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Discussion Question 1: Your 100-bed, not-for-profit rural hospital is in the same community as a county-owned nursing home that has been struggling. After trying unsuccessfully to sell the home, the county has asked your hospital to take over its operations. It has less-than-stellar reputation: only half of its 50 beds are full. The nearest nursing home is 70 miles away. If your hospital doesn’t take it over, the nursing home will close. But if you can’t turn around its reputation in 12 months, it will jeopardize the hospital’s thin margin. What do you do?


Discussion Question 2: Your business development manager wants your health care system to open a full-service day spa. He has run the financials and says it will contribute to the bottom line in a short period of time, and it is a natural tie-in with holistic therapies and wellness activities. However, your chief nursing officer argues that the hospital should not be investing in activities so far removed from the mission of patient care, and that the spa’s cosmetic services, such as manicures and haircuts, put an emphasis on looks over health. The spa services are not covered by insurance. As a CEO, do you approve the project?