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CNML Exam > Financial Management > Flashcards

Financial Management Flashcards

1
Q

What population do for Profit Organizations serve?

A

lower income

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2
Q

Most important note of for-profit organization?

A

Can lawfully release a patient that cannot pay.

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3
Q

Most important factor of nonprofit organizations?

A

Must treat all conditions/people regardless of insurance or ability to pay.

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4
Q

Medicare is for what individuals?

A

65 and over; any age End stage renal failure; any age w/ medical disabilities.

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5
Q

What are the 4 parts of Medicare?

A
  1. Part A: Hospital Insurance
  2. Part B: Medical Insurance
  3. Part C: Medicare Advantage plan
  4. Part D: Prescription drug coverage
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6
Q

Which Medicare part involves insurance for hospital care?

A

Part A

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7
Q

T or F: Medicare has no monthly premium for Part A

A

True

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8
Q

T or F: Medicare has no monthly premium for Part B

A

False–monthly premium for Part B
(and Part D)

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9
Q

What does part B of Medicare cover?

A

doctors visits and outpatient care (PT etc.)

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10
Q

What is Part C of Medicare?

A

Combined Part A (hospital care) and Part B (doctor/outpatient care)
*most also include part D (drug)

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11
Q

What does part D of Medicare cover?

A

prescription drug coverage

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12
Q

How does Medicaid differ from Medicare?

A

Mandated services for low income children, pregnant women, and elderly

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13
Q

Who is medicaid funded by?

A

government at state and federal level

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14
Q

What is the #1 goal of the affordable care act?

A

make health insurance affordable/available to all people (expand medicaid program)

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15
Q

Difference between self pay and charity payor systems?

A

Self: individual pays
charity: healthcare system receives no reimbursement for services

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16
Q

Which payor system is focused on preventative care?

A

HMO: Health Maintenance Organization

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17
Q

Which payor system has a predetermined set of services provided, paid as set fee?

A

HMO

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18
Q

Which payor system has an option to use in network providers at a discounted rate?

A

PPO: Preferred Provider Organization

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19
Q

Which payor system has a fixed payment for a service based on diagnosis, age, and treatment?

A

DRG (Diagnosis related groups)

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20
Q

Which payor system has reimbursement based on average cost if services?

A

DRGs

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21
Q

What is a payment made to hospital based on a DRG?

A

PPS Prospective payment system

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22
Q

Why is a PPS important?

A

Allows leader to form budget based on average

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23
Q

Which payor system is a combination of social, health, and medical services needed?

A

SHMO: Social Health Maintenance Organization

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24
Q

What payor system is defining financial incentives for hospitals to improve the quality of care provided?

A

P4P: Pay for Performance

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25
Q

What are the 4 quality measures of P4P?

A
  1. Performance
  2. Outcomes
  3. Patient satisfaction/experience
  4. Structures and technology (EHR)
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26
Q

What is included in a budget cycle?

A

Development, monitoring, reporting, justifying, variance analysis

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27
Q

What are the 4 types of budgets?

A
  1. Revenue
  2. Expense
  3. Capital
  4. Operating
28
Q

Using the anticipated amount of income to set a budget is what type?

A

Revenue

29
Q

Looking at fixed and variable costs is included in which budget type?

A

Expense

30
Q

A cost that remains constant such as rental fees and contract fees is what?

A

Fixed cost

31
Q

A cost that fluctuates based on unit activity such as census is what?

A

Variable cost

32
Q

What type of budget does large unit items come from?

A

Capital

33
Q

What type of lifespan does something in a capital budget have?

A

1 year or later

34
Q

What is assigning the cost of an asset over its lifetime

A

amortization

35
Q

What is it to expense fixed assets annually

A

depreciation

36
Q

Which budget is based on the past years unit activity in order to predict for next fiscal year?

A

Operating budget

37
Q

What is the number 1 expense in a budget?

A

Salary

38
Q

How are total patient days for a year calculated?

A

add together daily census for 365 days

39
Q

When is daily census obtained?

A

Midnight

40
Q

What is ADC?

A

Average daily census

41
Q

How is ADC calculated?

A

total patient days divided by # of calendar days

42
Q

What number of calendar days do you use to get average daily census?

A

365

43
Q

How many hours a year is a full FTE?

A

2080

44
Q

How is FTE hours calculated?

A

8 hours/day X 5 days/week X 52 weeks/year

**2080 hours

45
Q

2080 hours a year how many FTE

A

1.0 FTE

46
Q

What info do you need for FTE hour calculation?

A

-how long shift (ex 12 hrs)
-how many shifts/week (ex 3)
-52 weeks/year

47
Q

What is the HPPD

A

Hours per patient day

48
Q

What does HPPD do?

A

calculates amount of nursing care necessary per patient in a 24 hr period

49
Q

What is the HPPD formula?

A

total productive hours (divided by) total volume (ADC)

50
Q

Total volume on a unit is also known as?

A

ADC (average daily census)

51
Q

How do you calculate nonproductive time (in hours)

A

FTE (2080) x percentage of productive time (exam will give percentage of unproductive time)

52
Q

If exam doesn’t give nonproductive percentage, what should you use?

A

20% nonproductive/ 80% productive

53
Q

How do you determine FTE needed to staff unit? (if given ADC, nonproductive %, HPPD)

A

-calculate productive hours
-calculate productive hours/year
-multiply by productive time

54
Q

What is bad debt?

A

Losses due to uninsured or not collected?

55
Q
A
56
Q

What is the amount written off annually on a piece of equipment and buildings?

A

Depreciation

57
Q

What is a FTE workweek?

A

40 hours

58
Q

How many hours is a full 1.0 FTE?

A

2080 hours

59
Q

What is HPPD?

A

hours worked/ # of patient days

60
Q

What is the difference between what is actually collected from payers and total expenses?

A

Margin

61
Q

What is an occupancy rate?

A

ADC per budgeted beds

62
Q

What is a profit margin?

A

% difference between revenue and expenses

63
Q

What is a staffing mix?

A

Percentage of RN to other staff

64
Q

Why is staffing mix important?

A

must use when calculating productive time

65
Q

What is zero based budgeting?

A

budget starts at zero each year

CNML Exam (7 decks)

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