Effective: Late Spring 8-Week, 2018/2019

MGMT 353: Legal And Ethical Aspects Of Healthcare

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  Course Description

An overview of key laws and ethical issues that affect the delivery of health care.

Prerequisites: MGMT 265, MGMT 368.

Proctored Exams: None


As part of TruitionSM, students will receive their course materials automatically as described below.


  • Pozgar, G. D. Legal Aspects of Health Care Administration. 13th ed, Jones and Barlett, 2019.  
    • Note: This book is sold with digital access to Navigate 2 Advantage included, however, this course does not require the digital access.

Bookstore Information

Visit https://www.ccis.edu/bookstore.aspx for details.

eText Information

If a course uses an eText, (see textbook information above) the book will be available directly in Desire2Learn (D2L) seven days before the session begins, if registered for courses prior to that date. Upon first login to VitalSource, students should use their CougarMail email address; alternate email addresses cannot be used. More information about how to use the VitalSource platform, including offline access to eTexts, can be found in D2L.

Physical Course Materials Information

Students enrolled in courses that require physical materials will receive these materials automatically at the shipping address on file with Columbia College. Delivery date of physical materials is dependent on registration date and shipping location. Please refer to confirmation emails sent from Columbia College for more details on shipping status.

Returns: Students who drop a course with physical course materials will be responsible for returning those items. Additional instructions will be emailed to your CougarMail account after the enrollment period for the session has closed. Failure to return physical items from a dropped course will result in a charge to the student account for all unreturned items.

Note: Students who opt-out of having their books provided as part of TruitionSM are responsible for purchasing their own course materials.

  Course Overview

This course offers a guide to recognizing, understanding and complying with current laws and ethical standards relevant to health care management. We will explore judicial, legislative, agency and licensing authority and regulations and the rights and responsibilities of health care employers, employees, contractors, patients, and other stakeholders in the health care system. Students will gain knowledge through assigned readings, online discussions, and review of relevant case law, identifying key legal and ethical issues and synthesizing facts and law to given health care situations.

  Technology Requirements

Participation in this course will require the basic technology for all online classes at Columbia College:
  • A computer with reliable Internet access
  • A web browser
  • Acrobat Reader
  • Microsoft Office or another word processor such as Open Office

You can find more details about standard technical requirements for our courses on our site.

  Course Learning Outcomes

  1. Explain how healthcare laws are administered and enforced.
  2. Describe the legal rights and obligations that affect patients, healthcare personnel, and healthcare organizations.
  3. Explain patient privacy and confidentiality regulations.
  4. Describe how healthcare managers apply risk management concepts to the healthcare industry.
  5. Describe and explain the moral dilemmas and issues of healthcare personnel.


Grading Scale

Grade Points Percent
A 900-1000 90-100%
B 800-899 80-89%
C 700-799 70-79%
D 600-699 60-69%
F 0-599 0-59%

Grade Weights

Assignment Category Points Percent
Discussions 320 32%
Short Papers 160 16%
Research Paper 200 20%
Quizzes 320 32%
Total 1000 100%

  Schedule of Due Dates

Week 1

Assignment Points Due
Discussion 1 20 Wednesday/Sunday
Discussion 2 20 Friday/Sunday
Quiz 1 40 Sunday

Week 2

Assignment Points Due
Discussion 3 20 Wednesday/Sunday
Discussion 4 20 Friday/Sunday
Quiz 2 40 Sunday

Week 3

Assignment Points Due
Discussion 5 20 Wednesday/Sunday
Discussion 6 20 Friday/Sunday
Paper 1 80 Sunday
Quiz 3 40

Week 4

Assignment Points Due
Discussion 7 20 Wednesday/Sunday
Discussion 8 20 Friday/Sunday
Quiz 4 40 Sunday

Week 5

Assignment Points Due
Discussion 9 20 Wednesday/Sunday
Discussion 10 20 Friday/Sunday
Paper 2 80 Sunday
Quiz 5 40
Research Paper Topic

Week 6

Assignment Points Due
Discussion 11 20 Wednesday/Sunday
Discussion 12 20 Friday/Sunday
Quiz 6 40 Sunday

Week 7

Assignment Points Due
Discussion 13 20 Wednesday/Sunday
Discussion 14 20 Friday/Sunday
Research Paper 200 Sunday
Quiz 7 40

Week 8

Assignment Points Due
Discussion 15 20 Wednesday/Saturday
Discussion 16 20 Friday/Saturday
Quiz 8 40 Saturday
Total Points: 1000

  Assignment Overview

Discussion Assignments

There will be two graded discussions each week on topics addressed in the readings. The first initial post to the discussion must be completed by Wednesday night; the other two responses must be completed by Sunday night (except in Week 8, when all work is due by Saturday).

The initial post to the second discussion must be completed by Friday night, and the two responses (minimum; more are always welcome to any discussion) must be completed by Sunday night.

A minimum of six (6) substantive posts per week is expected.

Your initial response to each discussion question or prompt should be a full paragraph in length (8-10 sentences) and demonstrate your familiarity with and thoughtful analysis of the readings.

In addition, you are expected to respond to at least 2 classmates in each discussion by the deadlines. Responses should be substantive posts that advance the discussion. Reflect the strengths of their comments and/or challenge them when you disagree (politely, of course). Pose questions that will engage your classmates in further discussion.

You do not have to have significant citation for use in your posts, in fact, I urge you to present your own opinions and responses, rather than someone else’s (you can’t have your own facts, though). Do not post lengthy quotes from your text or other sources without a really good reason for doing so.


You will write two (2) shorter papers, and one longer research paper for the course. The shorter papers are due at the end of Week 3 and Week 5, and should be a minimum of 800 words in the body. These papers will involve your understanding and analysis of a case covered in our readings.

Papers 1 and 2: For Paper 1, choose one case discussed in Chapters 1, 2, 7, 8, or 9 (material from weeks 1-2). For Paper 2, you will choose any case from Chapters 3, 6, 10-15, 17, 19, or 24 (material from weeks 3-5).

You must look up the full case either online or in an official reporter and give the full and correct citation for it, and follow it with the page in our text on which it is found. Identify and list the relevant facts of the case, the issue presented, and the applicable law; and then, discuss the court’s ruling. Keep your facts focused on only the relevant ones, and carefully elicit the crucial issue of the case; thinking about why this case is included in our book and its significance.

Indicate whether you agree or disagree with the decision, but most importantly, why, not just what Pozgar states. Cite your text and other sources (including cases, if appropriate) that support or contradict the court’s decision. Identify key facts determinative to the court’s decision. Then, discuss your case; include evidence of critical thinking.

Your analysis can take many forms, but one approach might be to describe a different fact pattern that might lead to a different outcome. For example, if the court found one party to be liable, list the facts or issue that would have changed the case. Or, perhaps the court used a law that is no longer applicable, or the decision is very narrowly made on a very peculiar set of facts and or law.

Make an attempt to choose a case to analyze that both interests you, does not seem clear-cut, or that at least poses some challenges in its analysis.

The longer research paper is due at the end of Week 7 and should be a minimum of 2000 words. This paper will discuss a minimum of four (4) related court decisions, either from our text, or reported elsewhere (check with me when you propose your topic if you want to use other cases). You will compare and contrast the facts, issues, and holdings of these cases, identifying both the similarities and differences. “Related” refers to cases with the same general subject matter, such as cases regarding birth control, cases dealing with end-of-life issues, or cases regarding employer-employee law. Refer to the analysis examples for Papers 1 and 2.

You can find a rubric for the research paper in the Content section of this course. The paper will be graded on your demonstrated grasp of the basic subject matter, critical thinking, and analysis, supported by existing research and logical thought. The paper should use The Blue Book, A Uniform System of Citation (www.legalbluebook.com) format for citations, and include materials from credible and authoritative sources, such as those found at the Columbia College Stafford Library and reported court decisions. Some citing of other news sources such as newspapers, magazine articles is acceptable; however, the bulk of your research should include current authoritative sources from acceptable authorities on your chosen subject and current data.

All three of these papers will be posted and shared with your classmates and discussion will be encouraged.


You will have a quiz each week to test your understanding of the readings for the course. Quizzes will include 15 multiple-choice questions and include a short answer question requiring about a 5-sentence minimum response. You will have 50 minutes to complete each quiz.


This course does not allow you to submit work that has been previously submitted for any other course, or, that has been submitted for any other assignment earlier in the course.

  Course Outline

Click on each week to view details about the activities scheduled for that week.

Ch. 1-2
Discussion 1
Introduce yourself to me and to your classmates. Tell us something about your interest in the field of health care management. What is your experience with and knowledge of laws, regulations, and ethics related to health care? Also feel free to share information about your hobbies, family, educational goals, and favorite books so that we can get to know one another as the class begins. Respond to at least two classmates’ posts.
Discussion 2
A major change in health care law in the U.S. is the recent the passage of the Patient Protection and Affordable Care Act of 2010. How did each of the various sources of our laws—common, statutory, and administrative—play a role in making the PPACA law?
Quiz 1
Covers material in Chapters 1-2
Ch. 7-9
Discussion 3
Discuss the essential elements of an enforceable contract and the significance of each element. Describe a contract, possibly one in which you were a party, were involved, or of which you have personal knowledge, indicating whether the contract was express, implied, written or oral, and whether it was it breached or disputed. Did it contain the essential elements of enforceability? Did you learn anything from this experience, and if so, what would you do differently in entering into future contracts?
Discussion 4
Describe the general process of initiating a civil lawsuit, including the documents generally required and the considerations in determining the basis of a valid claim. As a defendant, what are your general rights and responsibilities in a civil lawsuit?
Quiz 2
Covers material in Chapters 7-9
Ch. 6 and 10-12
Discussion 5
The 1987 “Anti-Kickback Statute” (MMPPA) prohibits giving of or receiving compensation in exchange for referrals for Medicare or Medicaid services or goods. Why is it fraudulent and subject to a charge of criminal conspiracy to pay referral sources from Medicare and Medicaid reimbursement? Does payment or receipt for referrals constitute “obtaining property from more than one source by fraudulent pretense,” or is it billing for services not rendered, or falsifying information or misrepresentation? Does it make a difference if either the referring source or the referral receiver has a financial ownership or interest in the other’s entity?
Discussion 6
What role does an HCO play in supervising direct patient care by employees and independent contractors, such as physicians and nurses, and under what circumstances is an HCO liable for their criminal acts or negligence?
Paper 1

Choose one case, with my approval, discussed in Chapters 1, 2, 7, 8, or 9. Identify the relevant facts of the case, the issue presented, and applicable law; then discuss the court’s ruling. Indicate whether you agree or disagree with the decision, and why. Cite your text or other sources that support or contradict the court’s decision. Identify key facts determinative to the court’s decision and describe a fact pattern that might lead to a different outcome.

This paper should be at least 800 words in length. Share a complete draft of your paper with classmates in the appropriate discussion topic and provide feedback on their work. Submit your final version to the Dropbox by Sunday night.

Quiz 3
Covers material in Chapter 6 and Chapters 10-12
Ch. 13, 14, and 18
Discussion 7
Under what circumstances, and for what reasons, is confidential information generated by a provider or an HCO legally “discoverable,” and when is it not discoverable, but privileged?
Discussion 8
What medical care requires patients’ consent, and who or what entity is ultimately responsible for obtaining consent? What are patients’ rights to refuse consent to life-saving care for themselves or for their children? What are patients’ remedies if the refused care?
Quiz 4
Covers material in Chapters 13-15, 19, and 24

Ch. 15 and 22

Discussion 9
What are the principles of and differences between normative, consequential, situational, utilitarian, deontologic, nonconsequential and relative ethics approaches? Which approach is best suited to health care management and why?
Discussion 10

Describe the purpose and process of utilization review (UR). Then explain how UR is performed prospectively, concurrently, or retrospectively.

Paper 2

Choose one case, with my approval, discussed in Chapters 3, 6, 10-15, 17, 19, or 24. Identify the relevant facts of the case, the issue presented, and applicable law; then discuss the court’s ruling. Indicate whether you agree or disagree with the decision, and why. Cite your text or other sources that support or contradict the court’s decision. Identify key facts determinative to the court’s decision and describe a fact pattern that might lead to a different outcome.

This paper should be at least 800 words in length. Share a complete draft of your paper with classmates in the appropriate discussion topic and provide feedback on their work. Submit your final version to the Dropbox by Sunday night.

Quiz 5
Covers material in Chapters 3 and 17
Research Paper Topic

Submit your paper proposal to the Dropbox, describing your topic in a minimum of 4-5 sentences. Choices of topics must be approved by the end of Week 5. Please choose a contemporary, challenging topic that involves legal or ethical challenges in health practice.

Ch. 19, 20, and 21
Discussion 11
As an HCO manager, what are your personal professional responsibilities, and for what actions are you potentially liable? Does an HCO have responsibilities and potential liability, and if so, for what actions? What responsibilities and potential liability does the HCO have for negligence committed by its contractors or employees?
Discussion 12
Imagine that you are a large not-for-profit HCO manager and two competing unions have begun activities such as holding meetings and handing out union pamphlets. Employees are openly discussing plans to picket and strike. What are your rights and responsibilities to both your employees and to the HCO’s patients?
Quiz 6
Covers material in Chapters 20-22 and 23
Course Evaluation
Please evaluate the course. You will have an opportunity to evaluate the course near the end of the session. A link sent to your CougarMail will allow you to access the evaluation. Please note that these evaluations are provided so that I can improve the course, find out what students perceive to be its strengths and weaknesses, and in general assess the success of the course. Please do take the time to fill this out.
Ch. 3, 4, and 5
Discussion 13
What are the four elements of negligence, and what constitutes negligent health care?  What types of actions constitute “ordinary” negligence and what are considered “gross” negligence?  When are a health care practitioner’s actions criminal, negligent, or both? What defines an intentional tort?
Discussion 14
Health care, health care insurance, and health care negligence all cost large amounts of money and often, even larger problems. Discuss current tort reform measures, describing both their successes and failures. What tort reforms do you advocate, and why? Discuss alternative dispute resolution, specialized malpractice courts, damage caps, increased professional and insurance regulation and increased risk reduction or come up with your own proposals.
Research Paper

Identify a health care legal issue which I have approved for your topic. Then discuss a minimum of four (4) related court decisions, either from our text or reported elsewhere. Compare and contrast the facts, issues, and holdings of these cases, identifying both similarities and differences. Choices of topics must be approved by the end of Week 5. Please choose a contemporary, challenging topic that involves legal or ethical challenges in health practice.

The paper should be at least 2000 words in length and use The Blue Book. A Uniform System of Citation format for citing sources. You will find more information about how cite sources in the course Content area. You can also ask me, and use your book’s citation format for assistance. Share a complete draft of our paper with classmates in the appropriate discussion topic and provide feedback on their work. Submit your final version to the Dropbox by Sunday night.

Quiz 7
Covers material in Chapters 4, 5, and 25
Ch. 16 and 17
Discussion 15
Discuss individuals’ and states’ rights and restrictions to obtain abortions, with respect to considerations such as monetary assistance, the mother’s or the unborn’s gestational age, and impositions such as waiting periods and counseling requirements. What are an HCO’s rights, responsibilities, and restrictions related to the operation of a clinic providing these services?
Discussion 16
What factors are essential to consider in end-of-life analysis? Who should make end-of-life decisions when the patient’s wishes are unknown, family members disagree, and physicians are not in accord with a treatment plan? Does it matter whether the health care contemplated is active treatment or passive withdrawal of treatment?
Quiz 8
Covers material in Chapters 16 and 18

  Course Policies

Student Conduct

All Columbia College students, whether enrolled in a land-based or online course, are responsible for behaving in a manner consistent with Columbia College's Student Conduct Code and Acceptable Use Policy. Students violating these policies will be referred to the office of Student Affairs and/or the office of Academic Affairs for possible disciplinary action. The Student Code of Conduct and the Computer Use Policy for students can be found in the Columbia College Student Handbook. The Handbook is available online; you can also obtain a copy by calling the Student Affairs office (Campus Life) at 573-875-7400. The teacher maintains the right to manage a positive learning environment, and all students must adhere to the conventions of online etiquette.

Plagiarism and Academic Integrity

Academic integrity is a cumulative process that begins with the first college learning opportunity. Students are responsible for knowing the Academic Integrity policy and procedures and may not use ignorance of either as an excuse for academic misconduct. Columbia College recognizes that the vast majority of students at Columbia College maintain high ethical academic standards; however, failure to abide by the prohibitions listed herein is considered academic misconduct and may result in disciplinary action, a failing grade on the assignment, and/or a grade of "F" for the course.

Additionally, all required papers may be submitted for textual similarity review to Turnitin.com for the detection of plagiarism. All submitted papers may be included in the Turnitin.com reference database for the purpose of detecting plagiarism. This service is subject to the Terms and Conditions of Use posted on the Turnitin.com site.


There will be no discrimination on the basis of sex, race, color, national origin, sexual orientation, religion, ideology, political affiliation, veteran status, age, physical handicap, or marital status.

Student Accessibility Resources

Columbia College is committed to creating a learning environment that meets the needs of its diverse student body. If you anticipate or experience any barriers to learning, communicate your concerns with the instructor. In addition to speaking with the instructor, the following resources are available to ensure an opportunity to learn in an inclusive environment that values mutual respect.

  • For students with disabilities/conditions who are experiencing barriers to learning or assessment, contact the Student Accessibility Resources office at (573) 875-7626 or sar@ccis.edu to discuss a range of options to removing barriers in the course, including accommodations.
  • For students who are experiencing conflict which is impacting their educational environment, contact the Office of Student Conduct at studentconduct@ccis.edu or (573) 875-7877.
  • For students who have concerns related to discrimination or harassment based on sex, gender identity, sexual orientation, pregnancy or parental status, please contact the Title IX Office at titleixcoordinator@ccis.edu. More information can be found at http://www.ccis.edu/policies/notice-of-non-discrimination-and-equal-opportunity.aspx

Online Participation

You are expected to read the assigned texts and participate in the discussions and other course activities each week. Assignments should be posted by the due dates stated on the grading schedule in your syllabus. If an emergency arises that prevents you from participating in class, please let your instructor know as soon as possible.

Attendance Policy

Attendance for a week will be counted as having submitted any assigned activity for which points are earned. Attendance for the week is based upon the date work is submitted. A class week is defined as the period of time between Monday and Sunday (except for week 8, when the work and the course will end on Saturday at midnight.) The course and system deadlines are based on the Central Time Zone.

Cougar Email

All students are provided a CougarMail account when they enroll in classes at Columbia College. You are responsible for monitoring email from that account for important messages from the College and from your instructor. You may forward your Cougar email account to another account; however, the College cannot be held responsible for breaches in security or service interruptions with other email providers.

Students should use email for private messages to the instructor and other students. The class discussions are for public messages so the class members can each see what others have to say about any given topic and respond.

Late Assignment Policy

An online class requires regular participation and a commitment to your instructor and your classmates to regularly engage in the reading, discussion and writing assignments. Although most of the online communication for this course is asynchronous, you must be able to commit to the schedule of work for the class for the next eight weeks. You must keep up with the schedule of reading and writing to successfully complete the class.

No late discussion posts will be accepted.

Assignments are due on the dates specified. Points for any late submissions will be deducted each day that an assignment is late. I will not grade assignments submitted after more than one week after a deadline. Quizzes must be taken by the date assigned. In the case of an emergency, you must contact with me prior to the deadline. Emergent situations will be evaluated on a case-by-case basis.

Course Evaluation

You will have an opportunity to evaluate the course near the end of the session. A link will be sent to your CougarMail that will allow you to access the evaluation. Be assured that the evaluations are anonymous and that your instructor will not be able to see them until after final grades are submitted.

  Additional Resources

Orientation for New Students

This course is offered online, using course management software provided by Desire2Learn and Columbia College. The course user guide provides details about taking an online course at Columbia College. You may also want to visit the course demonstration to view a sample course before this one opens.

Technical Support

If you have problems accessing the course or posting your assignments, contact your instructor, the Columbia College Technology Solutions Center, or the D2L Helpdesk for assistance. If you have technical problems with the VitalSource eText reader, please contact VitalSource. Contact information is also available within the online course environment.

Online Tutoring

Smarthinking is a free online tutoring service available to all Columbia College students. Smarthinking provides real-time online tutoring and homework help for Math, English, and Writing. Smarthinking also provides access to live tutorials in writing and math, as well as a full range of study resources, including writing manuals, sample problems, and study skills manuals. You can access the service from wherever you have a connection to the Internet. I encourage you to take advantage of this free service provided by the college.

Access Smarthinking through CougarTrack under Students -> Academics -> Academic Resources.