| Course | HCM 700 Healthcare Administration Capstone |
|---|---|
| Module | Module 8 |
| Paper type | graduate capstone milestone on evaluation, risk and sustainability |
| Length | About 1,160 words, 7 pages |
| Format | APA 7 student paper |
| School | Southern New Hampshire University |
| Program | MS Healthcare Administration |
| Updated | September 2026 |
Free sample paper for HCM 700 Module 8
Milestone Three: Knowing It Works and Keeping It Working at Willow Creek Care Center
[Student Name]
Southern New Hampshire University
HCM 700: Healthcare Administration Capstone
Module Eight Milestone Three
[Instructor Name]
[Date]
The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.
Milestone Three: Knowing It Works and Keeping It Working at Willow Creek Care Center
With the solution designed and its finances tested, the remaining task is to make sure Willow Creek Care Center can tell whether Stay and Grow is working, respond when it is not and keep its gains after the capstone ends. This milestone sets out evaluation questions and design, measures and targets, data and reporting, a risk register and a sustainability and spread plan.
Evaluation Questions
Five questions guide the evaluation. Did nursing staff turnover and agency use fall, and by how much? Did resident outcomes and ratings improve? Did the facility's finances improve as projected? Were the plan's components carried out as designed? And did the changes cause harm elsewhere, such as excessive overtime or staff injuries? The first three concern results, the fourth concerns fidelity and the fifth concerns unintended effects.
Evaluation Design
The design is an interrupted time series using monthly data for 24 months before launch and 36 months after, which shows whether trends changed when the plan began rather than relying on a single before-and-after comparison. To account for regional labor market changes, Willow Creek's turnover and staffing will be compared with eight nursing homes in the same region using federal payroll-based journal data. Gandhi et al. (2021) showed that these payroll records can be used to measure turnover consistently across facilities, making such a comparison feasible without surveying competitors.
Outcome Measures
Outcome measures cover workforce, residents and finances. On the workforce side, the team follows total and aide turnover, how many new aides remain after three months, open positions and the agency portion of nursing hours. Resident outcomes are 30-day rehospitalization of short-stay residents, long-stay falls with major injury, antipsychotic use, inspection deficiencies and the overall star rating. Financial outcomes are operating margin, average daily census, agency spending and cost per resident day.
Fidelity Measures
The INTERACT trial by Kane et al. (2017) showed that a program's effect depends on how thoroughly it is used, since benefits appeared only in facilities with heavy use. Willow Creek will therefore track fidelity for each component: the share of new aides paired with a mentor, completed first-, second- and third-month check-ins, the percentage of shifts following consistent assignment, the float pool's share of call-outs covered, charge nurse coaching completion, career ladder enrollment and, in phase two, documented use of early-warning tools per resident. Poor results can then be traced to weak implementation rather than a flawed idea.
Balancing Measures
Balancing measures watch for harm. Overtime hours could rise as the facility reduces agency use; staff injuries could rise if lifts are unused; wage costs per resident day could outpace plan; and admissions of residents with complex needs could fall if managers protect staff workloads by being selective. Each will be reviewed monthly alongside outcomes.
Targets
Table 1 sets baselines and targets for the main measures. Targets reflect the financial analysis so that evaluation and finance use the same expectations.
Table 1. Key Measures, Baselines and Targets
| Measure | Baseline | Year 1 target | Year 3 target |
|---|---|---|---|
| Nursing staff turnover | 94% | 75% | 50% |
| Aide 90-day retention | 53% | 70% | 85% |
| Agency share of nursing hours | 18% | 13% | 5% |
| Consistent assignment (shifts) | Not tracked | 60% | 85% |
| Short-stay 30-day rehospitalization | 25.8% | 25% | 21% |
| Overall star rating | 2 | 2 | 3 |
| Average daily census | 97 | 100 | 107 |
| Operating margin | -3.1% | -3.4% | 2.1% |
| Overtime share of nursing hours | 6% | 8% maximum | 6% maximum |
Note. Targets aligned with the Module Seven financial analysis.
Data and Reporting
Human resources will supply monthly turnover, retention, vacancy and fidelity data; payroll will supply agency and overtime hours; the director of nursing will supply clinical measures from resident assessments and incident reports; and finance will supply census and margin. Each month's figures go onto run charts read with standard signal rules, such as a run of six months all landing above, or all below, the center line. The steering committee reviews the dashboard monthly, the parent board quarterly.
The Risk Register
The steering committee identified seven risks. Table 2 rates each and assigns an owner. The highest-rated are a regional wage escalation, loss of the director of nursing and another infectious disease outbreak. Xu et al. (2020) found that nursing homes with COVID-19 cases among staff or residents were more likely to report staff shortages, a reminder that outbreaks can undo workforce gains quickly.
Table 2. Risk Register
| Risk | Likelihood | Impact | Mitigation | Owner |
|---|---|---|---|---|
| Regional wage escalation | High | High | Annual market review; reserve for step adjustments | HR director |
| Director of nursing leaves | Medium | High | Assistant director development; documented processes | Administrator |
| Outbreak causes shortages | Medium | High | Float pool cross-training; outbreak staffing plan | Director of nursing |
| Medicaid rate cut | Low | High | Advocacy; payer mix review | Administrator |
| Float pool unfilled | Medium | Medium | Higher differential; internal recruitment | HR director |
| Phase two trigger not reached | Medium | Medium | Six-month review of retention components | Steering committee |
| Data errors | Medium | Low | Monthly data validation | Project lead |
Note. Ratings agreed by the steering committee.
Contingency Triggers
Specific triggers prompt action. If agency hours have not fallen by a quarter at the six-month checkpoint, the committee will review each retention component's fidelity and adjust before spending more. If turnover rises for three consecutive months, human resources will conduct stay interviews within two weeks. If overtime exceeds 8% of nursing hours for two months, the float pool and staffing floor will be reviewed. Triggers turn the risk register from a document into a management tool.
Sustainability
Gains fade when programs depend on one champion or on temporary funding. Stay and Grow will be written into policy, including the compensation policy, scheduling policy and job descriptions, so it survives leadership changes. Its costs will be built into the operating budget rather than funded as a project. Mentor and charge nurse training will be repeated for each new cohort. Consistent assignment, which Castle (2013) associated with lower turnover and absenteeism, will become the default scheduling model. Stay interviews will continue quarterly after the evaluation ends.
Spreading the Program
The parent organization operates two other nursing homes with similar turnover. If year one results meet at least four of the six main targets, the plan recommends adapting Stay and Grow for one of them in year two, adjusting wages to its local market. Willow Creek's steering committee members, including the aide representatives, would help teach the other facility's staff what worked and what did not.
Ethical Considerations
Evaluation involves staff and resident information. Stay interview notes and readiness surveys will be kept confidential from direct supervisors and reported only in aggregate. Resident outcome data will be reported without identifying individuals. Aides will be told how their feedback is used, which also builds the trust the readiness survey found lacking.
Conclusion
The evaluation plan asks whether Stay and Grow works, how well it is carried out and what harms it might cause, using a time series with regional benchmarks, clear targets and monthly reporting. A risk register with owners and triggers, policies that embed the program and a plan for spread give it a future beyond the capstone. The final report will bring every piece together for the board.
References
Castle, N. G. (2013). Consistent assignment of nurse aides: Association with turnover and absenteeism. Journal of Aging & Social Policy, 25(1), 48-64. https://doi.org/10.1080/08959420.2012.705647
Gandhi, A., Yu, H., & Grabowski, D. C. (2021). High nursing staff turnover in nursing homes offers important quality information. Health Affairs, 40(3), 384-391. https://doi.org/10.1377/hlthaff.2020.00957
Kane, R. L., Huckfeldt, P., Tappen, R., Engstrom, G., Rojido, C., Newman, D., Yang, Z., & Ouslander, J. G. (2017). Effects of an intervention to reduce hospitalizations from nursing homes: A randomized implementation trial of the INTERACT program. JAMA Internal Medicine, 177(9), 1257-1264. https://doi.org/10.1001/jamainternmed.2017.2657
Xu, H., Intrator, O., & Bowblis, J. R. (2020). Shortages of staff in nursing homes during the COVID-19 pandemic: What are the driving factors? Journal of the American Medical Directors Association, 21(10), 1371-1377. https://doi.org/10.1016/j.jamda.2020.08.002
What the HCM 700 Module 8 instructions ask for
HCM 700 Milestone Three usually asks how you will evaluate your capstone solution, manage its risks and sustain its results. A paper of roughly six to eight pages with four or more peer-reviewed sources in APA 7 fits most versions. Pose clear evaluation questions, pick a design that tracks trends over time or against peers instead of one pre-post snapshot and define outcome, fidelity and balancing measures with baselines and targets. Build a risk register with likelihood, impact, mitigation and owners, set triggers for action and explain how the program will be embedded and possibly spread. HCM 700 graders notice clean headings in HCM 700 papers. HCM 700 names and dates need checking before HCM 700 submission. HCM 700 prompts vary by term, so recheck HCM 700 directions.
How this HCM 700 Module 8 milestone three example is built
The milestone poses five evaluation questions and uses an interrupted time series with eight regional peers measured through payroll staffing data, as Gandhi and colleagues did. Outcome measures cover workforce, residents and finances; fidelity measures follow Kane and colleagues' lesson that effects depend on use; balancing measures watch overtime and injuries. A target table aligns with the financial analysis, a risk register rates seven risks with Xu and colleagues' outbreak findings in mind, triggers define responses and policy, budget and training steps sustain the program before spread. HCM 700 students can reuse this structure for HCM 700 work. HCM 700 claims here trace to cited HCM 700 sources. HCM 700 readers can adapt each section to HCM 700 data.
Where the HCM 700 Module 8 rubric puts the points
Evaluation and sustainability milestones in HCM 700 are commonly graded on the clarity of evaluation questions, strength of design, completeness of measures including fidelity and balancing, realism of targets, quality of the risk plan, sustainability strategy and APA 7 mechanics. The strongest submissions align targets with the financial case, assign owners to every risk and define triggers that prompt specific actions. Graders reward plans that anticipate implementation failure and explain how the organization would tell weak execution from a weak idea. HCM 700 marks favor careful formatting across HCM 700 sections. HCM 700 citations keep every HCM 700 argument credible. HCM 700 instructors weigh evidence heavily in HCM 700 grading.
HCM 700 Module 8 help: the mistakes that cost points
Evaluation milestones lose points when measures are vague, when there is no baseline or target, when fidelity is not tracked or when risks are listed without owners or responses. Another frequent gap is assuming a program will sustain itself. Ask clear questions, choose a sound design, define all measure types, set aligned targets, build a register with triggers and embed the change in policy and budget. Where the course asks for a named evaluation model, Donabedian's structure-process-outcome triad for instance, send it with your HCM 700 notes. HCM 700 drafts start well from a HCM 700 outline. HCM 700 feedback already received guides HCM 700 revisions. HCM 700 rubrics posted in Brightspace clarify HCM 700 expectations.
Get HCM 700 Module 8 written to your instructions
Send the HCM 700 Milestone Three prompt and your solution and financial plan. The milestone will pose evaluation questions, choose a design, define outcome, fidelity and balancing measures with targets, build a risk register with triggers and plan sustainability, within 24 to 48 hours, free the first time. The paper above is an original model document written by our desk, not a submitted student paper and not an official Southern New Hampshire University document.
More HCM 700 papers and related MS Healthcare Administration samples
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HCM 700 Module 8 questions, answered
Where can I find a free HCM 700 Module 8 Milestone Three sample?
Every section of HCM 700 Milestone Three is published here: a nursing home plan's evaluation design, fidelity and balancing measures, risk register and sustainability plan.
What are fidelity measures?
Measures of whether a program's components are carried out as designed, such as the share of shifts following consistent assignment.
Why use an interrupted time series?
It uses many months before and after a change, showing whether trends shifted rather than relying on one comparison.
What belongs in a risk register?
Each risk's likelihood, impact, mitigation and a named owner, often with triggers that prompt action.
How can a capstone program be sustained?
Write it into policy, build costs into the operating budget, repeat training for new staff and keep gathering feedback.