Health Services Administration

Course Description

Health Services Administration provides an overview of management and leadership concepts in healthcare settings, including hospitals, long-term care, ancillary services, and public agencies. The curriculum addresses legal and regulatory concepts in healthcare, policy development, planning, organizing, staffing, and leading departments and facilities.

Within the SCNS taxonomy, HSA is the Health Services Administration prefix. Daytona State publishes this at 3 credits, offered fall, spring and summer.

Healthcare management differs from general management in a way that is easy to state and hard to internalise: the organisation's core work is performed by licensed professionals who are personally accountable to their own regulators, and the output is measured in human harm. A manufacturing manager who cuts corners produces defects; a healthcare manager who understaffs a unit produces preventable deaths, and the regulatory, legal, and reimbursement environment is built around that fact.

Daytona State does not publish a contact-hour figure for this course. It is an unsuffixed upper-division lecture course, and the institution's lecture convention is 15 contact hours per credit — AMH2010, GEB1011 and MAN2021 are all live at 3 credits and 45 hours. This course is priced at that convention.

Learning Outcomes

Required Outcomes

• Describe the structure of the American healthcare system.
• Describe the settings in which healthcare is delivered.
• Describe how healthcare is financed and reimbursed.
• Describe payers, including Medicare, Medicaid, and commercial insurance.
• Describe value-based and fee-for-service payment models.
• Describe the regulatory environment governing healthcare organisations.
• Describe accreditation and its relationship to licensure and payment.
• Describe conditions of participation and survey processes.
• Describe management functions in a healthcare setting.
• Apply planning and goal setting to a department.
• Describe organisational structure and design in healthcare.
• Describe staffing, scheduling, and workforce planning.
• Describe recruitment, retention, and the cost of turnover.
• Describe supervision, performance management, and development.
• Describe budgeting and financial management at departmental level.
• Interpret basic financial statements and departmental reports.
• Describe productivity and operational measurement.
• Describe quality management and improvement methods.
• Describe patient safety programmes and event reporting.
• Describe risk management and compliance functions.
• Describe policy development and implementation.
• Describe strategic planning and environmental assessment.
• Describe leadership in professional organisations.
• Describe ethical obligations of healthcare managers.

Optional Outcomes

• Describe healthcare marketing and community relations.
• Describe health information systems and their management.
• Describe population health management.
• Describe long-term care administration and its licensure.
• Describe public health agency administration.
• Describe healthcare policy at state and federal level.

Major Topics

Required Topics

• Structure of the healthcare system
• Delivery settings
• Financing and reimbursement
• Payers and coverage
• Value-based and fee-for-service models
• The regulatory environment
• Accreditation
• Conditions of participation and survey
• Management functions
• Planning and goal setting
• Organisational structure
• Staffing and workforce planning
• Recruitment, retention, and turnover
• Supervision and performance management
• Departmental budgeting
• Financial statements and reports
• Productivity measurement
• Quality management
• Patient safety and event reporting
• Risk management and compliance
• Policy development
• Strategic planning
• Leadership of professionals
• Managerial ethics

Optional Topics

• Healthcare marketing
• Health information systems
• Population health
• Long-term care administration
• Public health administration
• Health policy

Resources & Tools

• Your college library's health databases — free with enrolment; CINAHL, MEDLINE and PubMed access is the difference between a serious paper and a weak one.
• PubMed (pubmed.ncbi.nlm.nih.gov) — free; the primary index for health research literature.
• Agency for Healthcare Research and Quality (ahrq.gov) — free evidence reports, patient safety material, and practice tools.
• CDC and Florida Department of Health — free data, guidance, and state-specific health statistics.
• Your college writing centre — free, and upper-division health courses are writing-heavy.
• Professional association for your own discipline — practice standards and student membership; the standards are usually free to read.
• CMS (cms.gov) — free; conditions of participation, quality reporting programmes, and public data including Care Compare.
• The Joint Commission (jointcommission.org) — free National Patient Safety Goals and Sentinel Event Alerts; the alerts are short, specific, and among the best reading available on how healthcare harm happens.
• Agency for Health Care Administration (ahca.myflorida.com) — free; Florida's licensure and regulation of health facilities, and public facility data.
• ACHE — American College of Healthcare Executives (ache.org) — the professional body; student membership, and the FACHE credential as a long-term goal.

Career Pathways

• Health services managers and administrators — SOC 11-9111; strong projected growth and a large Florida sector.
• Clinical department and practice management — the usual destination for an experienced clinician moving into leadership.
• Quality improvement, patient safety, and accreditation roles.
• Compliance, risk management, and privacy officer roles.
• Utilisation review, case management, and care coordination.
• Health informatics and analytics.
• Long-term care and senior services administration — a very large Florida sector; note that nursing home administrators are separately licensed.
• Public health and community health agencies.
• Insurance, managed care, and payer organisations.
• Clinical research coordination and regulatory affairs.
• Continue to a graduate degree — MHA, MPH, MBA or MSN; most senior healthcare leadership expects one.

Special Information

⚠⚠ Fraud and abuse law binds managers personally — and the rules are counter-intuitive

• Healthcare has a body of fraud and abuse law with no real equivalent in other industries, and it reaches arrangements that would be ordinary business practice anywhere else.
• ⚠⚠ The Anti-Kickback Statute prohibits offering or receiving anything of value to induce referrals for services paid by federal healthcare programmes. It is intent-based and it is criminal, and "anything of value" is read broadly — meals, speaking fees, discounted rent, and equipment loans have all been at issue.
• ⚠⚠ The Stark Law prohibits certain physician self-referrals and is a strict liability statute — good intentions are not a defence, and a technical violation is a violation. This is the point managers most often get wrong.
• The False Claims Act reaches claims submitted to federal programmes that are false or unsupported, with substantial penalties per claim, and it permits whistleblower actions by employees.
• ⚠ Billing for services not rendered, upcoding, and unbundling are fraud, and so is submitting claims for services that were not medically necessary or not adequately documented.
• Exclusion from federal programmes is effectively a professional death sentence for an organisation, which is why compliance programmes exist and are taken seriously.
• Run arrangements past compliance and counsel before entering them — safe harbours and exceptions exist, and they are technical.
• ⚠ A manager who suspects improper billing must act. Knowing and continuing is far worse than discovering and correcting, and self-disclosure processes exist.
• ⚠ Rule 11 applies. These statutes and their regulations change; verify with counsel rather than relying on this guide.

⚠ Managing licensed professionals is not ordinary supervision

• Clinicians hold personal licences and personal accountability to their own regulatory boards, and a manager cannot direct a clinician to practise outside their scope or against their professional judgement.
• ⚠ A clinician who refuses an unsafe assignment is exercising a professional obligation, not being difficult, and pressuring them is a serious matter.
• Staffing decisions are patient safety decisions. The relationship between staffing levels and patient outcomes is well documented, which makes a budget decision a clinical one.
• Turnover is expensive and largely self-inflicted. Replacing an experienced clinician costs a substantial fraction of a salary, and the reasons people leave are usually workload, respect, and scheduling rather than pay.
• ⚠⚠ Punitive responses to error destroy reporting. If staff believe reporting an error leads to discipline, they stop reporting — and an organisation that cannot see its errors cannot prevent them. This is the single most important management insight in patient safety.
• Just culture distinguishes human error, at-risk behaviour, and reckless conduct, and responds differently to each. It is not the absence of accountability; it is accountability aimed correctly.
• Ask the people doing the work. Frontline staff know the workarounds, and a workaround is a defect report nobody filed.
• Support staff after adverse events. Clinicians involved in serious harm suffer measurably, and organisations that abandon them lose them.

How Florida course levels affect transfer

The first digit of an SCNS number denotes the year of offering, not transferability. Courses at the 1000 and 2000 levels transfer transparently between Florida public institutions, and 3000 to 4000 is unproblematic since both are upper division. The boundary that actually matters is 2000 to 3000, where lower-division credit generally cannot satisfy an upper-division requirement.

HSA4107 is 3 credits and approximately 45 contact hours, offered fall, spring and summer at Daytona State.

See this repository's HSA4353 (Organizational Behavior) guide for the companion course.