The Nurse Managers Guide to Budgeting and Finance

by Rundio, Al, Ph.d

• ISBN13: 9781935476658
• ISBN10: 1935476653
• Format: Paperback
• Copyright: 2012-02-14
• Publisher: Nursing Knowledge

Summary

As a nurse, you focus on the art and science of caregiving, but as a nurse manager, you deal with the economic reality of patient-staffing ratios, budgets, reports, and accountants. Acronyms such as FTEs and ADCs can feel like a foreign language you haven't learned yet. Thankfully, there's help.

Author Biography

Al Rundio, PhD, DNP, RN, APRN, NEA-BC, DPNAP, is an experienced clinician, administrator, and educator. He is Assistant Dean, Clinical Professor of Nursing, and Chair of the Doctor of Nursing Practice Program at Drexel University College of Nursing and Health Professions. Formerly Vice President of Nursing at Shore Medical Center in Somers Point, New Jersey, Rundio is co author of Nurse Executive Review and resource Manual, published by American Nurses Credentialing Center.

Table of Contents

About the Author	p. vii
Introduction	p. xiii
Budgeting for the Nurse Manager	p. 1
What Is a Budget	p. 3
The Benefits of Budgeting	p. 4
The Integral Nature of Budgeting	p. 8
Summary	p. 10
How Does Health Care Reimbursement Work?	p. 11
Health Care Reimbursement in the USA	p. 12
The Early Role of Insurance Companies	p. 13
The Advent of Medicare and Medicaid	p. 14
Part D and the "Donut Hole"	p. 15
Medicaid	p. 17
The Role of Philanthropy	p. 18
Managed Care	p. 18
Types of Health Care Reimbursement	p. 20
Capitation	p. 22
The Role of Social Policy	p. 25
Accountable-Care Organizations (ACOs)	p. 27
The Importance of Reimbursement: An Example	p. 29
Summary	p. 31
Varieties of Budgets	p. 33
Forms of Budgets	p. 34
Zero-Based Budgets	p. 35
Fixed Budgets	p. 35
Flexible Budgets	p. 36
Historical Budgets	p. 36
Operating Budgets Versus Capital Budgets	p. 38
Summary	p. 39
The Budget-Development Work Flow	p. 41
Collecting Relevant Data	p. 42
Planning Services	p. 46
Planning Activities	p. 46
Implementing the Plan	p. 48
Monitoring the Budget	p. 48
Taking Corrective Measures When Necessary	p. 49
Management's Role in Budgeting	p. 50
Summary	p. 52
Building an Operating Budget	p. 53
Key Metrics in the Operating Budget	p. 54
Understanding Expenses	p. 57
Projecting Expenses	p. 59
Calculating Employee-Related Costs	p. 60
The Number of FTEs Needed	p. 62
Accounting for Benefit Time	p. 63
Other Key Calculations	p. 65
Putting It All Together	p. 66
Busting Budget Myths	p. 68
Summary	p. 70
Fixed Budgets	p. 35
Flexible Budgets	p. 36
Historical Budgets	p. 36
Operating Budgets Versus Capital Budgets	p. 38
Summary	p. 39
The Budget-Development Work Flow	p. 41
Collecting Relevant Data	p. 42
Planning Services	p. 46
Planning Activities	p. 46
Implementing the Plan	p. 48
Monitoring the Budget	p. 48
Taking Corrective Measures When Necessary	p. 49
Management's Role in Budgeting	p. 50
Summary	p. 52
Building an Operating Budget	p. 53
Key Metrics in the Operating Budget	p. 54
Understanding Expenses	p. 57
Projecting Expenses	p. 59
Calculating Employee-Related Costs	p. 60
The Number of FTEs Needed	p. 62
Accounting for Benefit Time	p. 63
Other Key Calculations	p. 65
Putting It All Together	p. 66
Busting Budget Myths	p. 68
Summary	p. 70
Understanding Capital Budgets	p. 71
Budgeting for Major Movable Equipment	p. 72
Budgeting for Fixed Assets	p. 73
Examples of Capital Expenditures	p. 73
Why Develop a Capital Budget?	p. 74
Developing the Capital Budget	p. 75
Including a Contingency Line	p. 80
Summary	p. 81
Analyzing Budget Variances	p. 83
Conducting a Variance Analysis	p. 84
Calculating Variances	p. 85
Calculating the Efficiency Variance	p. 86
Calculating the Volume Variance	p. 87
Calculating the Cost Variance	p. 89
Putting It All Together	p. 90
Summary	p. 92
Budget Reports	p. 93
Types of Budget Reports	p. 94
Comparative Staff Summary Report #1	p. 96
Comparative Staff Summary Report #2	p. 98
Comparative Staff Summary Report #3	p. 100
Comparative Staffing Report #4	p. 103
Comparative Staffing Report for the ICU/CCU	p. 103
Staff Mix Analysis Report	p. 103
Nursing Care Hour Report	p. 107
Summary	p. 107
Conclusions	p. 109
Get Politically Involved	p. 111
Know What Types of Insurance Plans Reimburse Your Organization	p. 112
Develop Strategic Relationships with Key Individuals in Your Organization	p. 113
Speak the Language of Finance	p. 115
Do It	p. 116
Concluding Remarks	p. 117
Glossary	p. 119
Index	p. 133
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