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# Nursing Case Study: Finance

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Question: Discuss about the Report on Nursing Case Study in Finance?   Answer: Introduction The given report reflects about the costs and budgetary analysis of the medical unit of 33- west. The organization is suffering from the variances of costs to meet the requirements of the concerned patients. The total amount of Hours per patient day (HPPD) is taken as 4.2 hours. However, it may be seen that the actual amount of HPPD may be more than 4.2 hours. Based on the given analysis, several recommendations can be given to the nursing unit to minimize the total amount of costs and variances of their cash budget. 1   Positions Variable FTEs % by Position FTEs by Position RN 34 0.65 22.1 LVN 34 0.2 6.8 NA 34 0.15 5.1  Total    34 Table 1: Calculation of FTEs by Position The above table reflects that the total amount of FTE’s is 34. With the help of the segmentation of the total amount of variables of FTE’s of the unit and total amount of percentage by position, the total amount of FTE’s by position has been calculated. 2   Positions FTEs Salary Hours Salary Subtotals Benefits Total MANAGER 1 80,000 860 80,000 12000 92,000 RN 22.1 35 860 665210 99781.5 764991.5 LVN 6.8 24 860 140352 21052.8 161404.8 NA 5.1 13 860 57018 8552.7 65570.7 US 2.2 11 860 20812 3121.8 23933.8 Totals           1,107,901 Table 2: Personal budget of the unit There are different forms of human resources that are present in the respective hospital unit. These are the manager, RN, LVN, NA, US. All the respective amount of salary, hours and subtotals has been calculated based on the number of hours estimated. The fringe benefits are estimated to be around 15 percent and is calculated based on the salary subtotals of the nursing unit.  By adding up the total amount of salary subtotals and fringe benefits, the respective total has been calculated for all the FTE’s and nursing manager of the firm. There are the total amount of FTE’s that are present in the respective amount of units. The salary of the manager is 80000 per year. Consequently, the total amount of salary and the respective budget has been prepared for all the other FTE’s as well as the total amount of US (Noh, 2015) The given personal budget reflects that total amount of personal budget required is 1,107,901. It is also assumed that the Hours per patient day (HPPD) are 4.3 hours. In addition to this, a total amount of working days is assumed 200 days. 3: Calculation Of Hours Per Patient Day Acuity Mix Average Hours of Care Required Average Daily Census Total Hours of Care Per Day (ADC) I 1.5 3 4.5 II 4.3 14 60.2 III 5.7 21 119.7 IV 9 4 36 Totals   220.4 Hours per patient day (HPPD) 5.247619048 Table 3: Calculation of Hours per patient day (HPPD) Result Of Such Variances The above table reflects that that HPPD is coming 5.24. It is more than 4.3. Therefore, it will have a negative implication on the personal budget of 3-West.   In addition to this, several changes are also required in terms of personal budget analysis. Therefore, the given unit will require an additional number of nurses to take care of the patients.  Apart from this, the unit will also incur the additional amount of budget will also increase by a considerable amount. The total amount of variances is coming to be 5.2-4.3 = 0.9.  It is a significant amount of variance as it may a pivotal impact on the resources of the unit. The total amount of capacity of the unit may also have to reduce to keep it at par with the required amount of budget (Bekaert and Hodrick, 2012) Implications Of Nurse Manager The given variances in Hours per patient day can have a major implication on the nursing manager of the respective unit.  The average amount of salary of the nursing manager will increase due to the higher amount of HPPD.  The nurse manager may also find it difficult to allocate the total number of duty hours among the 34 FTE’s.  The total amount of supply costs, Average Daily Census, and overtime costs may also increase by a considerable percentage. Apart from this, the total percentage of fringe benefits will increase by 15 percent due to the total amount of overcome costs. On the other hand, the total amount of supply costs of the resources will also increase from the previously planned budget. Average Daily Census may also decrease to control the total amount of costs of the budget.  Due to this reason, the nursing manager will have to face several problems due to a higher amount of HPPD while allocation of resources. There is no scope of overtime hours for the respective FTE’s as it will further increase the total amount of fringe benefits as well as the salaries of all the human resources (Grieve, 2013). 4 Positions FTEs Salary Hours Salary Subtotals Benefits Total Previous Variances MANAGER 1 68,000 1048 68,000 10200 78,200     RN 24.1 35 1048 883988 132598 1016586.2     LVN 4.8 24 1048 120730 18109 138839.04     NA 6.6 13 1048 89918 13488 103406.16     US 2.2 11 1048 25362 3804.2 29165.84     Totals           1,366,197 1107901 258,296 Table 4: Adjusted Personal budget of the unit Based on the requirements of the unit, the organization has set up an updated variable cost. With a proper allocation of the resources and by making HPPD 5.24 from 4.3, the newly formed budget has a total amount of 258,296.   Therefore, the firm has failed to minimize the total amount of unfavorable variances.  Several allocations of resources were implemented by the respective firm. However, the variances are still on the higher side.  Before the allocation of resources, the total amount of variances was more than 258,296. It has minimized after the changes in hours of some of the FTE’s. It is recommended that organization needs to minimize the total amount of costs of all the respective FTE’s.  In addition to this, the total amount of fringe benefits may be increased to cut down the total amount of costs. On the other hand, the total amount of resources is also required to be rearranged to minimize the effect of the variances. However, the total amount of FTE’s requires to be increased due to minimize the total amount of resources (Lach, 2014). It is important to cut down the costs of the salaries of all the managers to minimize and curtail down the variances of the total amount of costs. In addition to this, it is also essential to prepare a variances cost sheet to rectify in what areas the total amount of variances is required. It will further assist the medical unit to recover from the higher amount of expenses that resulted from a higher amount of Hours per patient day of the surgical unit. 5 Positions FTEs Salary Previous Salary Hours Previous hours Salary Subtotals Benefits Total Previous Variances MANAGER 1 40,000 80,000 1152.8 860 40,000 6000 46,000 52,000 -6,000 RN 22.1 30 35 1152.8 860 764306.4 76430.64 840737 917168 -76,431 LVN 3.8 20 24 1152.8 860 87612.8 8761.28 96374.08 105135 -8,761 NA 6.6 10 13 1152.8 860 76084.8 7608.48 83693.28 91302 -7,608 US 3.2 10 11 1152.8 860 36889.6 3688.96 40578.56 44268 -3,689 Totals 36.7 40070 80083 5764 4300 1004893.6 102489.36 1,107,383 1107901 -518                       Table 5: Recommended Personal budget of the unit The above table reflects that; there are several changes are required to be made to minimize the total amount of variances. With the help of the given recommended budget, the respective unit can totally minimize the overall variances of the given personal budget. The major changes that took place are a minimization of the resources of LVN and increase of US. On the other hand, the total amount of salary of the nursing manager will be minimized by around 50 percent of the respective amount. The rate of fringe benefits can be minimized from 15 percent to 10 percent.  This will further help to minimize the total amount of variances by a considerable percentage. The total amount of hours is taken as 5.2 hours per day; therefore, the total amount of hours has increased annually by comparing with the previous budget of the nursing unit. In addition to this, the salaries of all the FTE’s have decreased to meet the requirements of the treatments of the patients effectively (Li, 2013) Conclusion The above report concludes the importance of maintaining the effective cash budget for every industry. The key findings of the report are that the actual amount of (HPPD) Hours per patient day is 5.28, while 4.3 is the targeted HPPD of the unit. In order to attain the concerned targets, an effective cash budget is recommended to the nursing unit. The recommended budget reflects the importance of minimization of costs in terms of their salary structure. The main target of the organization is to provide (HPPD) Hours per patient day of around 5.28 hours. In accordance to that, the personal budget of the firm has been modified.   References Bekaert, G. and Hodrick, R. (2014). International financial management. Harlow, Essex: Pearson. Brooks, R. (2013). Financial management. Boston: Pearson. Dalbor, M., Hua, N. and Andrew, W. (2014). Factors that Impact Unsystematic Risk in the U.S. Restaurant Industry. The Journal of Hospitality Financial Management, 22(2), pp.89-96. Grieve, I. (2013). Microsoft Dynamics GP 2013 financial management. Birmingham, UK: Packt Pub. Lach, H. (2014). Financial Conflicts of Interest in Research. Nursing Research, 63(3), pp.228-232. Li, S. (2013). The Challenge of Managing Government-Industry Relationships. JFRM, 02(04), pp.84-86. Li, S. and Qiu, J. (2014). Financial Product Differentiation over the State Space in the Mutual Fund Industry. Management Science, 60(2), pp.508-520. Madura, J. (2012). International financial management. Mason, OH: South-Western, Cengage Learning. Noh, Y. (2015). Financial effects of open innovation in the manufacturing industry. Management Decision, 53(7), pp.1527-1544.

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