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HCM 515 – Dis14
Reply1: GHADAH ALOWFI
The bankruptcy of a healthcare institution due to financial mismanagement represents a profound
breakdown of fiduciary duty and social responsibility. In Saudi Arabia’s rapidly evolving healthcare
landscape, such an event not only disrupts service delivery but also infringes on patient rights and
community welfare. The consequences of such failures resonate deeply within the legal and ethical
frameworks governing healthcare operations (Faraz et al., 2024). This discussion critically evaluates the
ramifications of mismanaged funds leading to healthcare collapse, emphasizing how comprehensive
reform strategies could have averted these crises.
Judicial Responsibilities in Healthcare Financial Failures
When a healthcare entity collapses because of board-level financial misconduct, the legal implications are
extensive. Under Saudi commercial and healthcare laws, directors bear direct accountability for
safeguarding institutional assets and ensuring operational sustainability (Dirbas & Al Haddad, 2024).
Misappropriation or negligence could trigger civil litigation, fines, and potential criminal proceedings,
particularly if public funds were involved. Furthermore, patients and employees impacted by the sudden
cessation of services could initiate lawsuits seeking compensation for damages, disruption of care, or loss
of employment. The Saudi healthcare regulatory framework, strengthened through entities like the Saudi
Commission for Health Specialties (SCFHS), mandates ethical governance and transparency, thus
making mismanagement a direct breach of established legal norms (Alruwaili, Islam, & Usher, 2022). A
facility’s bankruptcy due to board negligence represents not just financial collapse but a violation of public
trust, enforceable under multiple legal provisions.
Moral Obligations Toward Affected Communities
From an ethical standpoint, the closure of a healthcare facility creates an immediate vacuum in critical
health services, particularly in rural or underserved regions of Saudi Arabia. Ethical theories such as
deontology and utilitarianism emphasize the duty of healthcare leaders to act in ways that maximize
community well-being and minimize harm. Mismanagement that leads to service discontinuity is a stark
violation of these principles (Faraz et al., 2024). Patients with chronic conditions, such as those relying on
continuous oncology treatments or dialysis, face life-threatening risks when facilities shutter without
appropriate transition plans. Staff members, too, encounter ethical dilemmas, torn between their
professional obligations and the collapse of their employer institution. In a case study from the Eastern
Province, gaps in disaster preparedness highlighted by Alruwaili et al. (2022) revealed how fragile the
healthcare safety net can be without proper oversight, magnifying the ethical responsibility of governance
to prevent such disasters proactively. Moreover, ethical stewardship demands that leadership prioritizes
sustainability and contingency planning. Financial mismanagement, thus, is not merely an administrative
failure but an ethical breach that sacrifices community health at the altar of poor leadership.
Preventive Measures Through Healthcare Reform Initiatives
Preventing healthcare bankruptcy requires strategic foresight embedded within national reform efforts.
Saudi Arabia’s Vision 2030 agenda, which targets privatization, improved quality assurance, and
governance transparency, is a critical shield against financial mismanagement (Mani & Goniewicz, 2024).
Through reform measures such as mandatory financial audits, performance-based accountability
systems, and director competency evaluations, the likelihood of board-driven collapses can be
significantly reduced. The development of frameworks like the Mostadam-HCF rating system, aimed at
sustainability in healthcare facilities (Balabel & Alwetaishi, 2021), exemplifies how infrastructural reforms
can anchor institutional resilience. By embedding sustainability metrics into healthcare administration,
reform policies ensure that institutions are not only clinically competent but also financially viable and
ethically governed.

Real-world application of these reforms is already visible. For instance, enhanced financial oversight at
major hospitals in Riyadh has resulted in reduced operational deficits and improved patient satisfaction.
Through Vision 2030’s initiatives, healthcare organizations are increasingly held to rigorous standards of
transparency, leadership competence, and community engagement mechanisms that, had they been
universally enforced earlier, could have prevented mismanagement-induced bankruptcies.
Conclusion
Healthcare facility bankruptcy due to mismanaged resources poses serious legal, ethical, and societal
challenges, particularly within Saudi Arabia’s ambitious healthcare transformation landscape. Legal
systems hold board members accountable for breaches of fiduciary responsibility, while ethical
frameworks demand unwavering commitment to patient welfare and community health. National reforms,
especially those aligned with Vision 2030, present robust preventative mechanisms by enhancing
transparency, governance, and sustainability. In ensuring financial stewardship and ethical integrity,
healthcare institutions not only protect themselves from collapse but also fulfill their essential role as
guardians of societal well-being.
References
Balabel, A., & Alwetaishi, M. (2021). Toward sustainable healthcare facilities: An initiative for
development of “mostadam-hcf” rating system in Saudi Arabia. Sustainability (Switzerland), 13(12).

Dirbas, W. A., & Al Haddad, H. M. (2024). The Interplay of Profitability and Social Responsibility in
Achieving Institutional Excellence: An Exploratory Study in Government and Private Hospitals in Jeddah,
Kingdom of Saudi Arabia. Global Journal of Management and Business Research, 1–10.

Faraz, A., Deyab, A. A., Alanzan, A., Muwayni, A. M., Alhodairy, M., Alharbi, M., Alharbi, M., & Alruwaili,
S. (2024). Assessing Medical Ethics Knowledge and Practice Among Healthcare Professionals in Al
Majma’ah, Saudi Arabia. Cureus.
Alruwaili, A., Islam, M. S., & Usher, K. (2022). Hospitals Disaster Preparedness and Management in the
Eastern Province of the Kingdom of Saudi Arabia: A Cross-sectional study. Disaster Medicine and Public
Health Preparedness, 16(3), 1038–1045.
Mani, Z. A., & Goniewicz, K. (2024). Transforming Healthcare in Saudi Arabia: A Comprehensive
Evaluation of Vision 2030’s Impact. Sustainability (Switzerland), 16(8).

Reply2: WSEEMAH ALMUTAIRI
The legal and ethical ramifications of bankruptcy
The legal and ethical ramifications of bankruptcy due to mismanaged funds by the Board of Directors in
Saudi healthcare are multifaceted, involving both corporate governance and criminal liability aspects.
Legally, the Board of Directors in Saudi Arabia is held accountable for the misuse of company funds,
which can lead to criminal penalties, including imprisonment and fines, as outlined in the Saudi
commercial system. This system emphasizes the misuse of company funds against the company’s
interests, requiring special criminal intent for personal gain (Almutairi & Bitar, 2025). Ethically, the Board’s
failure to adhere to corporate governance principles can significantly impact stakeholders’ interests and
the overall economic efficiency, as corporate governance is crucial for attracting investment and ensuring
accountability. The Board’s responsibilities are also highlighted in the context of limited liability
companies, where directors may be held jointly and severally liable for unpaid obligations if negligence is
proven (Idayanti & Mukhidin, 2024).
Healthcare reform in Saudi Arabia could have potentially prevented financial mismanagement and
bankruptcy due to mismanaged funds by the Board of Directors through several strategic interventions.
The implementation of Population Health Management (PHM) and the formation of Accountable Care
Organizations (ACOs) under Vision 2030 are pivotal in driving transformational change by focusing on
prevention, early detection, and integrated care, which could enhance financial oversight and
accountability within healthcare institutions (Alakhrass, n.d.). The privatization of the healthcare sector, as
highlighted in Vision 2030, aims to introduce competition and efficiency, which could mitigate the risks of
financial mismanagement by diversifying funding sources and reducing reliance on government funds
(Rahman, 2020). Moreover, the introduction of managed care programs, such as Health Maintenance
Organizations (HMOs), could reduce unnecessary expenditures and improve cost control by shifting to
less expensive care options and implementing prepayment models, thereby reducing the financial burden
on healthcare providers (Mufti, 2000).
The need for active monitoring and corrective legislation is emphasized to stimulate reform processes
and ensure financial accountability, which could prevent mismanagement by the Board of Directors.
Additionally, the adoption of diverse payment models, as suggested in the literature, could improve the
quality of care and maintain funding for universal healthcare coverage, thus preventing financial instability
(AlRuthia et al., 2020). Furthermore, the use of National Health Accounts (NHAs) to track and inform the
flow of funds could provide transparency and accountability, helping to prevent financial mismanagement
(Khallaf, 2022). Implementing these strategies not only promotes fiscal responsibility but also enhances
the overall efficiency of healthcare systems, ultimately leading to better patient outcomes and a more
sustainable model for future care delivery.
References
Alakhrass, H. (n.d.).Saudi Arabia’s Health Care Reform.
Almutairi, O., & Bitar, M. (2025). Criminal penalties for company board members for misuse of company
funds.Majallah Al-Dawlīyah Lil-Buḥūth Wa-al-Dirāsāt al-Qānūnīyah =.

AlRuthia, Y., Aydan, N. B., Al-Orf, N., & Asiri, Y. A. (2020). How can Saudi Arabia reform its public
hospital payment models? A narrative review.Journal of The Saudi Pharmaceutical Society.

Idayanti, S., & Mukhidin, M. (2024). Responsibility Of The Board Of Directors In Bankruptcy Of Limited
Liability Companies From The Perspective Of Law Number 40 Of 2007.Pena Justisia: Media Komunikasi
Dan Kajian Hukum (Edisi Elektronik).

Khallaf, A. N. S. (2022).Finance system of healthcare and it’s effects and challenges in saudi arabia
hospitals.
Mufti, M. H. (2000). A need for managed care in Saudi Arabia.Saudi Medical Journal.
Rahman, R. (2020).The Privatization of Health Care System in Saudi
Arabia.

Reply3: NORAH ALGHERIBI
Legal and Ethical Ramifications of Healthcare Facility Bankruptcy and the Role of Healthcare Reform
The bankruptcy of a healthcare facility due to financial mismanagement by its Board of Directors presents
serious legal and ethical ramifications, particularly in relation to the community it serves. Legally, board
members have fiduciary duties—duties of care, loyalty, and obedience—to act in the best interest of the
organization. Mismanagement that leads to bankruptcy may constitute a breach of these fiduciary duties
and can expose the board to legal action from creditors, employees, and possibly the community
(Savage, 2020). Moreover, depending on the jurisdiction, criminal or civil penalties may apply if the
mismanagement involved fraud or gross negligence.
From an ethical perspective, healthcare institutions have a duty to provide care, especially when they are
one of the few providers in underserved areas. The principle of beneficence requires institutions to act in
ways that promote the well-being of patients, while the principle of justice demands the fair distribution of
healthcare resources (Varkey, 2021). When a facility closes due to mismanagement, it can create a
vacuum in care delivery, particularly for vulnerable populations with limited access to alternative
healthcare services.
The ripple effects of such a closure extend beyond legal and ethical issues. Communities may suffer from
decreased access to emergency care, specialty services, and preventive medicine, leading to poorer
health outcomes. For example, underserved rural populations are disproportionately impacted by such
closures, leading to increased mortality and decreased patient satisfaction (DeLia & Wood, 2022).
Employees, too, face job losses and career instability, which affects both their personal well-being and
the regional healthcare labor market.
Healthcare Reform as a Preventative Measure
Comprehensive healthcare reform can play a critical role in preventing these types of institutional failures.
Firstly, reforms that increase transparency and accountability in financial governance—such as requiring
annual independent audits, internal compliance systems, and public financial disclosures—help detect
and deter mismanagement (Kass & Ali, 2023). Secondly, reforms that mandate board competency
through certification and ongoing governance training ensure that decision-makers possess the
knowledge required to manage complex healthcare organizations ethically and legally.
Moreover, value-based care models, a cornerstone of many reform agendas including Vision 2030 in
Saudi Arabia, emphasize outcomes over volume. These models incentivize financial sustainability
through efficient care rather than excessive service provision. By shifting the financial focus toward longterm health outcomes and cost control, such reforms reduce the risk of misaligned incentives that often
lead to overspending and poor budget oversight (Al-Hanawi et al., 2020).
Additionally, healthcare reform can bolster community safety nets, ensuring that when one provider exits
the market, others can step in. This includes supporting public-private partnerships, funding community
clinics, and expanding telehealth infrastructure—initiatives that maintain care continuity during
organizational disruptions.
Conclusion
The bankruptcy of a healthcare facility due to board-level financial mismanagement is both a legal failure
and an ethical breach with profound implications for community health. Healthcare reform—focused on
governance accountability, financial oversight, and service delivery innovation—can serve as a critical
tool to mitigate such risks. As Saudi Arabia continues to evolve its healthcare system under Vision 2030,
integrating robust reform strategies will be essential to ensuring sustainable, equitable care for all
citizens.

References
Al-Hanawi, M. K., Khan, S. A., Al-Borie, H. M., & Al-Kibsi, T. A. (2020). Healthcare finance reform in Saudi
Arabia: A step toward achieving Vision 2030. Frontiers in Public Health, 8, 1–7.

DeLia, D., & Wood, E. (2022). The impact of hospital closures on healthcare access in rural and
underserved communities. Journal of Health Care for the Poor and Underserved, 33(1), 101–120.

Kass, N. E., & Ali, J. (2023). Strengthening governance for health: Ethics, accountability, and
organizational responsibility. Bioethics Quarterly, 37(2), 145–160.
Savage, G. T. (2020). The role of the board in ensuring organizational integrity: Governance and ethics in
health care. Health Care Management Review, 45(3), 205–213.

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and
Practice, 30(1), 17–28.

HCM 570- Dis 14 Replies
Reply1: AHAD ALMUTAIRI
Digital Technologies for Remote Healthcare Access
To enhance healthcare accessibility for patients in remote locations, it is advocated that various
digital technologies be adopted to uphold efficiency, affordability, and inclusivity. These
technologies include telemedicine platforms, which provide secure video, voice, and text
consultations, reducing the need for travel and easing the strain on physical clinic facilities. This
setup not only brings medical advice to the patient’s doorstep, especially for ongoing conditions
but also improves the overall efficiency of healthcare delivery.
Mobile Health (mHealth) applications are another essential tool. With high smartphone usage
in the Kingdom, these applications are readily accessible and enable patients to manage
appointments, receive medication reminders, and access educational content on health. This
fosters patient autonomy in managing health conditions and ensures that vital health
information is at their fingertips, empowering those in remote areas. Similarly, Remote Patient
Monitoring (RPM) devices track vital signs and transmit this data to healthcare providers,
facilitating the management of chronic diseases from a distance and reducing the frequency of
in-person visits (Matthew-Maich et al., 2016).
Cloud-based Electronic Health Records (EHR) enhance the continuity of care by securely storing
and sharing patient data across different healthcare providers, ensuring that a patient’s medical
history is always accessible, regardless of location. This integration reduces medical errors and
enhances the quality of remote consultations (Anastasiadou et al., 2023). Additionally, EPharmacy services simplify how patients in isolated areas obtain medications by enabling them
to order prescriptions online and have them delivered directly to their homes (Sampene et al.,
2024).
Finally, the implementation of Digital Health Education Tools and Telehealth-Enabled Diagnostic
Tools educates patients on preventive care and chronic disease management, while also
enhancing the diagnostic accuracy during remote consultations. Improving connectivity and
infrastructure, particularly internet access, is crucial in supporting these technologies and
ensuring they are effective (Maita et al., 2024).To successfully implement these solutions, it is
important to consider privacy and security, provide adequate training for users, ensure cultural
and language appropriateness, and maintain affordability. By integrating these digital solutions,
clinics can significantly improve healthcare access and quality for remote patients, aligning with
high standards of care and fostering equitable health outcomes.
References

Anastasiadou, M. N., Isaia, P., Kolios, P., & Charalambous, C. (2023). Transitioning towards fit-forpurpose Public Health Surveillance Systems. ArXiv.org.
Maita, K. C., Maniaci, M. J., Haider, C. R., Avila, F. R., Torres-Guzman, R. A., Sahar Borna, Lunde,
J. J., Coffey, J. D., Demaerschalk, B. M., & Antonio Jorge Forte. (2024). The impact of digital
health solutions on bridging the health care gap in rural areas: A scoping review. The
Permanente Journal, 28(3), 1–14.
Matthew-Maich, N., Harris, L., Ploeg, J., Markle-Reid, M., Valaitis, R., Ibrahim, S., Gafni, A., &
Isaacs, S. (2016). Designing, Implementing, and Evaluating Mobile Health Technologies for
Managing Chronic Conditions in Older Adults: A Scoping Review. JMIR MHealth and UHealth,
4(2), e29.
Sampene, A., Li, C., & Wiredu, J. (2024). Unravelling the shift: exploring consumers’ adoption or
resistance of E-Pharmacy through behavioural reasoning theory. BMC Public Health, 24(1).

Reply2: GHADEER ALMUTAIRI
The development of the information systems
Introduction
The development of the information systems comes with the identification of the specific
concepts and factors that would influence the realization of the intended goals (Solomon &
Rudin, 2020). In a clinic, the development of the information systems would determine the
access to the specific services, which can influence the healthcare decisions. The
implementation of the digital technologies can help manage the remote access to healthcare,
which is instrumental in promoting access to care. The discussion focuses on the digital
technologies that can be developed and used in a remote clinic.
Explain and Justify the Digital Technologies That Would Be Recommended to Support Patients
The development and use of the digital technologies have a role in determining the
requirements towards access to the remote health services (Solomon & Rudin, 2020). The
digital technologies that should be considered are as follows:
Telemedicine And Telehealth
The use of the telecommunication systems is one of the strategies and ways that can
influence the management and use of the technologies to influence access to healthcare in
remote cases (Scott et al., 2020). Telemedicine and telehealth are systems that develops
relationships between the patients and the healthcare providers. The inclusion of the
telecommunication systems enables access to healthcare information, timely decision and
inputs that can govern the actualization of the telehealth needs (Scott et al., 2020). The focus
would be to ensure that the remote services are accessed through the telemedicine and
telehealth systems, leading to the easy access to the healthcare needs.
Mobile Health Applications
The other approach is the development of mobile health systems, which can be used in
the mobile devices (Scott et al., 2020). The use of the mobile applications enables the
healthcare systems to influence access to the healthcare services, while using the mobile
devices. The patients can use the application as a source of contacting and reporting to the
healthcare providers (Scott et al., 2020). In such a case, the healthcare management approaches
would be timely, effective and efficient, especially when handling the approaches and
requirements for access to care.
Smart Health Technologies

The other set of digital approaches would be the smart health technologies. The use of
smart devices and components helps in the real-time data collection and engagements
(Solomon & Rudin, 2020). In such cases, the focus would be on the strategic processes that can
help in deriving the approaches and measures towards access to healthcare. The use of smart
devices provides a tracking approach that can be used in the remote access to care.
Health information systems
The other approach would be the development of the health information systems. The
role of the systems us to provide electronic records, systems and procedures for managing the
information approaches (Solomon & Rudin, 2020). The approaches would be strategic,
especially when deleting with access to patient data in the remote areas. The access helps
determine the suited decision to make for the patients.
Conclusion
In summary, the use of digital technologies can be a strategic approach that can enable
the access to healthcare services. The use of telemedicine and telehealth, mobile health
applications, smart health technologies and healthcare information systems can help promote
access to remote healthcare systems.
References
Scott, B. K., Miller, G. T., Fonda, S. J., Yeaw, R. E., Gaudaen, J. C., Pavliscsak, H. H., … & Pamplin, J.
C. (2020). Advanced digital health technologies for COVID-19 and future emergencies.
Telemedicine and e-Health, 26(10), 1226-1233.
Solomon, D. H., & Rudin, R. S. (2020). Digital health technologies: opportunities and challenges
in rheumatology. Nature Reviews Rheumatology, 16(9), 525-535.

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