Module 3 Assignment 1: Financial Management Case Study VSu22(2)

Overview: Financial Management Case Study

One of the important duties of a nurse leader is to manage personnel and personnel budgets. In this assignment, you will assume the role of a nurse manager. You will use given data to make important decisions regarding budgets and staffing.

Module 3 Assignment 1: Financial Management Case Study VSu22(2)

Some nurse managers have computer spreadsheets or software applications to help them make decisions regarding budgets and staffing. You will only need simple mathematical operations* to perform the needed calculations in this assignment because the scenario has been simplified.

Furthermore, some data have been provided for you that a nurse leader might need to gather or compute in a real setting. Still, you will get a glimpse of the complexity of responsibilities nurse leaders’ shoulder regarding financial management.

  • To calculate the percent of the whole a given number represents, follow these steps:

Change the percentage to a decimal number by moving the decimal twice to the left (or dividing by 100).

Multiply the new decimal number by the whole.

Example: What is 30% of 70?

30%= .30;      (.30) × 70 = 21

  • To find out what percentage a number represents in relation to the whole, follow these steps:

Divide the number by the whole (usually the small number by the large number).

Change the decimal answer to percent by moving the decimal twice to the right (or multiplying by 100).

Example: What percent of 45 is 10?

10 ÷ 45 = .222; so, 10 is 22% of 45.

* You will only need addition, subtraction, multiplication, and division.

Case Study

You are the manager for 3 West, a medical/surgical unit. You have been given the following data to assist you in preparing your budget for the upcoming fiscal year.

Patient Data

Average Daily Census (ADC): 55

Budget based on 6.2 Avg. Hours per patient day (HPPD)

(6.2 HPPD excludes Nurse Manager and unit secretaries)

Staff Data

Total FTEs                  40 Variable FTEs

1 Nurse Manager

3 Unit Secretaries

44 Total FTEs

Staffing Mix

RN       75%

LVN    10%

NA      15%

 Average Salary Scale per Employee

Benefits are 35% of annual salaries

Nurse Manager $90,000.00 per year
Registered Nurses (RN) $38.00 per hour
Licensed Vocational Nurses (LVN) $25.00 per hour
Nurse Aides (NA) $15.00 per hour
Unit Secretary (US) $14.00 per hour

Rubric

Use this rubric to guide your work on this assignment.

Criteria Target Acceptable Unacceptable
Question 1 Both % and FTEs column totals within ± 2 of correct answers(13-16 Points) Either  % or FTEs column totals within ± 2 of correct answers(5-12 points) Neither  % nor FTEs column totals within ± 2 of correct answers(0-4 points)
Question 2 All column (except Hours and Salary) totals within ± 2 of correct answers(17-20 Points) At least 3 column totals within ± 2 of correct answers(5-16 points) Less than 3 column totals within ± 2 of correct answers(0-4 points)
Question 3

  1. Table
All six values within ± 2 of correct answers(6-8 points) At least five values within ± 2 of correct answers(1-7 points) Less than five values within ± 2 of correct answers(0-1 point)
  1. Significance of variance in HPPD
Response is clearly stated and explains some potential details, ramifications, and/or solutions(6-8 points) Response states some potential details or ramifications(2–7 points) Response is unclear or lacks potential details or ramifications(0-2 points)
  1. Implications for nurse leader
Response shows keen understanding of responsibilities of the nurse leader regarding staff budgets(6-8 points) Response shows some knowledge of responsibilities of the nurse leader(2-7 points) Response fails to demonstrate knowledge of responsibilities of the nurse leader(0-1 point)
Question 4 All columns (except Hours and Salary) totals within ± 2 of correct answers(17-20 Points) At least 3 column totals within ± 2 of correct answers(5-16 points) Less than 3 column totals within ± 2 of correct answers(0-4 points)
Question 5 All columns (except Hours and Salary) totals within ± 2 of correct answers(17-20 points) At least 3 column totals within ± 2 of correct answers(5-16 points) Less than 3 column totals within ± 2 of correct answers(0-4 points)

Questions

  1. How many RNs, LVNs, and NAs, by category, are on the staff of 3 West? (Round FTEs to the nearest tenth.) Compute totals for each column.
Positions Variable FTEs % by Position FTEs by Position
RN 40 0.75 30
LVN 40 0.10                4
NA 40 0.15                6
Totals               1.00              40
  1. Compute the annual salary budget for 3 West.

Compute totals for appropriate columns.

Positions FTEs Salary Hours Salary Subtotals Amount of Benefits Total
MANAGER 1.0 $90,000.00 XXXX $90,000.00 $31,500.00 $121,500.00
RN 30 $38.00 2080 $2,371,200.00 $829,920.00 $3,201,120.00
LVN 4 $25.00 2080 $208,000.00 $72,800.00 $280,800.00
NA 6 $15.00 2080 $187,200.00 $65,520.00 $252,720.00
Sec 3 $14.00 2080 $87,360.00 $30,576.00 $117,936.00
Totals 44 XXXXX XXXXXX $2,943,760.00 $1,030,316.00 $3,974,076.00
  1. Your hospital unit, 3 West, is a 60-bed general medical-surgical unit. Over the past year, the ADC (Ave. Daily Census) was 53 patients.

Use the following data on 3 West during the last year to perform these calculations and answer these questions.

  1. Complete this table to calculate the actual average hours of care required per patient day (HPPD) for the patients in 3 West. Round to the nearest tenth
Acuity Mix Average Hours of Care Required Average Daily Census(ADC) Total Hours of Care Per Day
I 1.4 8 11.2
II 3.9 21               81.9
III 5.6 19 106.4  
IV 8.8 5 44.0
Totals 53              243.5
Hours per patient day (HPPD) 4.6
  1. Remember that your established personnel budget for 3 West assumes a HPPD of 6.2. If your calculated HPPD is different, explain the significance of the variance. (If your calculated HPPD is different than 6.2, you must write more than, “We need more/less nurses.”)

What is the Significance of the variance?  If you believe you need more staff, what will be your             rationale for making this requirement?  If you have too much staff, what would your proposal be for bringing your staffing into a better balance?

The calculated hours per patient per day (HPPD) is 4.6, while the expected HPPD is 6.2. The calculated HPPD is, therefore 1.6 less than the desired HPPD. The significance of this variance is that more staff is required to meet the desired HPPD. According to Griffiths et al. (2020), HPPD is a unit of measure that is used by hospitals to manage staff and track the budget in acute care settings. HPPD is directly proportional to the quality of patient acuity (Lockhart, 2019). Consequently, more staff is required for 3 West

A lower HPPD corresponds to less resources and less patient care per day. Less patient care per day has been correlated with diminished patient-centered care, and poor-quality patient care as most of the patient needs remain unmet. Similarly, a low HPPD correlates with decreased staff and underutilization of resources which results in high levels of inefficiency, staff burnout and high levels of job dissatisfaction.

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

Tracking HPPD ensures that a facility is financially healthy and stable as expenditures on staffing can be accounted for. However, a low HPPD indicates shortage of nursing staff. Patients in understaffed institutions face an enormous risk of hospital mortality, missed nursing care, postoperative complications, higher risk of infections and failure to rescue rates (Paulsen, 2018).

On the other hand, nursing shortages significantly contribute to medical errors, burnout, dissatisfaction and high patient-to-nurse ratios. Other observations that can be made while reviewing the total budget are those related to high inefficiency, including high supply costs, more overtime hours, an average census of 53 in a  60-bed unit, high patient-to-nurse ratios, and less full-time equivalents.

  1. You have set two new goals for your unit for the next year related to personnel:
  • Provide stronger unit management support on evening and night shifts and in the absence of the manager.
  • Correct unfavorable efficiency variances due to overtime.

To accomplish these goals, you plan to make these changes:

  • Add 1.0 RN FTE position
  • Eliminate 1.5 LVN positions
  • Add 1.5 FTEs NA positions
  • Add 1.0 Assistant HN position at $70,000/year

Calculate ONLY the cost of the proposed recommendations for 3 West. Compute totals for each column. If the change represents a reduction in the budget for that category, record the total as a negative number. If it represents an increase in the budget for that category, record the total as a positive number.

Positions FTEs Salary Hours Salary Subtotals Benefits Total
RN 1 38.00 2080 $79,040.00 $27,664.00 $106,704.00
LVN -1.5 25.00 2080 $-78,000.00 $-27,300.00 $-105,300.00
NA 1.5 15.00 2080 $46,800.00 $16,380.00 $63,180.00
AHN 1 70,000 XXXXX $70,000. 00 $24,500.00 $94,500.00
Totals 2 XXXXX XXXXX $117, 840.00 $41,244.00 $159,084.00
  1. Assume your proposal was approved. Calculate the new personnel budget (You will use your budget from question 2 and account for the changes you requested in question 4). Compute totals for each column.
Positions FTEs Salary Hours Salary Subtotals Benefits Total
Manager 1 $90,000.00 XXXXX $90,000.00 $31,500.00 $121,500.00
AHN 1 $70,000 XXXXX $70,000.00 $24,500.00 $94,500.00
RN 31 38.00 2080 $2,450,240.00 $857,584.00 $3,307,824.00
LVN  2.5 25.00 2080 $130,000.00 $45,500.00 $175,500.00
NA  7.5 15.00 2080 $234,000.00 $81,900.00 $315,900.00
Sec 3 14.00 2080 $87,360.00 $30,576.00 $117,936.00
Totals 46 XXXXX XXXXX $3,061,600.00 $1,071,560.00 $4,133,160.00

References

Financial Management Case Study

A 3 page case study using the questions below to guide the written response.

  1. What is the precise financial management concept?
  2. Provide at least three (3) relevant perspectives found in this case, and why (include assertions for answer), reference research and literature.
  3. How does an organization address financial management through organizational leadership? What strategies will you engage in your workplace in order to change financial outcomes?
  4. What particular concept/practice from this case could be engaged to include financial management and wellness in your workplace? Provide clear, accurate, precise information with examples.

Write a comprehensive essay (3 pages) on concepts and financial management tools and processes used to ensure equity within the organization.  Be sure to define equity, financial management, financial responsibility, and other terms used in your essay.