Start your day with hope, but end it with accomplishment .
Start your day with hope, but end it with accomplishment.
Dec 26, 2015
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Transcript
Start your day
with hope
but end it with
accomplishment
BUDGETING FOR BUDGETING FOR NURSING SERVICE NURSING SERVICE
Healthcare organizations are increasingly focused on cost-containment and efficacious use of financial resources Todayrsquos nursing leaders require budgeting knowledge in order to efficiently manage operations in the patient care environment and meet financial targets
Budgets A budget is a detailed financial plan used to carry out organizational goals The budget includes proposed earnings and expenditures as well as details about how resources( money time and people) will be acquired and used The purpose of the budget is to project future plans and costs
Operating budget-deals primarily with salaries supplies and contractual services It is the financial plan for the day to day activities of the organization containing a statement of expected revenues and expenses for the fiscal year
Revenue Budget- includes expected income based on volume and mix of patients rates and discounts
Expense Budget- includes salary and non-salary items that reflect patient care objectives and planned activities for the nursing unit
Cost and Profit
Cost Center-the smallest area for which costs are accumulated They may produce revenue such as laboratory and radiology or not produce revenue such as nursing
Profit Center- a unit where performance is measured in terms of profit the difference between revenues and expenses
Classification of Costs
Fixed Costs-expenses that remain the same such as rent or insurance premiums
Variable costs-expenses that change with changes in volume and acuity
Mixed Costs-may vary with volume but not directly
Direct Costs-affect patient care
Salary (Personnel) Budget
The personnel budget projects the salary costs that will be paid and charged to the cost center It accounts for replacement of staff for benefit time overtime shift differentials orientation on-call hours bonuses and premiums and salary increases
Variance Analysis
The difference between the amount that was budgeted for a specific revenue or cost and the actual revenue or cost that resulted during the course of activities is known as the variance
There is an established level at which a variance needs to be investigated
A variance may be favorable or unfavorable and may be related to patient volume efficiency in relation to nursing care hours provided rates in hourly rates paid or in non-salary expenditures
Position Control- a tool to monitor actual numbers of employees to the number of FTErsquos budgeted
Why you need budgeting skills
oAbsolutely essential management skilloFinancial viabilityoQuality patient careoUnit operational efficiencyoStaff satisfactionoLeadership expectationoMost nurse managers do not come into the job with these skills
Department Patient Nurse ratio
ICUCCUNNN Burnt 1 1
Paediatric and Emergency
3 1
General Wards 6 1
Isolation ward 2 1
OPD (each) 1
Dressing Room (each)
1
OT 3 1
Capital Budgeting Process
Identify immediate needs
New services
New technology
Broken equipment
Identify Long-term needs
New servicesNew patient populationsNew technologyImproved technologyEquipment replacement planElimination of rentals
Give what they want
Get input
MDs (Intensivists surgeons cardiologistspecialists) RN Staff Respiratory Therapy Ancillary staff
Vendors1048707 Develop (compliant) vendor relationships throughout the year1048707 Be aware of contracted vendors1048707 Become knowledgeable about products1048707 Ask for demos1048707 Ask for references (and check them)1048707 Evaluate the literature provided to you1048707 Drive a hard bargain1048707 Donrsquot forget trade-in value1048707 Consider contract for training costs
Hidden Sources
Investigate sources of fundingTechnology committeesSpecialty funds Workplace safety fundsPatient safety fundsEquipment used in Clinical TrialsVendor trialsContingency Funds
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
BUDGETING FOR BUDGETING FOR NURSING SERVICE NURSING SERVICE
Healthcare organizations are increasingly focused on cost-containment and efficacious use of financial resources Todayrsquos nursing leaders require budgeting knowledge in order to efficiently manage operations in the patient care environment and meet financial targets
Budgets A budget is a detailed financial plan used to carry out organizational goals The budget includes proposed earnings and expenditures as well as details about how resources( money time and people) will be acquired and used The purpose of the budget is to project future plans and costs
Operating budget-deals primarily with salaries supplies and contractual services It is the financial plan for the day to day activities of the organization containing a statement of expected revenues and expenses for the fiscal year
Revenue Budget- includes expected income based on volume and mix of patients rates and discounts
Expense Budget- includes salary and non-salary items that reflect patient care objectives and planned activities for the nursing unit
Cost and Profit
Cost Center-the smallest area for which costs are accumulated They may produce revenue such as laboratory and radiology or not produce revenue such as nursing
Profit Center- a unit where performance is measured in terms of profit the difference between revenues and expenses
Classification of Costs
Fixed Costs-expenses that remain the same such as rent or insurance premiums
Variable costs-expenses that change with changes in volume and acuity
Mixed Costs-may vary with volume but not directly
Direct Costs-affect patient care
Salary (Personnel) Budget
The personnel budget projects the salary costs that will be paid and charged to the cost center It accounts for replacement of staff for benefit time overtime shift differentials orientation on-call hours bonuses and premiums and salary increases
Variance Analysis
The difference between the amount that was budgeted for a specific revenue or cost and the actual revenue or cost that resulted during the course of activities is known as the variance
There is an established level at which a variance needs to be investigated
A variance may be favorable or unfavorable and may be related to patient volume efficiency in relation to nursing care hours provided rates in hourly rates paid or in non-salary expenditures
Position Control- a tool to monitor actual numbers of employees to the number of FTErsquos budgeted
Why you need budgeting skills
oAbsolutely essential management skilloFinancial viabilityoQuality patient careoUnit operational efficiencyoStaff satisfactionoLeadership expectationoMost nurse managers do not come into the job with these skills
Department Patient Nurse ratio
ICUCCUNNN Burnt 1 1
Paediatric and Emergency
3 1
General Wards 6 1
Isolation ward 2 1
OPD (each) 1
Dressing Room (each)
1
OT 3 1
Capital Budgeting Process
Identify immediate needs
New services
New technology
Broken equipment
Identify Long-term needs
New servicesNew patient populationsNew technologyImproved technologyEquipment replacement planElimination of rentals
Give what they want
Get input
MDs (Intensivists surgeons cardiologistspecialists) RN Staff Respiratory Therapy Ancillary staff
Vendors1048707 Develop (compliant) vendor relationships throughout the year1048707 Be aware of contracted vendors1048707 Become knowledgeable about products1048707 Ask for demos1048707 Ask for references (and check them)1048707 Evaluate the literature provided to you1048707 Drive a hard bargain1048707 Donrsquot forget trade-in value1048707 Consider contract for training costs
Hidden Sources
Investigate sources of fundingTechnology committeesSpecialty funds Workplace safety fundsPatient safety fundsEquipment used in Clinical TrialsVendor trialsContingency Funds
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Healthcare organizations are increasingly focused on cost-containment and efficacious use of financial resources Todayrsquos nursing leaders require budgeting knowledge in order to efficiently manage operations in the patient care environment and meet financial targets
Budgets A budget is a detailed financial plan used to carry out organizational goals The budget includes proposed earnings and expenditures as well as details about how resources( money time and people) will be acquired and used The purpose of the budget is to project future plans and costs
Operating budget-deals primarily with salaries supplies and contractual services It is the financial plan for the day to day activities of the organization containing a statement of expected revenues and expenses for the fiscal year
Revenue Budget- includes expected income based on volume and mix of patients rates and discounts
Expense Budget- includes salary and non-salary items that reflect patient care objectives and planned activities for the nursing unit
Cost and Profit
Cost Center-the smallest area for which costs are accumulated They may produce revenue such as laboratory and radiology or not produce revenue such as nursing
Profit Center- a unit where performance is measured in terms of profit the difference between revenues and expenses
Classification of Costs
Fixed Costs-expenses that remain the same such as rent or insurance premiums
Variable costs-expenses that change with changes in volume and acuity
Mixed Costs-may vary with volume but not directly
Direct Costs-affect patient care
Salary (Personnel) Budget
The personnel budget projects the salary costs that will be paid and charged to the cost center It accounts for replacement of staff for benefit time overtime shift differentials orientation on-call hours bonuses and premiums and salary increases
Variance Analysis
The difference between the amount that was budgeted for a specific revenue or cost and the actual revenue or cost that resulted during the course of activities is known as the variance
There is an established level at which a variance needs to be investigated
A variance may be favorable or unfavorable and may be related to patient volume efficiency in relation to nursing care hours provided rates in hourly rates paid or in non-salary expenditures
Position Control- a tool to monitor actual numbers of employees to the number of FTErsquos budgeted
Why you need budgeting skills
oAbsolutely essential management skilloFinancial viabilityoQuality patient careoUnit operational efficiencyoStaff satisfactionoLeadership expectationoMost nurse managers do not come into the job with these skills
Department Patient Nurse ratio
ICUCCUNNN Burnt 1 1
Paediatric and Emergency
3 1
General Wards 6 1
Isolation ward 2 1
OPD (each) 1
Dressing Room (each)
1
OT 3 1
Capital Budgeting Process
Identify immediate needs
New services
New technology
Broken equipment
Identify Long-term needs
New servicesNew patient populationsNew technologyImproved technologyEquipment replacement planElimination of rentals
Give what they want
Get input
MDs (Intensivists surgeons cardiologistspecialists) RN Staff Respiratory Therapy Ancillary staff
Vendors1048707 Develop (compliant) vendor relationships throughout the year1048707 Be aware of contracted vendors1048707 Become knowledgeable about products1048707 Ask for demos1048707 Ask for references (and check them)1048707 Evaluate the literature provided to you1048707 Drive a hard bargain1048707 Donrsquot forget trade-in value1048707 Consider contract for training costs
Hidden Sources
Investigate sources of fundingTechnology committeesSpecialty funds Workplace safety fundsPatient safety fundsEquipment used in Clinical TrialsVendor trialsContingency Funds
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Budgets A budget is a detailed financial plan used to carry out organizational goals The budget includes proposed earnings and expenditures as well as details about how resources( money time and people) will be acquired and used The purpose of the budget is to project future plans and costs
Operating budget-deals primarily with salaries supplies and contractual services It is the financial plan for the day to day activities of the organization containing a statement of expected revenues and expenses for the fiscal year
Revenue Budget- includes expected income based on volume and mix of patients rates and discounts
Expense Budget- includes salary and non-salary items that reflect patient care objectives and planned activities for the nursing unit
Cost and Profit
Cost Center-the smallest area for which costs are accumulated They may produce revenue such as laboratory and radiology or not produce revenue such as nursing
Profit Center- a unit where performance is measured in terms of profit the difference between revenues and expenses
Classification of Costs
Fixed Costs-expenses that remain the same such as rent or insurance premiums
Variable costs-expenses that change with changes in volume and acuity
Mixed Costs-may vary with volume but not directly
Direct Costs-affect patient care
Salary (Personnel) Budget
The personnel budget projects the salary costs that will be paid and charged to the cost center It accounts for replacement of staff for benefit time overtime shift differentials orientation on-call hours bonuses and premiums and salary increases
Variance Analysis
The difference between the amount that was budgeted for a specific revenue or cost and the actual revenue or cost that resulted during the course of activities is known as the variance
There is an established level at which a variance needs to be investigated
A variance may be favorable or unfavorable and may be related to patient volume efficiency in relation to nursing care hours provided rates in hourly rates paid or in non-salary expenditures
Position Control- a tool to monitor actual numbers of employees to the number of FTErsquos budgeted
Why you need budgeting skills
oAbsolutely essential management skilloFinancial viabilityoQuality patient careoUnit operational efficiencyoStaff satisfactionoLeadership expectationoMost nurse managers do not come into the job with these skills
Department Patient Nurse ratio
ICUCCUNNN Burnt 1 1
Paediatric and Emergency
3 1
General Wards 6 1
Isolation ward 2 1
OPD (each) 1
Dressing Room (each)
1
OT 3 1
Capital Budgeting Process
Identify immediate needs
New services
New technology
Broken equipment
Identify Long-term needs
New servicesNew patient populationsNew technologyImproved technologyEquipment replacement planElimination of rentals
Give what they want
Get input
MDs (Intensivists surgeons cardiologistspecialists) RN Staff Respiratory Therapy Ancillary staff
Vendors1048707 Develop (compliant) vendor relationships throughout the year1048707 Be aware of contracted vendors1048707 Become knowledgeable about products1048707 Ask for demos1048707 Ask for references (and check them)1048707 Evaluate the literature provided to you1048707 Drive a hard bargain1048707 Donrsquot forget trade-in value1048707 Consider contract for training costs
Hidden Sources
Investigate sources of fundingTechnology committeesSpecialty funds Workplace safety fundsPatient safety fundsEquipment used in Clinical TrialsVendor trialsContingency Funds
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Operating budget-deals primarily with salaries supplies and contractual services It is the financial plan for the day to day activities of the organization containing a statement of expected revenues and expenses for the fiscal year
Revenue Budget- includes expected income based on volume and mix of patients rates and discounts
Expense Budget- includes salary and non-salary items that reflect patient care objectives and planned activities for the nursing unit
Cost and Profit
Cost Center-the smallest area for which costs are accumulated They may produce revenue such as laboratory and radiology or not produce revenue such as nursing
Profit Center- a unit where performance is measured in terms of profit the difference between revenues and expenses
Classification of Costs
Fixed Costs-expenses that remain the same such as rent or insurance premiums
Variable costs-expenses that change with changes in volume and acuity
Mixed Costs-may vary with volume but not directly
Direct Costs-affect patient care
Salary (Personnel) Budget
The personnel budget projects the salary costs that will be paid and charged to the cost center It accounts for replacement of staff for benefit time overtime shift differentials orientation on-call hours bonuses and premiums and salary increases
Variance Analysis
The difference between the amount that was budgeted for a specific revenue or cost and the actual revenue or cost that resulted during the course of activities is known as the variance
There is an established level at which a variance needs to be investigated
A variance may be favorable or unfavorable and may be related to patient volume efficiency in relation to nursing care hours provided rates in hourly rates paid or in non-salary expenditures
Position Control- a tool to monitor actual numbers of employees to the number of FTErsquos budgeted
Why you need budgeting skills
oAbsolutely essential management skilloFinancial viabilityoQuality patient careoUnit operational efficiencyoStaff satisfactionoLeadership expectationoMost nurse managers do not come into the job with these skills
Department Patient Nurse ratio
ICUCCUNNN Burnt 1 1
Paediatric and Emergency
3 1
General Wards 6 1
Isolation ward 2 1
OPD (each) 1
Dressing Room (each)
1
OT 3 1
Capital Budgeting Process
Identify immediate needs
New services
New technology
Broken equipment
Identify Long-term needs
New servicesNew patient populationsNew technologyImproved technologyEquipment replacement planElimination of rentals
Give what they want
Get input
MDs (Intensivists surgeons cardiologistspecialists) RN Staff Respiratory Therapy Ancillary staff
Vendors1048707 Develop (compliant) vendor relationships throughout the year1048707 Be aware of contracted vendors1048707 Become knowledgeable about products1048707 Ask for demos1048707 Ask for references (and check them)1048707 Evaluate the literature provided to you1048707 Drive a hard bargain1048707 Donrsquot forget trade-in value1048707 Consider contract for training costs
Hidden Sources
Investigate sources of fundingTechnology committeesSpecialty funds Workplace safety fundsPatient safety fundsEquipment used in Clinical TrialsVendor trialsContingency Funds
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Cost and Profit
Cost Center-the smallest area for which costs are accumulated They may produce revenue such as laboratory and radiology or not produce revenue such as nursing
Profit Center- a unit where performance is measured in terms of profit the difference between revenues and expenses
Classification of Costs
Fixed Costs-expenses that remain the same such as rent or insurance premiums
Variable costs-expenses that change with changes in volume and acuity
Mixed Costs-may vary with volume but not directly
Direct Costs-affect patient care
Salary (Personnel) Budget
The personnel budget projects the salary costs that will be paid and charged to the cost center It accounts for replacement of staff for benefit time overtime shift differentials orientation on-call hours bonuses and premiums and salary increases
Variance Analysis
The difference between the amount that was budgeted for a specific revenue or cost and the actual revenue or cost that resulted during the course of activities is known as the variance
There is an established level at which a variance needs to be investigated
A variance may be favorable or unfavorable and may be related to patient volume efficiency in relation to nursing care hours provided rates in hourly rates paid or in non-salary expenditures
Position Control- a tool to monitor actual numbers of employees to the number of FTErsquos budgeted
Why you need budgeting skills
oAbsolutely essential management skilloFinancial viabilityoQuality patient careoUnit operational efficiencyoStaff satisfactionoLeadership expectationoMost nurse managers do not come into the job with these skills
Department Patient Nurse ratio
ICUCCUNNN Burnt 1 1
Paediatric and Emergency
3 1
General Wards 6 1
Isolation ward 2 1
OPD (each) 1
Dressing Room (each)
1
OT 3 1
Capital Budgeting Process
Identify immediate needs
New services
New technology
Broken equipment
Identify Long-term needs
New servicesNew patient populationsNew technologyImproved technologyEquipment replacement planElimination of rentals
Give what they want
Get input
MDs (Intensivists surgeons cardiologistspecialists) RN Staff Respiratory Therapy Ancillary staff
Vendors1048707 Develop (compliant) vendor relationships throughout the year1048707 Be aware of contracted vendors1048707 Become knowledgeable about products1048707 Ask for demos1048707 Ask for references (and check them)1048707 Evaluate the literature provided to you1048707 Drive a hard bargain1048707 Donrsquot forget trade-in value1048707 Consider contract for training costs
Hidden Sources
Investigate sources of fundingTechnology committeesSpecialty funds Workplace safety fundsPatient safety fundsEquipment used in Clinical TrialsVendor trialsContingency Funds
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Classification of Costs
Fixed Costs-expenses that remain the same such as rent or insurance premiums
Variable costs-expenses that change with changes in volume and acuity
Mixed Costs-may vary with volume but not directly
Direct Costs-affect patient care
Salary (Personnel) Budget
The personnel budget projects the salary costs that will be paid and charged to the cost center It accounts for replacement of staff for benefit time overtime shift differentials orientation on-call hours bonuses and premiums and salary increases
Variance Analysis
The difference between the amount that was budgeted for a specific revenue or cost and the actual revenue or cost that resulted during the course of activities is known as the variance
There is an established level at which a variance needs to be investigated
A variance may be favorable or unfavorable and may be related to patient volume efficiency in relation to nursing care hours provided rates in hourly rates paid or in non-salary expenditures
Position Control- a tool to monitor actual numbers of employees to the number of FTErsquos budgeted
Why you need budgeting skills
oAbsolutely essential management skilloFinancial viabilityoQuality patient careoUnit operational efficiencyoStaff satisfactionoLeadership expectationoMost nurse managers do not come into the job with these skills
Department Patient Nurse ratio
ICUCCUNNN Burnt 1 1
Paediatric and Emergency
3 1
General Wards 6 1
Isolation ward 2 1
OPD (each) 1
Dressing Room (each)
1
OT 3 1
Capital Budgeting Process
Identify immediate needs
New services
New technology
Broken equipment
Identify Long-term needs
New servicesNew patient populationsNew technologyImproved technologyEquipment replacement planElimination of rentals
Give what they want
Get input
MDs (Intensivists surgeons cardiologistspecialists) RN Staff Respiratory Therapy Ancillary staff
Vendors1048707 Develop (compliant) vendor relationships throughout the year1048707 Be aware of contracted vendors1048707 Become knowledgeable about products1048707 Ask for demos1048707 Ask for references (and check them)1048707 Evaluate the literature provided to you1048707 Drive a hard bargain1048707 Donrsquot forget trade-in value1048707 Consider contract for training costs
Hidden Sources
Investigate sources of fundingTechnology committeesSpecialty funds Workplace safety fundsPatient safety fundsEquipment used in Clinical TrialsVendor trialsContingency Funds
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Salary (Personnel) Budget
The personnel budget projects the salary costs that will be paid and charged to the cost center It accounts for replacement of staff for benefit time overtime shift differentials orientation on-call hours bonuses and premiums and salary increases
Variance Analysis
The difference between the amount that was budgeted for a specific revenue or cost and the actual revenue or cost that resulted during the course of activities is known as the variance
There is an established level at which a variance needs to be investigated
A variance may be favorable or unfavorable and may be related to patient volume efficiency in relation to nursing care hours provided rates in hourly rates paid or in non-salary expenditures
Position Control- a tool to monitor actual numbers of employees to the number of FTErsquos budgeted
Why you need budgeting skills
oAbsolutely essential management skilloFinancial viabilityoQuality patient careoUnit operational efficiencyoStaff satisfactionoLeadership expectationoMost nurse managers do not come into the job with these skills
Department Patient Nurse ratio
ICUCCUNNN Burnt 1 1
Paediatric and Emergency
3 1
General Wards 6 1
Isolation ward 2 1
OPD (each) 1
Dressing Room (each)
1
OT 3 1
Capital Budgeting Process
Identify immediate needs
New services
New technology
Broken equipment
Identify Long-term needs
New servicesNew patient populationsNew technologyImproved technologyEquipment replacement planElimination of rentals
Give what they want
Get input
MDs (Intensivists surgeons cardiologistspecialists) RN Staff Respiratory Therapy Ancillary staff
Vendors1048707 Develop (compliant) vendor relationships throughout the year1048707 Be aware of contracted vendors1048707 Become knowledgeable about products1048707 Ask for demos1048707 Ask for references (and check them)1048707 Evaluate the literature provided to you1048707 Drive a hard bargain1048707 Donrsquot forget trade-in value1048707 Consider contract for training costs
Hidden Sources
Investigate sources of fundingTechnology committeesSpecialty funds Workplace safety fundsPatient safety fundsEquipment used in Clinical TrialsVendor trialsContingency Funds
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Variance Analysis
The difference between the amount that was budgeted for a specific revenue or cost and the actual revenue or cost that resulted during the course of activities is known as the variance
There is an established level at which a variance needs to be investigated
A variance may be favorable or unfavorable and may be related to patient volume efficiency in relation to nursing care hours provided rates in hourly rates paid or in non-salary expenditures
Position Control- a tool to monitor actual numbers of employees to the number of FTErsquos budgeted
Why you need budgeting skills
oAbsolutely essential management skilloFinancial viabilityoQuality patient careoUnit operational efficiencyoStaff satisfactionoLeadership expectationoMost nurse managers do not come into the job with these skills
Department Patient Nurse ratio
ICUCCUNNN Burnt 1 1
Paediatric and Emergency
3 1
General Wards 6 1
Isolation ward 2 1
OPD (each) 1
Dressing Room (each)
1
OT 3 1
Capital Budgeting Process
Identify immediate needs
New services
New technology
Broken equipment
Identify Long-term needs
New servicesNew patient populationsNew technologyImproved technologyEquipment replacement planElimination of rentals
Give what they want
Get input
MDs (Intensivists surgeons cardiologistspecialists) RN Staff Respiratory Therapy Ancillary staff
Vendors1048707 Develop (compliant) vendor relationships throughout the year1048707 Be aware of contracted vendors1048707 Become knowledgeable about products1048707 Ask for demos1048707 Ask for references (and check them)1048707 Evaluate the literature provided to you1048707 Drive a hard bargain1048707 Donrsquot forget trade-in value1048707 Consider contract for training costs
Hidden Sources
Investigate sources of fundingTechnology committeesSpecialty funds Workplace safety fundsPatient safety fundsEquipment used in Clinical TrialsVendor trialsContingency Funds
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Why you need budgeting skills
oAbsolutely essential management skilloFinancial viabilityoQuality patient careoUnit operational efficiencyoStaff satisfactionoLeadership expectationoMost nurse managers do not come into the job with these skills
Department Patient Nurse ratio
ICUCCUNNN Burnt 1 1
Paediatric and Emergency
3 1
General Wards 6 1
Isolation ward 2 1
OPD (each) 1
Dressing Room (each)
1
OT 3 1
Capital Budgeting Process
Identify immediate needs
New services
New technology
Broken equipment
Identify Long-term needs
New servicesNew patient populationsNew technologyImproved technologyEquipment replacement planElimination of rentals
Give what they want
Get input
MDs (Intensivists surgeons cardiologistspecialists) RN Staff Respiratory Therapy Ancillary staff
Vendors1048707 Develop (compliant) vendor relationships throughout the year1048707 Be aware of contracted vendors1048707 Become knowledgeable about products1048707 Ask for demos1048707 Ask for references (and check them)1048707 Evaluate the literature provided to you1048707 Drive a hard bargain1048707 Donrsquot forget trade-in value1048707 Consider contract for training costs
Hidden Sources
Investigate sources of fundingTechnology committeesSpecialty funds Workplace safety fundsPatient safety fundsEquipment used in Clinical TrialsVendor trialsContingency Funds
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Department Patient Nurse ratio
ICUCCUNNN Burnt 1 1
Paediatric and Emergency
3 1
General Wards 6 1
Isolation ward 2 1
OPD (each) 1
Dressing Room (each)
1
OT 3 1
Capital Budgeting Process
Identify immediate needs
New services
New technology
Broken equipment
Identify Long-term needs
New servicesNew patient populationsNew technologyImproved technologyEquipment replacement planElimination of rentals
Give what they want
Get input
MDs (Intensivists surgeons cardiologistspecialists) RN Staff Respiratory Therapy Ancillary staff
Vendors1048707 Develop (compliant) vendor relationships throughout the year1048707 Be aware of contracted vendors1048707 Become knowledgeable about products1048707 Ask for demos1048707 Ask for references (and check them)1048707 Evaluate the literature provided to you1048707 Drive a hard bargain1048707 Donrsquot forget trade-in value1048707 Consider contract for training costs
Hidden Sources
Investigate sources of fundingTechnology committeesSpecialty funds Workplace safety fundsPatient safety fundsEquipment used in Clinical TrialsVendor trialsContingency Funds
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Capital Budgeting Process
Identify immediate needs
New services
New technology
Broken equipment
Identify Long-term needs
New servicesNew patient populationsNew technologyImproved technologyEquipment replacement planElimination of rentals
Give what they want
Get input
MDs (Intensivists surgeons cardiologistspecialists) RN Staff Respiratory Therapy Ancillary staff
Vendors1048707 Develop (compliant) vendor relationships throughout the year1048707 Be aware of contracted vendors1048707 Become knowledgeable about products1048707 Ask for demos1048707 Ask for references (and check them)1048707 Evaluate the literature provided to you1048707 Drive a hard bargain1048707 Donrsquot forget trade-in value1048707 Consider contract for training costs
Hidden Sources
Investigate sources of fundingTechnology committeesSpecialty funds Workplace safety fundsPatient safety fundsEquipment used in Clinical TrialsVendor trialsContingency Funds
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Identify immediate needs
New services
New technology
Broken equipment
Identify Long-term needs
New servicesNew patient populationsNew technologyImproved technologyEquipment replacement planElimination of rentals
Give what they want
Get input
MDs (Intensivists surgeons cardiologistspecialists) RN Staff Respiratory Therapy Ancillary staff
Vendors1048707 Develop (compliant) vendor relationships throughout the year1048707 Be aware of contracted vendors1048707 Become knowledgeable about products1048707 Ask for demos1048707 Ask for references (and check them)1048707 Evaluate the literature provided to you1048707 Drive a hard bargain1048707 Donrsquot forget trade-in value1048707 Consider contract for training costs
Hidden Sources
Investigate sources of fundingTechnology committeesSpecialty funds Workplace safety fundsPatient safety fundsEquipment used in Clinical TrialsVendor trialsContingency Funds
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Identify Long-term needs
New servicesNew patient populationsNew technologyImproved technologyEquipment replacement planElimination of rentals
Give what they want
Get input
MDs (Intensivists surgeons cardiologistspecialists) RN Staff Respiratory Therapy Ancillary staff
Vendors1048707 Develop (compliant) vendor relationships throughout the year1048707 Be aware of contracted vendors1048707 Become knowledgeable about products1048707 Ask for demos1048707 Ask for references (and check them)1048707 Evaluate the literature provided to you1048707 Drive a hard bargain1048707 Donrsquot forget trade-in value1048707 Consider contract for training costs
Hidden Sources
Investigate sources of fundingTechnology committeesSpecialty funds Workplace safety fundsPatient safety fundsEquipment used in Clinical TrialsVendor trialsContingency Funds
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Give what they want
Get input
MDs (Intensivists surgeons cardiologistspecialists) RN Staff Respiratory Therapy Ancillary staff
Vendors1048707 Develop (compliant) vendor relationships throughout the year1048707 Be aware of contracted vendors1048707 Become knowledgeable about products1048707 Ask for demos1048707 Ask for references (and check them)1048707 Evaluate the literature provided to you1048707 Drive a hard bargain1048707 Donrsquot forget trade-in value1048707 Consider contract for training costs
Hidden Sources
Investigate sources of fundingTechnology committeesSpecialty funds Workplace safety fundsPatient safety fundsEquipment used in Clinical TrialsVendor trialsContingency Funds
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Vendors1048707 Develop (compliant) vendor relationships throughout the year1048707 Be aware of contracted vendors1048707 Become knowledgeable about products1048707 Ask for demos1048707 Ask for references (and check them)1048707 Evaluate the literature provided to you1048707 Drive a hard bargain1048707 Donrsquot forget trade-in value1048707 Consider contract for training costs
Hidden Sources
Investigate sources of fundingTechnology committeesSpecialty funds Workplace safety fundsPatient safety fundsEquipment used in Clinical TrialsVendor trialsContingency Funds
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Hidden Sources
Investigate sources of fundingTechnology committeesSpecialty funds Workplace safety fundsPatient safety fundsEquipment used in Clinical TrialsVendor trialsContingency Funds
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Make a convincing caseHow does this equipment improve quality of patient careIs it a regulatory compliance issueWill it improve patient safetyWill it improve staff safetyWill it save you money in the long run
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Final Advice
Be mindful of deadlinesAllow enough time for each step of the processVendor response timePaperworkLocalregionalcorporate approvalsFiscal year
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Budget Variance in the Operating Budget
WHY ARE YOU OVER BUDGET
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Budget Variance
bullPayroll budget
bullNon-payroll budget
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Non-payroll Operating Budget
Supply Costs
Equipment Costs
Operational Costs
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Non-payroll costs
bullUnit upkeep constructionbullOperational CostsbullEducationbullConference feesbullReferences materialsbullEmployee recognition
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Non-payroll (cont)
Transportation
Traveler housing
One-time expenses
Lost patient belongings
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Supply Costs
Ask yourself ldquoIs there a change in the supply
OR
a change in the patientsrdquo
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Change in supply cost
New productChange in cost of productChange in vendorChange in contract priceSubstitute productStocking Issues
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Change in Patient
bullChange in volume
bullChange in patient population
bullIndividual patient need
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Equipment Cost
PurchasesRentalsMaintenanceVendor changeContract ChangeConsider capitated costs for rentals
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Payroll Budget
Simply puthellipWhat you pay the people who take care of the patients
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Payroll Budgeting Tips1048707 Budget to full-time equivalents (FTEs) and dollars1048707 Account for inflation and salary increases1048707 Factor in contractual obligations1048707 Estimate non-productive time1048707 Account for anticipated changes in patient volume and acuity
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Payroll budget1048707Volume1048707Acuity1048707Overtime Pay1048707 Penalty Pay1048707Registry and Traveler PayPayroll Variance1048707 Volume1048707 HPPD1048707 CPPD
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
VolumeJanuary Patient DaysBudgeted = 310 Actual = 434 Variance = 124To calculate volume varianceVariance daysbudgeted days124310 = 4ConclusionYou are 40 over your budgeted volume
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Summary of Variance
Examine Payroll and Non-payroll costsLook at both in relation to volumeNon-payrollSupply costEquipment costsOther operating costs PayrollPayrollOT and Registry UsageTraining CostsConcisely explain why
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Developing a Staffing MatrixRequired information
1048707 Predictedbudgeted average dailycensus (ADC)1048707 Historical trends1048707 Population changeschanges in casemix1048707 Changes in servicespecialty offerings
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Hours Per Patient DayHPPD = number of hours worked in the 24hour period divided by themidnight censusExampleNOC shift staffed with 4 RNsDAY shift staffed with 5 RNs and a NAPM shift staffed with 5 RNs and a NAMidnight census = 8HPPD = (16 employees x 8 hours) census of 8 = 1288=16
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Cost Per Patient Day
CPPD =[(Total RNs 8 hours) hourly salary +
(Total LVNs 8 hours) hourly salary +
(Total NAs 8 hours) hourly salary)]divided by midnight census
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Developing a Position ControlDocumentRequired information1048707 Budgeted Average Daily Census (ADC)1048707 Required full-time equivalents (FTEs) in eachjob category (from staffing matrix)1048707 Current hired FTEs in each job category pershift1048707 Current Posted FTEs in each job category pershift1048707 Historical use of non-productive time
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
ANALYSIS
1 What can we determine from this positioncontrol document
2 Have we budgeted for enough staff
3 Do we currently have enough staff
4 What additional positions would we need topost
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
Step one Review past performance
1 As a starting point the nurse executive will require to review the following
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
a The financial records from prior financial periods as a basis for planning
b The present activities of the nursing division
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
c The activities that the division plans to institute during the projected financial period
d Those activities the division plans to delete during the projected period
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
bull Step two Review the organizations goals and projections
bull The nurse executive has to study the organizations goals and financial projections thoroughly - Items in the major budgetary report that affect the nursing department should be determined
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
bull Step three Review of the variances with higher levels of management
bull Once the goal statement is finished it (together with the actual versus budget analysis done earlier) should be reviewed with higher level management
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
bull The departmental goals proposed should be carefully considered as well as the variances their causes and proposed corrective actions should be reviewed
bull Once the final statement for the department is in place the new budgeting process can begin in earnest
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
bull Step four Actual preparation of the budget
bull The actual preparation of a new budget can be done based on a previous budgetary plan or newly proposed plan (if a newly developed or modified service)
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
bull To complete the budget a budget worksheet is essential Worksheet is a tool used by managers to prepare their budget It includes a number of columns including information about
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
a) Historic information with old budget
b) Actual numbers with comments explaining the variances
c) Revenue and costs
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
What have you learned
Capital Budget Identify short and long-term needsWork effectively with vendorsPlan ahead and allow lots of timeAnalysis of Operating Budget variancePayrollNon-payrollStaffing MatricesPosition Control
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
The quickest way to get what you want is to help others get what they want
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
SHIFT TO POPULATION BASED CARE AND INCREASING COMPLEXICITY OF PATIENT CARE
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
THE GREAT THING IN THIS WORLDIS NOT SO MUCH WHERE WE STANDhellipBUT IN WHAT DIRECTION WE AREGOINGhelliphellip
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