receive
credit for an excused absence you must submit documentation to the submission folder. Emails do not count.
You only need to contact the instructor about an absence, if it is on the day of an exam.
Attendance policy conforms to University policy:
http://www.csulb.edu/divisions/aa/grad_undergrad/senate/documents/policy/2001/01/.
In-Class Exercises
In Class Exercises (ICE) – must attend class to receive credit for the assignment
Preparation and Participation
You are expected to have read the assigned readings before the class session, to be prepared to comment on the
material (including the exercises) and to actively participate in class discussions. Lectures will cover highlights
of the reading and include supplementary information. If you have trouble understanding what you read or hear,
please ask for clarification in class or make an appointment with me to discuss the problem area(s). Disabled
students requiring special accommodations, please advise instructor.
Guest speakers
From time to time a guest speaker will present in class. Dates to be determined. You will learn more from guest
speakers if you ask questions during class. Topic matter may be included on the midterm and final exam.
Movie/Documentary
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From time to time a movie/documentary or portions of a movie/documentary will be shown in class. This
presentation will offer another avenue for you to learn about class material. If you have any restrictions on
movie content inform the professor. Topic matter may be included on the midterm and final exam. An in-class
exercise assignment may be due.
4. Exams
A. Midterm (80 pts)
The mid-term will be multiple choice/true-false format. The exam questions will come from assigned
readings and lectures. Chapters to be covered on the exam will be announced in class. Scantron will be
required.
B. Final (120 pts)
The final will be multiple choice/true-false format. The exam questions will come from assigned
readings and lectures. Chapters to be covered on the exam will be announced in class. Scantron will be
required.
5. Summary: Course Assignment Summary and Grade Weights
Item
Research paper
Case study and team presentation
Attendance (5 points/12 classes) and Participation
In-Class Exercise (4 assignments)
Points
60
60
60
Percent
15%
15%
15%
20
5%
Midterm exam
80
20%
Final exam
120
30%
Total
400
100%
Final Course Grade Thresholds:
A = 400-360
B = 359-320
C = 319-280
D = 279-240
The total number of points determines your grade. There will be no curving.
6. Course Schedule and Assignments
Session # and
Topic
Date
1. 1/27
Introduction to HCA 439/539
Review syllabus, question/answer
The “Savages” Movie Clips
“So you want to be a CNA” Video
2. 2/3
Overview of Long-Term Care
Long-Term Care Policy: Past, Present,
and Future
3. 2/10
The Long-Term Care Industry
Legal Environment
4. 2/17
Regulation and Enforcement
Reading
Assignments
F = 239-0
Class Work/Deliverables
Chapter 1
Chapter 2
Chapter 3
Chapter 5
Chapter 6
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Mandated Reporter/Abuse
Video
Form Case Study Teams &
Select Topic
5. 2/24
Financing and Reimbursement
Chapter 7
Kiplinger Video
Work with Team
Post Case Study Team Topic
on Discussion Board and in
Group Drop Box
6. 3/3
Social Services, Admission, and
Discharge
Medical Care, Nursing, and
Rehabilitation
Chapter 9
Work with Team
Chapter 10
7. 3/10
“Away From Her” Movie
8. 3/17
Midterm Exam
9. 3/24
Recreation and Activities
Dietary Services
10. 3/31
Spring Break
11. 4/7
Plant and Environmental Services
Administrative and Information Systems
Chapter 13
Chapter 14
Research Paper Due
12. 4/14
Case study presentations
N/A
13. 4/21
Case study presentations
N/A
14. 4/28
Effective Governance, Leadership, and
Management
Effective Human Resource and Staff
Development
Chapter 15
All Case Study Group
outlines due
Case study presentations
Group 1-4
In-Class Exercise (5 points)
Case study presentations
Group 5-8
In-Class Exercise (5 points)
Case study presentations
Group 9-11
In-Class Exercise (5 points)
15. 5/5
16. 5/12
In-Class Exercise (5 points)
Research paper topic due
Chapters 3, 5-7,
9, 10
Chapter 11
Chapter 12
Ethical issues facing LTC administrators
Effective Budgeting and Financial
Controls
Effective Quality and Productivity
Management
Final Exam 5:00 – 7:00 p.m.
Chapter 16
Work with Team
Chapter 18
Chapter 19
Chapters 11-16
7. Classroom Rules
Turn off and put away laptops, cell phones or other electronic devices before class begins. Violation of
HCA 439/539
this policy will result in 1. First time per semester "verbal warning," 2. 2nd time excused for class
session that day and written warning, 3rd time per semester 5 points deducted from course score and
each violation thereafter.
No eating during class.
Arrive on time
Actively participate in all classroom activities and discussions.
Be respectful of others’ opinions and perspectives.
You are responsible for ALL weekly reading assignments and are expected to have read the chapter
prior to attending the lecture.
Check BeachBoard regularly, including the gradebook. If there is any discrepancy between the posted
grades and your records, advise the instructor immediately.
Rules on academic dishonesty will be strictly enforced. See “cheating and plagiarism” below. Text
messaging during a quiz or exam will result in your exam being voided for presumed cheating and a
grade of 0 points.
Rules of the college catalog apply in this classroom.
8. Grading Policies
Rubrics (grading scoresheets) will be provided for all written assignments.
Assignments are due on the date specified. All assignments must be submitted to the appropriate drop
box on BeachBoard before class begins. Late work will not be accepted. Draft submissions: You may
submit a draft of your individual paper for review and comment 2 weeks before the due date of each
of each assignment. I will assign a preliminary grade, and offer suggestions for improvement.
Submitting a draft offers you an opportunity to revise and resubmit your work and earn a better grade,
but there is no guarantee. Your submission must be documented APA style and submitted through the
assigned drop box on BeachBoard. If you submit a draft assignment and are satisfied with your grade,
you do not need to resubmit. NO ASSIGNMENTS ACCEPTED AFTER THE LAST DAY OF
CLASS.
Students absent for a scheduled presentation, quizzes, or the final exam must provide written third party
documentation of unforeseen and unavoidable circumstances in order to be eligible to take a make-up
quiz or exam or reschedule the presentation.
Students absent for a class session in which a graded in-class exercise is conducted who wish to receive
make-up credit must provide either: 1) prior written request to instructor stating reason for absence; or
2) written third party documentation of unforeseen and unavoidable circumstances. Instructor will
evaluate requests on a case by-case basis, and may request additional documentation.
Disabled students, who qualify for alternative testing arrangements, please advise the instructor at least
2 weeks prior to the exam.
9. Expectations of Student Skill Performance
Write clearly and concisely, using correct grammar, punctuation and spelling.
Cite all references using APA style.
Communicate articulately in oral presentations; use appropriate audio-visual aids.
Search the web and research publications and apply the information found.
Analyze information, both numeric and text; don’t just present data.
Apply internationally-accepted metrics to compare health and healthcare systems.
Synthesize information about factors that impact health and healthcare systems.
Compare and contrast countries, situations, historic and current times.
Participate in class discussions.
Submit all assignments on time through BeachBoard drop box dedicated to that assignment.
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10. Student Responsibilities and University Policies
Assignments are due before class on the date specified. If you submit a draft assignment and are
satisfied with your grade, you do not need to resubmit. Late work will not be accepted. All work must
be submitted to the appropriate drop box on BeachBoard before class begins. Once the instructor has
collected the assignment, all other assignments are considered late. Students who miss class or appear
late for class will be penalized. Students may have a valid reason to miss a class. When any of the
following reasons (see below) directly conflict with class meeting times, students are responsible for
informing the instructor of the reason for the absence and for arranging to make up missed assignments,
tests, quizzes, and class work insofar as this is possible. Assignments/papers are NOT accepted by
e-mail.
Campus Behavior “Civility Statement-Civility and mutual respect toward all members of the
University community are intrinsic to the establishment of excellence in teaching and learning. The
University espouses and practices zero tolerance for violence against any member of the University
community. A threat of violence is an expression of intention that implies impending physical injury,
abuse, or damage to an individual or his/her belongings. All allegations of such incidents will be
aggressively investigated. Allegation that are sustained may result in disciplinary action up to and
including dismissal from employment, expulsion from the University, and /or civil and criminal
prosecution.” (CSULB Catalog, AY 2010-2011, p. 743).
Unprofessional and Disruptive Behavior-It is important to foster a climate of civility in the classroom
where all are treated with dignity and respect. Therefore, students engaging in disruptive or
disrespectful behavior in class will be counseled about this behavior. If the disruptive or disrespectful
behavior continues, additional disciplinary actions may be taken.
Cheating and Plagiarism. Please be aware of and ensure that your behavior conforms to University
Policy, as contained in the California State University, Long Beach Policy Statement 80-01:
http://www.csulb.edu/divisions/aa/grad_undergrad/senate/documents/policy/2008/02. All papers will be
screened for plagiarism using the “TurnItIn” software system. Your “TurnItIn” percentage must be less
than 25%.
Although the University catalog does not cover this aspect of plagiarism, please be aware that it is NOT
acceptable to submit the same paper for two courses. If you want to write a paper on the same topic area
for two different courses, you must submit two different papers. If I discover that you have submitted
the same paper for another course, you will receive an “F” for your paper in this course.
E-mail address and Internet access to use the online BeachBoard course software system. All grades
including attendance will be posted on the online BeachBoard. For problems, contact the CSULB
Technology Help Desk by phone at 562-985-4959, via e-mail at helpdesk@csulb.edu or go in-person to
Horne Center.
Disabilities. It is the student's responsibility to notify the instructor of record in advance of a need for
accommodation of a disability that has been verified by the University. Instructor may require
confirmation of disability and evaluation of accommodation request from Disabled Student Services.
Withdrawal policy. Withdrawal is the responsibility of student. Per University policy:
http://www.csulb.edu/divisions/aa/grad_undergrad/senate/documents/policy/2002/02/. Withdrawal after
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2nd week and before final 3 weeks is “permissible for serious and compelling reasons;” instructor will
evaluate student withdrawal requests on a case by case basis.
Communications: Students are expected to check email and BeachBoard accounts regularly for class
announcements and their standing in the course.
E-Cigarettes: Are not allowed in the classrooms.
Leaving class early will result in an absence for the day unless the student has made arrangements with the
instructor in advance.
11. Additional Resources
Books
Allen, J.E. (2006). Nursing home federal requirements: Guidelines to surveyors and survey protocols (6th Ed.).
New York: Springer
Allen, J.E. (2003). Nursing Home Administration (5th Ed.). New York: Springer.
Baxendale, S.J., Gupta, M. & Raju, P.S. (2005). Profit enhancement using an ABC model: Excel planning
model optimizes process improvement efforts at a retirement and assisted living community.
Management Accounting Quarterly 6(2):11-22. Retrieved April 6, 2008 from ABI/Inform.
Bradley, M.G., & Thompson, N.R., (2000). Quality management integration in long-term care: Guidelines for
excellence. Baltimore, MD: Health Professions Press.
Evashwick, C. (2005). The continuum of long-term care (3rd Ed.). Albany, NY:
Delmar Publishers, Inc.
Evashwick, C. & Holt, T. (2000). Integrating long-term care, acute care, and housing: St. Louis: Catholic
Hospital Association.
Gift, R. & Kinney, C.(1996). Today’s management methods. Chicago: American Hospital Publishing (Classic).
Harris, M.D. (2005). Handbook of home health care administration. Sudbury, MA: Jones & Bartlett.
Kissler,G. (1996). Leading the health care revolution. Chicago: Health Administration Press (Classic).
Kouzes, J. & Posner, B. (1995). The leadership challenge. San Francisco: Jossey-Bass (Classic).
Lazer, D. & Schwartz-Cassell, T. (1998). Adding value to long-term care: An administrator’s guide to
improving staff performance, patient experience, and financial health. San Francisco: Jossey-Bass.
Longest, Jr., B., & Darr, K. (2008). Managing health services organizations and systems (5th Ed). Baltimore,
MD: Health Professions Press.
McKeon, T. (1996). Home health financial management. Gaithersburg, MD: Aspen.
Namazi, K.H. & Chafetz, P.K. (2001). Assisted living: Current issues in facility management and resident care.
Westport, CT: Auburn House, Greenwood Publishing Group.
HCA 439/539
Pearce, B.W. (1998). Senior living communities: Operations management and marketing for assisted living,
congregate and continuing-care retirement communities. Baltimore, MD: Johns Hopkins University
Press.
Ross, A., Wenzel, F. & Mitlying, J. (2002). Leadership of the future: Core competencies in healthcare. Chicago:
Health Administration Press.
Stevenson-Brown, K. (2000) Guide to long-term care financial management. San Francisco: Jossey-Bass.
U.S. Government Accounting Office. (2004, April). Assisted living: Examples of state efforts to improve
consumer protections. Washington, DC: Author. Retrieved April 6, 2008 from
http://www.gao.gov/new.items/d04684.pdf.
Vinz-Miller, T. (1998). Outcome based quality improvement for long-term care. Gaithersburg, MD: Aspen
Publishers, Inc.
Yeatts, D.E., Cready, C.M., & Noelker, L.S. (2008). Empowered work teams in long-term care: The family
guide to improving communication. Baltimore, MD: Health Professions Press.
Journals
Frontiers of Health Service Management
Health Care Financial Management
Journal of Health and Human Services Administration
Long Term Care Monthly
McKnight’s Long Term Care News
Modern Healthcare
Web Sites
American Health Care Association Home Page www.ahca.org
American College of Healthcare Executives Home Page, www.ache.org
American Hospital Association Home Page, www.aha.org
California Association of Health Care Facilities (CAHF) Home Page, www.cahf.org
Centers for Medicare and Medicaid Services, Home Health Agency Center:
http://www.cms.hhs.gov/center/hha.asp.
Journal of Science and Health Policy Home Page, www.scipolicy.net
National Clearinghouse for Long-Term Care Information,
http://www.cms.hhs.gov/Partnerships/LTCInformation.asp.
University of Minnesota. NH Regs Plus: http://www.hpm.umn.edu/nhregsPlus/.
HCA 439/539
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