Week 10; Budgeting Flashcards
What is a budget?
prediction, plan
A budget is either fixed or what?
variable
A budget is either controllable or what?
non controllable
What are the 3 types of budgets?
- personnel
- operational
- capital
What 3 cycles can help organize budget preparation?
- yearly cycle
- fiscal cycle
- calendar cycle
What is a budgeting where only incremental amounts are added to arrive at the new budgeted numbers?
incremental budgeting
What is a budgeting where preparing the budget from the scratch with a zero base?
zero based budgeting
What is a budgeting where it adjusts/flexes with change in activity/volume?
flexible budgeting
What is nursing viewed as fiscally?
as a cost center that does not independently generate revenue
What is challenging and not well defined in nursing?
ongoing efforts to measure and establish the cost of the various components of nursing care
What is nursing cost narrowly associated with?
budgeted and actual nursing care hours per patient day
What is nursing care hours per patient day?
a measure of time rather than a measure of type or level of care
What are a measure of the work commitments of a full-time employee?
full-time equivalents
What are hours worked and available for patient care designed as?
productive hours
what are considered nonproductive hours?
hours for benefits such as vacation, sick time, and education time
What is time spent providing hands-on care to patients
direct care
What is time spent on activities that are patient-related but are not done directly to the patient?
indirect care
What is a standard measure that quantifies the nursing time available to each patient by available nursing staff?
nursing hours per patient patient day
what does NHPPD reflect?
only productive nursing time available
Give an example of a calculation of NHPPD:
28 patients on a Step-Down Unit
7 RN’s x 2 shifts = 14 RN’s
14 RN’s working 12 hour shifts =168 hours available
168 hours/28 patients = 6 HPPD
What is the tool most broadly used to identify nursing most?
patient classification system
what is a measurement tool to determine nursing workload for specific patient or group of patients, over specified time period?
patient classification system
what is the measure of nursing workload that is generated for each patient?
patient acuity
What is patient classification data a valuable source of information for?
all organization levels
what do staff and managers use in regards to classification system data?
use data day-to-day to plan staffing for the next 24 hours
What does the central staffing office monitor?
monitors census and acuity on all units and deploys nursing resources to the areas in most need
What is unit level acuity data essential for?
essential in preparing month-end justification for variances in staffing numbers
What is organization level data essential for?
acuity data can be used to cost nursing services for a specific pt. population and global pt. types
What is when acuity data is used in preparing nursing staffing budgets for the upcoming fiscal year?
forecasting
What are considerations for a staffing plan?
Benchmarking – i.e. NDNQI Ratios Patient Classification HPPD Regulatory Requirements Skill Mix Staff Support Historical Considerations
What is a designated location in which staff is able to provide care to patients 24 hours a day, 7 days a week?
inpatient unit
What are the number of FTEs needed to meet the staffing plan calculated for?
- direct care needs
2. nonproductive time
How are direct care needs calculated?
by shift and 24-hours
How is nonproductive time calculated?
calculated amount of additional staff needed to provide for days off and benefit time
What are 3 scheduling considerations?
- patient needs
- volume
- experience and capability of staff
how are patient needs measured?
- PCS
2. Changes in needs
What are 3 ways to evaluate staffing and scheduling effectiveness?
- patient outcomes
- nursing staffing and nurse outcomes
- attain target productive hours
What are examples of non-nursing tasks?
Taking V/S
Transport pts.
Preparing meals
Getting supplies & equipment
What are examples of professional nursing tasks?
Interpreting V/S
Assessing/monitoring physical conditions
IV drugs, therapy
Planning for discharge
An Operational budget accounts for: A. Purchase of minor & major equipment B. Construction & renovation C. Income & expenses associated with daily activity within an organization D. Applications for new technology
C; Income & expenses associated with daily activity within an organization
Revenue is mostly generated through: A. Billable patient services B. Donations to service organizations C. Use of generic drugs/products etc. D. Messenger and escort services
A; billable patient services
Cost centers are best described by:
A. Developing historical and demographic data
B. Tracking expense line items
C. Plan for strategic growth
D. Tracking financial data within a department or unit
D; Tracking financial data within a department or unit(Answer)
The purpose of monitoring a budget is to:
A. Keep expenses above budget
B. Maintain revenue above the previous year’s budget
C. Ensure revenue is generated monthly
D. Generate revenue and control expenses within a projected framework
D; Generate revenue and control expenses within a projected framework
Productivity can be measured by:
A. Number of beds in hospital
B. Reimbursement rates for services rendered
C. Past Performance and history regarding revenue
D. Volume of services delivered
D; Volume of services delivered
Patient classification systems measure nursing workload needed by the patient. The higher the patient’s acuity, the more care that is required by the pt. Which of the following statement is a weakness of classifications systems?
A. Pt. Classification data are useful in predicting the required staffing for the next shift & for justifying nursing hours provided.
B. Pt. Classification data can be utilized by the nurse making assignments to determine what level of care a patient requires.
C. Classification systems typically focus on nursing tasks rather than a holistic view of a patient’s needs
D. Aggregate pt classification data are useful in costing out nursing services and for developing the nursing budget.
C; classification systems typically focus on nursing tasks rather than a holistic view of a patient’s needs
To determine the number of FTE’s required for a renal transplant unit, you must review all but which of the following?
A. Benefited time such as vacation and sick time.
B. Educational time for staff, including orientation of new staff.
C. Indirect patient care staff that support the operations of the direct care staff 24 hours a day.
D. Coverage for other depts. that do not staff to cover their own benefited time off.
D; coverage for other depts. that do not staff to cover their own benefited time off.
