Case Study You are the manager for 3 West, a medical/surgical unit. You have been given the following data to assist you in preparing your budget for the upcoming fiscal year. Patient Data Average Daily Census (ADC): 53 Budget based on 6.2 Avg. Hours per patient day (HPPD) (6.2 HPPD excludes Nurse Manager and unit secretaries (Fixed FTE's)) Staff Data Total FTEs

40 Variable FTEs 1 Nurse Manager 3 Unit Secretaries 44 Total FTEs Staffing Mix RN 75% LVN 10% NA 15% Average Salary Scale per Employee Benefits are 35% of annual salaries Nurse Manager $85,500.00 per year Registered Nurses (RN) $38.00 per hour Licensed Vocational Nurses (LVN) $27.00 per hour Nurse Aides (NA) $15.00 per hour Unit Secretary (US) $13.00 per hour

Questions Refer to the case study to obtain the data required to answer these questions. You calculate all the FTE's not a single FTE for each discipline.

1. How many RNs, LVNs, and NAs, by category, are on the staff of 3 West? (Round FTEs to the nearest tenth.) Compute totals for each column.

Positions	Variable FTEs	% by Position	FTEs by Position
RN	40	0.75
LVN	40
NA	40
Totals

2. Compute the annual salary budget for 3 West. Compute totals for appropriate columns.

Positions	FTEs	Salary	Hours	Salary Subtotals	Amount of Benefits	Total
MANAGER	1.0	$ 85,500.00	XXXX	$85,500.00	$29,925	$115,425
RN	30	$ 38.00	2080
LVN	4	$ 27.00	2080
NA	6	$ 15.00	2080
Sec	3	$ 13.00	2080
Totals	44	XXXXX	XXXXXX

3. You are the manager for 3 West, a medical/surgical unit. You have been given the following data to assist you in preparing your budget for the upcoming fiscal year. Patient Data Average Daily Census (ADC): 53 Budget based on 6.2 Avg. Hours per patient day (HPPD) (6.2 HPPD excludes Nurse Manager and unit secretaries (Fixed FTEs)) A. To complete the table calculate the actual average hours of care required per patient day (HPPD) for the patients in 3 West. Round to the nearest tenth

Acuity Mix	Average Hours of Care Required	Average Daily Census (ADC)	Total Hours of Care Per Day
I	1.4	8	11.2
II	3.9	21
III	5.6	19
IV	8.8	5
Totals	53
Hours per patient day (HPPD)

B. Remember that your established personnel budget for 3 West assumes a HPPD of 6.2. If your calculated HPPD is different, explain the significance of the variance. (If your calculated HPPD is different than 6.2, you must write more than, "We need more/less nurses.") What is the Significance of the variance? If you believe you need more staff, what will be your rationale for making this requires? If you have too many staff, what would your proposal be for bringing your staffing into a better balance? Your responses need to have detail and substance.

C. What are the implications for the Nurse Manager? As an example, based on your conclusions in Section B, what other observations would you make as you review your total budget and what would you expect to see as a result? (Ex: supply costs; overtime hours, average census of 50 on a 60 bed unit, etc.)

4. You have set two new goals for your unit for the next year related to personnel: Provide stronger unit management support on evening and night shifts and in the absence of the manager. Correct unfavorable efficiency variances due to overtime. To accomplish these goals, you plan to make these changes: Add 1.0 RN FTE position Eliminate 1.5 LVN positions Add 1.5 FTEs NA positions Add 1.0 Assistant HN position at $62,000.00/year Calculate ONLY the cost of the proposed recommendations for 3 West. Compute totals for each column. If the change represents a reduction in the budget for that category, record the total as a negative number. If it represents an increase in the budget for that category, record the total as a positive number.

Positions	FTEs	Salary	Hours	Salary Subtotals	Benefits	Total
RN	1
LVN	-1.5
NA	1.5
AHN	1		XXXXX
Totals	2	XXXXX	XXXXX

5. Assume your proposal was approved. Calculate the new personnel budget (You will use your budget from question 2 and account for the changes you requested in question 4). Compute totals for each column.

Positions	FTEs	Salary	Hours	Salary Subtotals	Benefits	Total
Manager	1		XXXXX
AHN	1		XXXXX
RN
LVN
NA
Sec
Totals		XXXXX	XXXXX