Basic Health Care Organization

Two basic types of healthcare organizations

For-profit and Not-for-profit.

For-profit ownership

Corporation or physician owned; profit returned to owners/shareholders.

Not-for-profit ownership

Religious/charitable/community organizations; surplus reinvested in mission.

Example—for-profit

Physician-owned imaging center (private hospital/clinic).

Example—not-for-profit

Shriners or community hospital.

Purpose of hospital accreditation

External quality standards and patient safety validation.

Why accreditation matters

Affects reimbursement/participation with payers (e.g., Medicare/Medicaid).

Common accrediting bodies

TJC/JCAHO; HFAP/ACHC.

Board of Trustees role

Set policy/standards; determine strategic direction of the organization.

For-profit board focus

Represents shareholders/owners.

Not-for-profit board focus

Represents community/mission (often religious/community members).

Special case—VA hospitals

Report up the Veterans Affairs chain; no local board.

CEO responsibility

Overall leadership and final decisions; answers to Board of Trustees.

COO responsibility

Oversees day-to-day operations (e.g., nursing, support services).

CFO responsibility

Manages all finances—budgets, revenue cycle, money in/out.

Director of Imaging Services

Leads daily operations of imaging disciplines; reports to admin (often COO/VP).

Physician’s role

Diagnose/treat; lead clinical decisions within medical staff governance/bylaws.

Radiologist’s role

Interpret imaging; perform image-guided procedures; set imaging protocols.

Accreditation review focuses on

Policies, patient safety, documentation, staff competence.

Why chain of command matters

Provides clear escalation and communication paths for safety and operations.

Typical radiology chain of command

CEO/Board → COO → Imaging Director → Lead Techs → Staff RTs → Students.

Student radiographer’s place

Bottom of chain; follow clinical supervisor/preceptor direction.

If unsure about a decision

Ask the clinical supervisor/lead tech (do not act alone).

Key difference: for-profit vs not-for-profit

Ownership & use of surplus (distribution to owners vs reinvestment in mission).

Service line example

Radiology/Imaging department.