The Role of Governance in Nonprofit Healthcare

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Trends and Issues in the Healthcare Environment that may affect the Financial Success of Nonprofit Hospitals

The recent trends in the healthcare industry have caused many healthcare managers to shift their focus to keep up with the emerging technologies, consumer demands and the economic pressures of the 21st century. As a manager in the healthcare industry, it is essential to be aware of the changes in the healthcare industry to make smart decisions for your organization (Shamian, Kerr, Laschinger & Thomson, 2016). The healthcare industry will continue to change, and health administrators/managers must address these changes while still managing to provide quality care to their patients. Various trends and issues in the healthcare environment may affect the financial success of nonprofit hospitals includes management issues, referral systems, staffing issues, regulation and governance, ethical issues, affordability of health services and insurance. The American healthcare system is unquestionably in need of some repairs.

It is with no doubt the costliest system of them all; costs are steady spiral out of limits, making this system unmanageable. There are at least forty-seven million Americans that are uninsured. As we try to brush up on reform, we tend to fail in the face of different political tensions, and this reason in itself result of deep-seated interests of various groups and organizations (Shamian, Kerr, Laschinger, & Thomson, 2016). Financial problems are continually growing in the U.S. With no sight of getting better or fixing the shortcomings that it presents. The following are discussions of impending trends and issues facing the healthcare systems.

Staffing Issues

While nurses are considered to be the key employees working at healthcare services various agencies have begun to hire other professionals as physiotherapists, vocational nurses, physicians and occupational therapists. The inadequacy of female nurses presents multiple challenges to multiple managers at different agencies. The following scenarios reflect the above problems, unavailability of female nurses originates various issues to the management (Shamian, Kerr, Laschinger & Thomson, 2016). Not only does it affect the agency's ability to serving patients, but also corner the administration into hiring employees without good experience and proper qualifications thus resulting to a negative impact on the quality of services offered to respective clients. In some cases, female nurses are denied by their families and communities the permission either provide their services at home healthcare facilities especially at night and evening shifts.

The above has contributed to the outsourcing of employees from different countries, e.g., Philippines and Cuba to curb the impending pressure and shortage. At times different management finds themselves in a position of hiring unqualified staff to enable them to run their operations, but this has resulted in misconducts and poor delivery of services to respective clients. Not only has the shortage of qualified personnel has affected the various financial position of agencies since the available ones require high wages but also changed the quality of services being offered thus creating a poor rapport (Cherry & Jacob, 2016). For example between 2008 -2018 the healthcare employment will grow by 23% compared to other employment sectors which only experience a 9 percent increase (Mike, 2003). With this increase, many healthcare facilities are experiencing a shortage of healthcare professionals, and it is up to healthcare managers to implement a plan to address this shortage (Ajunwa, Crawford & Ford, 2016). To successfully compete for highly skilled and qualified healthcare professionals' health administrators should go beyond competitive pay and benefits and find ways to attract those employees who show the most connection and passion for the facility.

Increasing Growth and Demand for Healthcare Services

America is considered the home to an aging population, and therefore, it is estimated that by 2020, 17% of the total population will be 65 years old or even older. That is approximate of 50 million individuals who will focus their dependence on the existing healthcare services. The recent survey from AARP indicates that nearly 90% of the aging population intends to receive their healthcare at their respective homes although about 20% will have to be transferred to different nursing homes (Cherry & Jacob, 2016). In the discussion of how the increasing demand and growth in specialty care facilities affects health administrators. Freel and Jordahl explain that with the increase in specialty care hospitals, health administrators must implement a competitive strategy that will set them apart from other specialty care facilities. Health administrators should investigate other specialty facilities to identify opportunities for growth within their facilities. Freel and Jordahl make it clear that health managers must consider numerous factors to create a specialty care strategy that best fits with their organization (Freel & Jordahl, 2016).

Regulation and Governance

Lack of proper management and support in the healthcare services impends a poor channel of communication for both feedbacks from clients. Due to the poor organization of the healthcare industry provides loose gaps and boundaries which does not define specific responsibilities of the health care providers more so those free-lancing and sole-proprietors (Panahi, Watson & Partridge, 2016). Ministry of Health is required to monitor and regulate all the activities being conducted by every healthcare service provider, both skilled healthcare services, non-medical care services and those agencies that provide both. How to generate an instrument various regulations which may be both protective of clients, yet not very restrictive to the service providers is often a challenging balance to maintain (Ajunwa, Crawford & Ford, 2016).

The implemented regulations do not have to be the only motive for the provision of standard and quality care from the providers. Various agencies should create a standard quality that the managements follow during their daily operation irrespective of pending regulatory changes and legislation. Therefore, provision of increased accountability and organization will create awareness to clients on superior healthcare providers. Therefore, Freel and Jordahl highlight that the focus on reimbursement is shifting from a fee for service model to a model that bases reimbursement on consumer satisfaction and with the pressure to expand, many hospitals are conducting extensive research to ensure they are meeting the needs of consumers (Panahi, Watson & Partridge, 2016). To be successful, health administrators must balance their finances to prepare for future changes such as expansion.

Technological Advancements

Due to the drastic technological advancements various tools and equipment either become obsolete or outdated, for instance, printing devices often become incompatible and obsolete with the modern technological advancements. Some occupy considerable space and are also slow and inefficient in operation (Ajunwa, Crawford & Ford, 2016). With many enterprises migrating from desktop storage devices to personal laptops, and further to mobile gadgets, the process of replacement is often frustrating. Therefore, managing, retaining and repairing various models and brands are expensive, because each model and brand require specific ink cartridges or proprietary toner (Catalano, 2015). Moreover, there is an escalating need for employee training on particular usage and maintenance procedures for every new machine purchased.

Henceforth, leasing devices are considered to be cost-effective since there is an availability of latest technologies at your disposal – the newer the technological tools, the more power efficient the devices. Therefore, it is advisable to replace or eliminate old equipment, However, dealing with either equipment or inventory, obsolete, not work to provide space for the new ones. Selling the old equipment is also another way of boosting company cash flow and taxable gains. Inventory management system should be comprehensively updated to keep track on the condition of the available inventories and equipment (Catalano, 2015). Therefore, health managers should be aware of the advances in technology to include advances in medicine, government regulations, and policy changes. By keeping up with these advances, healthcare managers can ensure their facilities are operating successfully and providing quality care to patients.

In conclusion, healthcare managers must control their finances to offset the caps that the government place on reimbursements for Medicare and Medicaid. Healthcare managers are faced with the challenge of offsetting their expenses to cope with the growing number of patients who are uninsured or underinsured and using government programs such as Medicare and Medicaid (Dempsey & Reilly, 2016).

Financial Opportunities and Threats a Nonprofit Hospital


One threat that can happen within the nonprofit hospital would be losing one or all of their funders/sponsors. Since nonprofit organization heavily rely on funding from other charitable organizations and sponsors, for example, significant donors are The NYC Department of Homeless Services (DHS) and The Robin Hood Foundation. Without funds from these organizations, the hospital budget will be significantly affected which will limit the number of funds that can be used in operating all hospital activities including helping financially unstable families with children and single adults/adult families with their hospital arrears. It may also affect salaries, healthcare policies and other benefits. Also, employees may get laid off due to budget cuts. Another possible threat will be if a massive scandal is discovered within the agency. Since nonprofits depend on contributions, they often must answer to their funders in the form of reports to ensure that their money is being used for the social cause that is being supported. So, in other words, reputation is outstanding, and even a small scandal can be damaging.


One opportunity that can happen in the future is more funding from sponsors to expand the organization. For example, an individual whose job is in the process of adding an Aftercare program which needed to ensure that clients who move out of shelter are maintaining their better living standards so that they don't end up back in the agency program. Such kind of programs can be added due to an increase in funding (Zietlow, Hankin, Seidner & O'Brien, 2018). To start with, DHS, for example, provides various institutions with the funds to add five more staff members at different location and targets that those specific organizations oblige. Therefore, within a given stipulation of time, if such targets are met, more funding is always provided to those particular institutions. Another possible opportunity in the nonprofit hospitals is training programs for staff to aid in professional development. Recently various institution has developed central offices for members of the team who currently hold a Master's Degree or those in school to obtain a Master's Degree (Zietlow et al., 2018). These kinds of programs targets to get an idea of how many people at different organization site is currently trying to develop professionally and provide other opportunities for those who may not be in school, but want to advance within the organization.

Advantages and Disadvantages of Joining a Medical Alliance


Networking. Organizations offer excellent networking opportunities thus allowing various personalities to associate with their fellow professionals, mentors, and even other different leaders in the industry. Associates of the organization have unique advantages of attending conventions, award dinners, seminars and other allied occasions with compatible fields of professionals. These occasions are often attended by brilliant minds who are a source of collaborative efforts and ideas. Therefore, an organization’s general meeting occasionally signifies a significant opportunity to network and associated with the primary gathering of similar profession yearly (Zietlow et al., 2018). Networking with external professionals provides broader healthcare and market perspective in general. Listening to daily professional experiences acts as a motivating factor to different individuals.

Education. In the faculty of medicine, there exist continuous drastic changes in both technologies, scientific discoveries, and medical practices. Therefore healthcare professionals often obtain scientific breakthroughs and developments through their organization bodies, journals, innovative seminars, CME courses together with various educational opportunities availed to them. In addition, multiple associations appropriately offer certification courses required through the entire career. The association also avail access to potential mentors thus giving the associates a better opportunity of participating in the mentorship program as well since the availability of mentors facilitate professional growth .therefore, an associate possess a unique chance of gaining a competitive edge. As an associate, you are in a distinctive position to advance a competitive advantage of utilizing all the available information resources.

Intrinsic Value: Organization bodies often require fresh energy to assist in organizing yearly meetings, legislative committees, CME program, and workshops (Zietlow et al., 2018). Providing support to organization bodies in improving the professionalism of all the available personnel often enhance the general state of the faculty of health care thus providing rewarding opportunities to all the associates.

Jobs. Healthcare organizations are strategic places of getting latest job updates for various professionals. Therefore, joining these associations boosts individual’s opportunity getting a dream job being employed by the relevant service provider.


Fees. Various professional organizations often require registration and annual fees payment. Even though $100 or so do not seem that much for some organization, it supplements when joint national and state professional association contribute in a pool (Ginter, 2018).

Time. National organizations often conduct both quarterly and annual meetings while those at the regional level convenes monthly meetings. The disadvantages of these meetings are, personal time is always insignificant to realize more so in situations where an individual belongs to a variety of organizations. Time is likewise included in perusing the month to month bulletin, messages, and distributions (Ginter, 2018). These affiliations may have benefited by keeping you over what's going on in your industry; however, the drawback is you aren't meeting new potential customers.

Expenses. Apart from the membership and applications fees, there are also impending expenses to be realized during organization breakfasts, dinners or sometimes lunches (Ginter, 2018). In addition, gas expenses and transport costs are also incurred during a given event.

Pressures. When you go along with, you might be euphorically taken off alone. Then again, you may get week after week or month to month suggestions to expand your vow, take a situation on an advisory group or enlist different individuals. The affiliation may take a position on a strategy that you do not concur with and accept that all individuals will bolster it. A calling incorporates individuals with a wide assortment of political arrangements, religious convictions, and individual qualities (Ajunwa, Crawford, & Ford, 2016). In some cases, an affiliation overlooks that.


Ajunwa, I., Crawford, K., & Ford, J. S. (2016). Health and big data: An ethical framework for health information collection by corporate wellness programs. The Journal of Law, Medicine & Ethics, 44(3), 474-480.

Catalano, J. T. (2015). Nursing now! Today's issues, tomorrow's trends. Duxbury, VT: FA Davis.

Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Amsterdam, Netherlands: Elsevier Health Sciences.

Dempsey, C., & Reilly, B.A. (2016). Nurse engagement: What are the contributing factors for success. The Online Journal of Issues in Nursing, 21(1).

Freel, R., & Jordahl, E. A. (2016). Implications of the Federal Reserve's actions for healthcare borrowers: expected Federal Reserve interest rate hikes will have several impacts on healthcare borrowers, which can use a range of strategies in response. Healthcare Financial Management, 70(4), 104-107.

Ginter, P. M. (2018). The strategic management of healthcare organizations. Hoboken, NJ: John Wiley & Sons.

Panahi, S., Watson, J., & Partridge, H. (2016). Social media and physicians: exploring the benefits and challenges. Health Informatics Journal, 22(2), 99-112.

Shamian, J., Kerr, M.S., Laschinger, H.K.S., & Thomson, D. (2016). A hospital-level analysis of the work environment and workforce health indicators for registered nurses in Ontario's acute-care hospitals. Canadian Journal of Nursing Research Archive, 33(4).

Zietlow, J., Hankin, J. A., Seidner, A., & O'Brien, T. (2018). Financial management for nonprofit organizations: Policies and practices. Hoboken, NJ: John Wiley & Sons.

January 19, 2024




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