| Course | HLTH 5603 Legal and Ethical Decision Making in Healthcare Administration |
|---|---|
| Module | Module 5 |
| Paper type | Decision memo to the opposing party |
| Length | 800 words, about 3 pages plus title and reference pages |
| Format | APA 7 student paper |
| School | American College of Education |
| Program | MHA |
| Updated | October 2026 |
Free sample paper for HLTH 5603 Module 5
Decision Memo to the Director of Revenue Cycle: Why the Collection Lawsuit Proposal Was Not Approved, and What Happens Next
Student Name
American College of Education
HLTH5603: Legal and Ethical Decision Making in Healthcare Administration
Module 5 Assignment
Instructor Name
February 7, 2028
The Decision
To: Director of Revenue Cycle. From: Chief Executive Officer. Date: February 7, 2028. Re: Proposal to file suit on 212 aged patient accounts. The individuals and hospital in this memo are composites written for this assignment.
After review by the executive team and the board's finance and community benefit committees, the proposal to file lawsuits and pursue wage garnishment on 212 accounts with balances over $1,000 has not been approved as submitted. In its place, every one of the 212 accounts will first be checked for likely charity care eligibility, balances will be forgiven where patients qualify, offer the remaining patients interest-free payment plans and file suit only in narrow circumstances described below. The hospital will not use wage garnishment. I want you to hear this decision from me, with the reasons, rather than read it in the minutes.
What Your Proposal Got Right
Your proposal was carefully prepared and correct on the facts that matter most to your department. Unpaid balances are real losses in a year when the hospital has operated at a deficit, and someone has to be responsible for recovering what can fairly be recovered. Your team documented that every account had received the notices and financial assistance information that federal rules require before any collection action (Internal Revenue Service [IRS], 2024), and the legal review confirmed that the proposal was lawful. Nothing in this decision questions your team's diligence or its compliance.
You also raised a point that the executive team agreed with: if the hospital does not collect what patients are able to pay, the cost falls on other patients and on the staff whose positions depend on a sustainable budget. That concern shaped the alternative. The decision is not a choice to stop collecting; it is a choice about whom the hospital pursues and how.
Why the Decision Went the Other Way
The review of the 212 accounts showed that for 74 patients, the income data we already hold points to eligibility for our charity program, and that many of the notices had been returned or unanswered. Nationally, unpaid medical bills fall hardest on people in lower-income areas (Kluender et al., 2021), and our accounts follow that pattern, with most of these patients, 131 in all, living in the lower-income half of the county's ZIP codes. Suing patients who were probably eligible for our charity care would comply with the rules and still contradict the mission the board has asked us to carry out and the community benefit our tax exemption assumes.
The finance committee also weighed the amounts. The expected net recovery was about $560,000, less than 0.2 percent of our operating budget. The harm to patients, to the hospital's standing in the community and to staff who have told us they would find the practice hard to defend was judged to outweigh that sum. People accept decisions more readily when they understand the reasons behind them and are treated with respect in how the decision is communicated, a pattern consistently found in research on fairness in organizations (Colquitt et al., 2001). I have tried to give you the reasons in full, because you will need to explain this decision to your own team.
What This Means for Your Department
Your team will lead the new process. First, a likely-eligibility check across every account, drawing on public benefits records and third-party income estimates, to be completed within 60 days. Second, interest-free payment plans for patients who do not qualify for assistance, with monthly payments capped at 5 percent of documented monthly income. Third, a lawsuit only where a patient's documented household income is more than four times the poverty guideline and the patient has turned down a payment plan after two contacts, with each filing approved by the chief financial officer. Your department's recovery target for these accounts will be revised to reflect the new approach, and the revision will not count against your team's performance evaluation this year.
Support and Next Steps
The hospital will fund the screening service for the first year, and the patient financial services team will add one financial counselor position to support payment plan enrollment. I would like to meet with you and your managers within two weeks to hear what else you need and to agree on how we report results to the board. If after a year the payment plans recover far less than expected, I want you to bring that evidence forward; the decision is firm, but it is not closed to what we learn. Thank you for the care your team put into the original proposal. It made this decision better informed than it would otherwise have been.
References
Colquitt, J. A., Conlon, D. E., Wesson, M. J., Porter, C. O. L. H., & Ng, K. Y. (2001). Justice at the millennium: A meta-analytic review of 25 years of organizational justice research. Journal of Applied Psychology, 86(3), 425-445. https://doi.org/10.1037/0021-9010.86.3.425
Internal Revenue Service. (2024). Requirements for 501(c)(3) hospitals under the Affordable Care Act: Section 501(r). U.S. Department of the Treasury.
Kluender, R., Mahoney, N., Wong, F., & Yin, W. (2021). Medical debt in the US, 2009-2020. JAMA, 326(3), 250-256. https://doi.org/10.1001/jama.2021.8694
The HLTH 5603 Module 5 assignment instructions
HLTH 5603 Module 5 asks you to write a decision for the person or group it goes against. Most prompts expect the decision stated plainly at the start, a fair acknowledgment of the losing position, reasoning the recipient can follow, consequences for their work and next steps. Many sections ask for a memo or letter format and a professional tone. The memo itself rarely runs past four pages; Canvas names who receives it and whether citations should appear in the memo or in a separate rationale. Some sections also ask for a short note on why the memo was written as it was.
How the HLTH 5603 Module 5 example is put together
The memo opens with the decision in one sentence and the alternative in the next, so the director does not have to search for it. The second section acknowledges what the proposal got right: unpaid balances are real, the department has targets and the proposal followed the federal steps. The reasoning section explains the decision in the director's terms: how many accounts would have qualified for assistance, how small the recovery would be relative to the risk, and what national research shows about medical debt. The next section explains what changes for the department, including new screening steps and adjusted targets. The last section offers support, names a meeting date and invites the director to help write the new policy. A short note explains why procedural fairness matters.
HLTH 5603 Module 5 rubric: what full marks look like
Decision memos are graded on clarity and fairness to the recipient. The opening row usually carries significant weight: decision and alternative stated in the first lines. Acknowledgment credit requires specific merits of the losing position, not generic thanks. Reasoning marks reward the case explained in terms the recipient uses, with facts they can check. Consequence and next-step marks go to concrete changes and support. Graders give credit for tone that is respectful and direct. Memo format, appropriate citations and APA 7 for any references complete the grade. Inviting the director to help write the new policy turns the memo into the start of a working relationship, which graders notice.
HLTH 5603 Module 5 help from the desk
Decision memos most often bury the decision after paragraphs of background. Another frequent weakness is praise that sounds empty because it is not specific. Students also write as if to a neutral reader rather than the person who lost. Lead with the decision. Name what the recipient got right. Use their numbers. Explain what changes for their team. Offer a meeting and a role in what comes next. If your decision concerns a budget request, a staffing proposal or a vendor contract, the desk can prepare a decision memo for it. Keep the memo to one or two pages. Avoid legal jargon.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official American College of Education document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
More HLTH 5603 and MHA sample papers
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HLTH 5603 Module 5 questions, answered
What does HLTH5603 Module 5 usually ask for?
HLTH5603 Module 5 typically asks students to write up a legal or ethical decision addressed to the person or group it goes against, such as a family, a physician, a department or a patient. The goal is a document that explains the reasoning clearly and respectfully. Your classroom's instructions decide the audience, the format and the length.
How should a decision be written for the person who loses?
State the decision first, acknowledge specifically what was right in their position, explain the reasoning in terms they will recognize, describe what the decision means for them in practice and say what support or recourse they have. A respectful explanation does not soften the decision, but it makes it easier to accept and to carry out.
Should the decision memo include citations?
Include them where they support a specific factual claim or where the reasoning rests on a rule or a body of evidence, but keep them few. The memo is written to a colleague, not a journal, so citations should support the reasoning without overwhelming it. Your instructor may require APA formatting even for a memo.
Where can I find a free HLTH 5603 Module 5 sample paper?
Scroll up. This HLTH 5603 Module 5 decision memo to the opposing party includes "The Decision", "Why the Decision Went the Other Way" and "Support and Next Steps", each annotated in the margin.
Why does the way a decision is delivered matter?
Research on organizational justice, such as Colquitt and colleagues' meta-analysis, shows that people accept decisions better when the process is fair, the reasons are explained and they are treated with respect.