Financial Exercise 3

Planning and Controlling

Answer the following questions. If needed, import Excel graphs or spreadsheets as indicated in the individual question instructions. Answers to the questions should be at a minimum a half page long with examples and scholarly citations to support the answer(s) provided.

1.How does pay for performance (P4P) or value-based purchasing (VBP) affect staffing?

2.As the nurse manager of the new 15-bed observation unit you are responsible for reporting to your nursing director and the finance department any variances identified within your operating budget. Listed below is your monthly operating report. Please review and discuss the specific variances and how you will determine the causes of variances.

Actual

Budget

Variance

Volume/Census

360

420

Supplies

$8,550

$7,800

Nursing Labor

$58,450

$52,575

3.As the nurse manager, you will now need to determine the staff mix based on budgeted full-time equivalents (FTEs). Consider the formula below:

Actual Price per FTE x Actual Total Number of FTEs = Budgeted Cost

Using the figure in the table above for nursing labor, calculate the Actual Cost and how you will divide the nursing labor expense based on skill mix. Consider safe staffing requirements, quality of care and operational needs to meet the demands of the new unit. Provide a detailed rationale of why and how you arrived at your decision.

4.The productivity standards for your new observation unit are set. You must meet the minimum target of 95% with a maximum target of 105%. Keep in mind that volume drives productivity in a positive direction. Using the formulas provided in your assigned textbook readings, determine the number of patients you need to admit to meet budgeted volumes. Consider the type of unit you are managing. An observation unit has a minimal stay of six (6) hours and a maximum stay of forty-eight (48) hours. Most patients are admitted into an appropriate next level of care (inpatient admission) or discharged home within 24 hours of admission into an observation unit. This demonstrates a unit with rapid turnover. Also include in your discussion how nursing labor/staffing will be managed when census/volume drops.