Financial Management for Nurse Managers and Executives

by Finkler, Steven A.

• ISBN13: 9781416033424
• ISBN10: 1416033424
• Edition: 3rd
• Format: Paperback
• Copyright: 2007-04-04
• Publisher: Elsevier Science Health Science div

Summary

Covering the financial topics all nurse managers need to know and use, this book explains how financial management fits into the healthcare organization. Youll study accounting principles, cost analysis, planning and control management of the organization's financial resources, and the use of management tools. In addition to current issues, this edition also addresses future directions in financial management. Chapter goals and an introduction begin each chapter. Each chapter ends with Implications For The Nurse Manager and Key Concepts, to reinforce understanding. Key Concepts include definitions of terms discussed in each chapter. A comprehensive glossary with all key terms is available on companion Evolve® website. Two chapter-ending appendixes offer additional samples to reinforce chapter content. Four NEW chapters are included: Quality, Costs and Financing; Revenue Budgeting; Variance Analysis: Examples, Extensions, and Caveats; and Benchmarking, Productivity, and Cost-Benefit and Cost-Effectiveness Analysis. The new Medicare prescription bill is covered, with its meaning for healthcare providers, managers, and executives. Coverage now includes the transition from the role of bedside or staff nurse to nurse manager and nurse executive. Updated information includes current nursing workforce issues and recurring nursing shortages. Updates focus on health financing and the use of computers in budgeting and finance. New practice problems are included.

Table of Contents

A Financial Management Framework	p. 1
Introduction and Overview	p. 3
Chapter Goals	p. 3
Introduction	p. 3
A Financial Management Framework	p. 3
The Health Care Environment	p. 3
Financial Management and Nursing Leadership in the Health Care Organization	p. 4
Key Issues in Applied Economics	p. 4
Quality, Costs, and Financing	p. 5
Financial Accounting	p. 5
Accounting Principles	p. 5
Financial Statement Analysis	p. 6
Cost Analysis	p. 6
Cost Management	p. 6
Determining Health Care Costs and Prices	p. 6
Recruiting and Retaining Staff	p. 7
Planning and Control	p. 7
Strategic Management	p. 7
Budgeting Concepts and Budget Preparation	p. 7
Controlling Operating Results and Variance Analysis	p. 8
Benchmarking, Productivity, and Analysis of Costs	p. 8
Managing Financial Resources	p. 8
Short-Term Financial Resources	p. 9
Long-Term Financial Resources	p. 9
Additional Management Tools	p. 9
Management Information Systems and Computers	p. 9
Forecasting and Other Decision-Making Methods	p. 9
Marketing	p. 10
The Nurse as Entrepreneur	p. 10
Nursing and Financial Management: Current Issues and Future Directions	p. 10
The Health Care Environment	p. 11
Chapter Goals	p. 11
Introduction	p. 11
The Key Participants in the Health Care System	p. 12
Providers	p. 12
Nurses	p. 12
Physicians	p. 13
Hospitals	p. 14
Government	p. 14
Other Providers	p. 15
Suppliers	p. 15
Consumers	p. 15
Regulators	p. 16
Payers	p. 17
Individual Consumers	p. 17
Insurers	p. 18
Employers	p. 18
Government	p. 19
Financing the Health Care System	p. 19
The Medicare and Medicaid Programs	p. 20
The Insurance System	p. 21
Moral Hazard	p. 22
Coinsurance, Deductibles, and Co-Payments	p. 22
Customary and Reasonable Charges	p. 23
Other Sources of Financing	p. 23
Alternative Payment Approaches	p. 24
Paying Health Care Providers	p. 25
Hospital Payment	p. 25
Cost-Based Reimbursement	p. 25
Charity Care	p. 26
Prospective Payment Systems	p. 26
Negotiated Rates	p. 27
Pay-for-Performance	p. 27
Nurse Payment	p. 28
Physician Payment	p. 29
Home Health Agency Payment	p. 29
Nursing Home Payment	p. 29
Methods Use to Control Payments for Care	p. 30
Managed Care	p. 30
Health Maintenance Organizations	p. 30
Preferred Provider Organizations	p. 31
Point of Service	p. 32
Implications for Nurse Managers	p. 32
Key Concepts	p. 33
Suggested Readings	p. 34
The Role of Financial Management and Nurse Leadership in Health Care Organizations	p. 35
Chapter Goals	p. 35
Introduction	p. 35
The Role of Management	p. 36
The Hierarchy of Health Care Organizations	p. 36
The Top Management Team	p. 37
Line vs. Staff Authority	p. 38
Formal Lines of Authority	p. 39
Informal Lines of Authority	p. 42
Centralized vs. Decentralized Organizations	p. 43
The Role of the CFO and Other Financial Managers	p. 44
The Finance Function	p. 45
The Financial Accounting Function	p. 46
The Managerial Accounting Function	p. 46
Internal Control Function	p. 47
The Role of the CNE in Financial Management	p. 47
The Role of Mid- and First-Level Nurse Managers in Financial Management	p. 48
Transition from Staff Nurse to Nurse Manager	p. 49
The Role of Staff Nurses in Financial Management	p. 50
Interactions Between Fiscal and Nurse Managers	p. 50
Responsibility Accounting	p. 51
Responsibility Centers	p. 52
Incentives and Motivation	p. 52
Power and Politics	p. 53
Networking	p. 53
Implications for Nurse Managers	p. 54
Key Concepts	p. 54
Suggesting Readings	p. 55
Key Issues in Applied Economics	p. 56
Chapter Goals	p. 56
Introduction	p. 56
Fundamental Concepts of Economics	p. 57
Economic Goods	p. 57
Utility	p. 57
Marginal Utility	p. 58
Marginal Cost	p. 58
Savings	p. 58
Supply and Demand	p. 58
Free Enterprise	p. 58
An Example of Supply and Demand	p. 59
Elasticity of Demand	p. 60
Economies of Scale	p. 61
Increasing Returns to Scale	p. 61
Decreasing Returns to Scale	p. 61
Economics and Incentives	p. 62
Market Efficiency	p. 62
Redistribution of Resources	p. 63
Collective Action	p. 63
Equity Improvement	p. 63
Market Failure	p. 63
Government Intervention	p. 63
Lack of Full Information	p. 65
Lack of Direct Patient Payment	p. 65
Monopoly Power	p. 65
Monopsony Power	p. 66
Government-Induced Inefficiency	p. 67
Externalities	p. 67
The Market for Nurses	p. 67
Implications for Nurse Managers	p. 68
Key Concepts	p. 69
Suggesting Readings	p. 70
Quality, Costs, and Financing	p. 71
Chapter Goals	p. 71
Introduction	p. 71
What Is Quality and How Is it Measured?	p. 72
The Impetus for Integrating Quality, Cost, and Financing	p. 75
Quality Reporting	p. 79
Balanced Scorecards	p. 81
The Magnet Movement	p. 82
The Baldridge Award	p. 83
Relationships Among Health Care Quality, Costs, and Financing	p. 84
A Business Case for Quality	p. 86
Implications for Nurse Managers	p. 87
Key Concepts	p. 90
Suggested Readings	p. 91
Financial Accounting	p. 93
Accounting Principles	p. 95
Chapter Goals	p. 95
Introduction	p. 95
The Basic Framework of Accounting	p. 96
The Key Financial Statements	p. 97
The Statement of Financial Position	p. 97
The Operating Statement	p. 98
Accounting Terminology	p. 98
Assets	p. 98
Liabilities and Owners' Equity	p. 100
Revenues and Expenses	p. 102
The Recording and Reporting Process	p. 103
Journal Entries	p. 103
Ledgers	p. 103
Reporting Information	p. 104
Generally Accepted Accounting Principles	p. 104
The Entity Concept	p. 104
Going Concern	p. 105
The Matching Principle and Cash vs. Accrual Accounting	p. 105
The Cost Principle	p. 105
Objective Evidence	p. 105
Materiality	p. 106
Consistency	p. 106
Full Disclosure	p. 106
Fund Accounting	p. 107
Implications for Nurse Managers	p. 107
Key Concepts	p. 108
Suggested Readings	p. 108
Analysis of Financial Statement Information	p. 109
Chapter Goals	p. 109
Introduction	p. 109
The Audit	p. 110
Balance Sheets and Operating Statements	p. 111
The Statement of Cash Flows	p. 111
Statement of Changes in Net Assets or Equity	p. 114
Notes to Financial Statements	p. 115
Ratio Analysis	p. 116
Common Size Ratios	p. 117
Liquidity Ratios	p. 118
Solvency Ratios	p. 119
Efficiency Ratios	p. 121
Profitability Ratios	p. 122
Management Reports	p. 123
Implications for Nurse Managers	p. 124
Key Concepts	p. 124
Suggested Readings	p. 125
Additional Sample Financial Statements	p. 126
Cost Analysis	p. 135
Cost Management	p. 137
Chapter Goals	p. 137
Introduction	p. 137
Basic Cost Concepts	p. 137
Definitions	p. 138
Fixed vs. Variable Costs	p. 140
Cost Graphs and the Relevant Range	p. 141
The Impact of Volume on Cost per Patient	p. 142
Marginal Cost Analysis	p. 143
Relevant Cost Case Study	p. 144
Cost Estimation Techniques	p. 145
Adjusting Costs for Inflation	p. 146
High-Low Cost Estimation	p. 147
Regression Analysis	p. 148
Mixed Costs and Regression Analysis	p. 149
Multiple Regression Analysis	p. 151
Break-Even Analysis	p. 152
Example of Break-Even Analysis	p. 153
Using Break-Even Analysis for Decision-Making	p. 155
Break-Even and Capitation	p. 156
Break-Even Analysis Cautions	p. 156
Implications for Nurse Managers	p. 157
Key Concepts	p. 158
Suggested Readings	p. 159
Determining Health Care Costs and Prices	p. 160
Chapter Goals	p. 160
Introduction	p. 160
Costs for Reporting vs. Costs for Management Control	p. 161
Traditional Cost-Finding Methods	p. 162
The Medicare Step-Down Approach	p. 162
A Detailed Look at the Cost-Finding Approach	p. 163
Accumulate Direct Costs for Each Cost Center	p. 163
Determine Bases for Allocation	p. 163
Allocate from Cost Centers to Revenue Centers	p. 164
Allocate Costs to Units of Service	p. 167
Is Good-Enough Cost Finding Good Enough?	p. 168
Costing Out Nursing Services	p. 168
Solutions to the Costing Problem	p. 170
Why Change the Costing Approach?	p. 173
Should Costing Be Linked to DRGs?	p. 175
Specific Approach to Costing Nursing Services	p. 176
Limitations of the RVU Approach	p. 178
Patient Classification vs. Other Work-Load Measurement	p. 178
Indirect Nursing Costs	p. 179
Staffing Mix	p. 179
Product-Line Costing	p. 179
Direct Care Hours	p. 180
Standard Costs	p. 181
Activity-Based Costing	p. 183
Setting Prices	p. 185
Total Financial Requirements	p. 185
Rate-Setting Approaches	p. 186
Cost-Based Prices	p. 186
Negotiated Prices	p. 186
Market Prices	p. 186
Financial Reimbursement for Nursing Services	p. 187
Pay-for-Performance (P4P)	p. 188
Implications for Nurse Managers	p. 189
Key Concepts	p. 190
Suggested Readings	p. 191
Costs and Other Issues Related to Recruiting and Retaining Staff	p. 193
Chapter Goals	p. 193
Introduction	p. 193
Retaining Staff	p. 194
Nurse Satisfaction	p. 194
Fringe Benefits	p. 195
Retention Programs	p. 196
Clinical Ladders	p. 199
Determining the Cost	p. 199
Recruiting Staff	p. 201
Marketing	p. 201
Recruiting and Retaining "Older" Nurses	p. 203
Use of Alternative Health Care Employees	p. 204
Agency Nurses	p. 204
Foreign Nurse Recruitment	p. 204
Alternative Care Givers	p. 206
The Use of Computers	p. 206
The Nursing Shortage	p. 207
Implications for Nurse Managers	p. 208
Key Concepts	p. 209
Suggested Readings	p. 209
Planning and Control	p. 211
Strategic Management	p. 213
Chapter Goals	p. 213
Introduction	p. 213
Quality Management	p. 214
Strategic Planning	p. 216
The Elements of a Strategic Plan	p. 217
The Mission Statement or Philosophy	p. 217
Statement of Long-Term Goals	p. 218
Statement of Competitive Strategy	p. 218
Statement of Organizational Policies	p. 220
Statement of Needed Resources	p. 220
Statement of Key Assumptions	p. 221
Benefits of the Strategic Planning Process	p. 221
Implementing a Strategic Management Process	p. 222
Long-Range Planning	p. 222
Program Budgeting and Zero-Base Budgeting	p. 223
Zero-Base Budgeting	p. 224
ZBB Case Study: Hemodialysis	p. 225
Ranking Decision Packages	p. 227
Business Plans	p. 227
What Is a Business Plan?	p. 227
Implications for Nurse Managers	p. 228
Key Concepts	p. 229
Suggested Readings	p. 230
Budgeting Concepts	p. 232
Chapter Goals	p. 232
Introduction	p. 232
Types of Budgets	p. 233
Operating Budget	p. 233
Long-Range Budgets	p. 233
Program Budgets	p. 234
Capital Budgets	p. 234
Generation of Capital Budget Proposals	p. 235
Justification of Capital Requests	p. 236
Evaluation of Capital Budget Proposals	p. 237
Product-Line Budgets	p. 238
Cash Budgets	p. 238
Cash Budget Preparation	p. 239
Cash Budget Example	p. 239
Special Purpose Budgets	p. 240
The Budget Process	p. 240
Budget Timetable	p. 241
Statement of Environmental Position	p. 242
General Goals, Objectives, and Policies	p. 242
Organization-Wide Assumptions	p. 242
Specification of Program Priorities	p. 243
Specific, Measurable Operating Objectives	p. 243
Budget Preparation	p. 243
Budget Negotiation and Revision	p. 243
Control and Feedback	p. 244
Implications for Nurse Managers	p. 244
Key Concepts	p. 245
Suggested Readings	p. 246
Time Value of Money	p. 247
Operating Budgets	p. 260
Chapter Goals	p. 260
Introduction	p. 260
Workload Budget	p. 261
Activity Report	p. 262
Adjusting Units of Service	p. 262
Calculating Workload	p. 262
Expense Budget: Personnel Services	p. 263
Average Daily Census and Occupancy Rate	p. 264
Staffing Requirements and Full-Time Equivalents	p. 264
Productive vs. Non-Productive Hours	p. 265
Assignment of Staff by Type and Shift	p. 265
Fixed Staff	p. 267
Converting Staff and FTEs to Positions	p. 267
Calculating FTEs by Type and Shift	p. 267
Establishing Positions	p. 268
Calculating Labor Cost	p. 270
Straight-Time and Overtime Salaries	p. 270
Differentials and Premiums	p. 272
Fringe Benefits	p. 273
Special Situations	p. 274
Expense Budget: Other-than-Personnel Services	p. 274
Budget Submission, Negotiation, and Approval	p. 275
Implementing the Approved Budget	p. 276
Implications for Nurse Mangers	p. 276
Key Concepts	p. 277
Suggested Readings	p. 278
Revenue Budgeting	p. 279
Chapter Goals	p. 279
Introduction	p. 279
The Revenue Budget	p. 280
Why Aren't All Nursing Units Revenue Centers?	p. 280
Why Are Nurse Managers Responsible for a Revenue Budget?	p. 281
The Elements of a Revenue Budget	p. 281
Prices or Rates	p. 281
Volume Estimates	p. 284
Environmental Scan	p. 286
Revenues from Managed Care	p. 286
Capitation vs. Fee-for-Service	p. 286
Money Flows Under Capitation	p. 288
Developing Capitated Rates	p. 288
Setting a Capitation Rate: An Example	p. 289
Incentive Risk Pools	p. 291
Implications for Nurse Managers	p. 291
Key Concepts	p. 292
Suggested Readings	p. 293
Performance Budgeting	p. 294
Chapter Goals	p. 294
Introduction	p. 294
When Is Performance Budgeting Appropriate?	p. 295
The Performance Budgeting Technique	p. 295
Determining Key Performance Areas	p. 295
Technical Steps in Performance Budgeting	p. 295
Performance Budget Example	p. 296
Developing Performance Area Measures	p. 299
Quality of Care	p. 299
Staffing	p. 301
Cost Control	p. 301
Increased Productivity	p. 302
Patient and Staff Satisfaction	p. 302
Innovation and Planning	p. 303
Direct Care	p. 303
Indirect Care	p. 303
Other	p. 303
Multiple Measures	p. 303
Implications for Nurse Managers	p. 304
Key Concepts	p. 305
Suggesting Readings	p. 305
Controlling Operating Results	p. 306
Chapter Goals	p. 306
Introduction	p. 306
The Budget as a Tool for Motivation	p. 306
Motivation and Incentives	p. 308
Motivation and Unrealistic Expectations	p. 309
Communication and Control	p. 309
Using Budgets for Interim Evaluation	p. 309
Variance Analysis	p. 310
Traditional Variance Analysis	p. 311
Unit and Department Variances	p. 312
Line-Item Variances	p. 312
Understanding Variances	p. 312
Flexible or Variable Budgets	p. 314
Flexible Budget Variance Analysis	p. 315
The Volume Variance	p. 315
The Price, or Rate, Variance	p. 316
The Quantity, or Use, Variance	p. 316
Determination of the Causes of Variances	p. 316
The Mechanics of Flexible Budget Variance Analysis	p. 317
Flexible Budget Notation	p. 318
An Example of Volume, Price, and Quantity Variances	p. 319
Revenue Variances	p. 322
Implications for Nurse Managers	p. 326
Key Concepts	p. 327
Suggested Readings	p. 327
Variance Analysis: Examples, Extensions, and Caveats	p. 328
Chapter Goals	p. 328
Introduction	p. 328
Aggregation Problems	p. 328
Exception Reporting	p. 330
Interpretation of Variances	p. 330
Rigid Staffing Patterns	p. 332
Flexible Budgeting and Acuity	p. 334
Fixed vs. Variable Costs	p. 335
Causes of Variances	p. 335
Investigation and Control of Variances	p. 336
Performance Budgets and Variance Analysis	p. 336
Implications for Nurse Managers	p. 338
Key Concepts	p. 339
Suggesting Readings	p. 339
Benchmarking, Productivity, and Cost-Benefit and Cost-Effectiveness Analysis	p. 340
Chapter Goals	p. 340
Introduction	p. 340
Benchmarking	p. 341
Benefits of Benchmarking	p. 347
Benchmarking Approaches	p. 342
The Benchmarking Process	p. 343
Requirements for Successful Benchmarking	p. 344
Productivity	p. 344
Productivity Standards	p. 345
Unit-Costing	p. 345
Unit-Costing and Productivity Standards	p. 348
Productivity Improvement	p. 348
Cost-Benefit and Cost-Effectiveness Analysis	p. 350
Cost-Benefit Analysis	p. 350
Determine Project Goals	p. 351
Estimate Project Benefits	p. 351
Estimate Project Costs	p. 351
Discount Cost and Benefit Flows	p. 351
Complete the Decision Analysis	p. 352
Cost-Effectiveness Analysis	p. 352
Implications for Nurse Managers	p. 352
Key Concepts	p. 354
Suggesting Readings	p. 355
Managing Financial Resources	p. 357
Short-Term Financial Resources	p. 359
Chapter Goals	p. 359
Introduction	p. 359
Current Assets	p. 360
Cash and Marketable Securities	p. 360
Short-Term Cash Investment	p. 361
Cash Flow vs. Revenue and Expense	p. 362
Cash Budgets	p. 362
Maintaining Security over Cash	p. 363
Accounts Receivable	p. 363
Preadmission Data Collection	p. 364
Credit Policies	p. 364
Ongoing Data Collection	p. 364
Discharge Review and Billing	p. 365
Aging of Receivables	p. 365
Cash Receipt and Lock Boxes	p. 366
Inventory	p. 366
Perpetual Inventory	p. 367
Economic Order Quantity	p. 367
Current Liabilities	p. 367
Accounts Payable	p. 368
Payroll Payable	p. 368
Short-Term Debt	p. 369
Taxes Payable	p. 369
Other Payables Made on Behalf of Employees	p. 369
Implications for Nurse Managers	p. 370
Key Concepts	p. 370
Suggested Readings	p. 371
Long-Term Financial Resources	p. 372
Chapter Goals	p. 372
Introduction	p. 372
Equity Sources of Financing	p. 372
Philanthropy	p. 373
Corporate Stock Issuance	p. 374
Government Grants	p. 374
Retained Earnings	p. 375
Debt Sources of Financing	p. 375
Mortgages and Long-Term Notes	p. 375
Leases	p. 376
Bonds	p. 378
Taxable vs. Tax-Free Bonds	p. 379
Bond Ratings and Insurance	p. 381
Zero-Coupon Bonds	p. 381
Debt Refinancing	p. 382
Feasibility Studies	p. 382
The Future of Health Care Financing	p. 383
Implications for Nurse Managers	p. 384
Key Concepts	p. 385
Suggested Readings	p. 385
Additional Management Tools	p. 387
The Use of Computers in Financial Management	p. 389
Chapter Goals	p. 389
Introduction	p. 389
Computer Hardware and Software	p. 389
Uses of Computers	p. 389
General Information Management	p. 390
Clinical Care	p. 390
Financial Management	p. 390
Financial Management Information	p. 390
Special Purpose Software	p. 393
Forecasting	p. 393
Costing	p. 393
Personnel Management	p. 394
Budgeting	p. 395
Acuity Systems	p. 396
Performance Evaluation	p. 398
The Future	p. 398
Implications for Nurse Managers	p. 399
Key Concepts	p. 400
Suggested Readings	p. 400
Forecasting and Other Methods for Decision Making	p. 402
Chapter Goals	p. 402
Introduction	p. 402
Probability Theory: Foundation for Forecasting and Decision Making	p. 403
Quantitative Methods for Forecasting	p. 404
Data Collection	p. 405
Appropriate Data Time Periods	p. 405
What Data Should Be Collected?	p. 406
Graphing Historical Data	p. 407
Analysis of Graphed Data	p. 408
Random Fluctuations	p. 409
Seasonality	p. 410
Trend	p. 410
Seasonality and Trend	p. 411
Forecasting Formulas	p. 412
Random Fluctuations	p. 412
Seasonality	p. 412
Trend	p. 413
Seasonality and Trend	p. 415
Using Computers for Forecasting	p. 416
Qualitative Methods for Forecasting	p. 422
Nominal Group Technique	p. 422
Delphi Technique	p. 422
Other Decision-Making Tools	p. 422
Expected Value	p. 423
Linear Programming	p. 423
Inventory Control	p. 426
Planning and Tracking a Project	p. 428
Gantt Chart	p. 428
Critical Path Method and PERT	p. 428
Implications for Nurse Managers	p. 430
Key Concepts	p. 431
Suggested Readings	p. 432
Marketing	p. 433
Chapter Goals	p. 433
Introduction	p. 433
The Essence of Marketing: Assessing Customer Needs	p. 434
Understanding Customers	p. 435
Why Is Marketing Important for Nurse Managers?	p. 436
Keeping the Organization Current	p. 436
Marketing the Importance of Nursing	p. 437
Marketing Concepts	p. 438
Understanding the Market	p. 438
Market Segmentation	p. 438
Customer Behavior	p. 439
Market Measurement	p. 439
Market Share	p. 440
Market Research	p. 440
Advertising	p. 441
Marketing Plans	p. 441
Organizational Mission/Goals	p. 441
Internal-External Analysis	p. 442
Strategic Marketing Plan	p. 442
The BCG Matrix	p. 446
Life-Cycle Analysis	p. 446
Choice of Strategy	p. 447
Tactics	p. 448
Product	p. 448
Price	p. 449
Place	p. 450
Promotion	p. 451
Marketing Failures	p. 451
The Role of Marketing in Nurse Recruitment	p. 452
Implications for Nurse Managers	p. 452
Key Concepts	p. 453
Suggested Readings	p. 454
The Nurse as Entrepreneur	p. 455
Chapter Goals	p. 455
Introduction	p. 455
Characteristics of Nurse Entrepreneurs	p. 455
Opportunities for Nurse Entrepreneurs	p. 456
Starting Your Own Business	p. 456
Legal and Financial Issues	p. 458
Business Plan	p. 458
The Steps in Developing a Business Plan	p. 459
Project Proposal	p. 459
Product Definition	p. 459
Market Analysis	p. 459
Rough Financial Plan	p. 460
Detailed Operations Plan	p. 460
Detailed Financial Plan	p. 460
Pro Forma Financial Statements	p. 461
Forecasting and Capital Budgeting	p. 467
Sensitivity Analysis	p. 462
Examination of Alternatives	p. 462
The Elements of a Business Plan Package	p. 462
Examples of Entrepreneurs	p. 463
	p. 463
	p. 463
	p. 463
	p. 463
Key Concepts	p. 464
Suggested Readings	p. 464
The Future	p. 467
Nursing and Financial Management: Current Issues and Future Directions	p. 469
Chapter Goals	p. 469
Introduction	p. 469
Nursing Financial Management Research	p. 469
Current and Future Issues in Financial Management in Nursing	p. 471
The Evolving Role of the Chief Nurse Executive in Financial Management	p. 471
Setting Organizational Policy	p. 472
Continuing Organizational Responsibility for Nursing Expenses	p. 472
Assuming Organizational Responsibility for Nursing Revenues	p. 473
Assuming an Organizational Role in New Ventures	p. 473
Responding to Extraorganizational Changes	p. 473
Government Relations	p. 473
Payer Relations	p. 474
Future Role of First- and Mid-Level Nurse Managers in Financial Management	p. 474
The Nurse as a Policymaker for Financing Health Care	p. 475
Lobbyist	p. 475
Policymaker	p. 475
Implications for Nurse Managers	p. 476
Key Concepts	p. 477
Suggested Readings	p. 477
Glossary	p. 479
Index	p. 503
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