Multiple Finance/Budget Questions
University of Scranton Hospital is a 175-bed community hospital serving a rural area of Pennsylvania. It is located 65 miles from a large metropolitan area and has a fine reputation.
The hospital is fully accredited and is licensed by the state. The hospital offers general medical/surgical services with a bed complement as follows:
The hospital has a 10 bed Ambulatory Surgical Unit. The hospital is in sound financial condition with a physical plant that is 15 years old and in excellent condition.
The hospital has just recruited a new general surgeon and an internist. These recruitment efforts filled a major need of the institution. It is estimated that in today’s current marketplace general surgeons are expected to increase inpatient admissions to an acute care community hospital by 1.5% annually and internists by .5%.
It is expected that admission volumes will increase with the addition of these two new physicians.
The community population has been relatively stable over the past 10 years and there is no expectation that this trend will change.
The percentage breakdown of patients by payor mix is as follows:
Blue Cross 16%
Medical Asst 08%
Commercial INS 07%
Self Pay 03%
The population breakdown is as follows:
Under 19 25%
19 to 64 44%
65 and over 31%
The primary initiative or goal for the 2014-2015 fiscal year is the establishment of a 15-bed Psychiatric Unit. This new unit will be infused into the current bed complement with no increase in the 175 bed count expected. This unit is expected to occupy space for 15 beds currently not set up and staffed at the hospital.
It is expected that during the year there will be an increase in inpatient services as a result of the Psychiatric Unit. The hospital laboratory is buying two new pieces of equipment at a cost of $400,000 that will allow them to do 35% more tests in house rather than send these tests out to a reference lab. It is also expected that the Radiology Department is purchasing a new CT scanner that is expected to increase current radiology volumes by 3.25%.
The budget calendar and target dates for budget completion are the same in this year’s budget as in years past.
In the new fiscal year, the hospital plans to:
a. Establish a separate distinct 15-bed inpatient psychiatric unit.
b. Install new equipment in the laboratory to enable the hospital to do 35% more tests in-house rather than send them to a reference lab.
c. Recruit a general surgeon and an internist.
d. Purchase an additional CT scanner which is expected to increase current radiology volumes by 3.25%.
FOUR DEPARTMENTS ARE INVOLVED IN OUR BUDGET EXERCISE. THEY ARE NURSING, LABORATORY, PHARMACY AND RADIOLOGY SERVICES.
2012 2013 2014 2015
Admissions In Pt (Nursing) 7395 7400 7370
Laboratory Test 399330 411810 421564
Pharmacy Rx 99832 100011 99642
Radiology Exams 68222 69124 68950
Laboratory spent $79,866 on supplies in 2012. They spent $86,480 in 2013 and $96,959 in 2013. These figures represent the cost of supplies to do tests at the hospital. The hospital spent $122,000 to perform tests outside the hospital last year. The cost of lab supplies is expected to increase 10% in the next budget year as a result of deflation. The hospital also had supplies costs in Radiology of $ 395,205 in 2012, $405,222 in 2013 and 410,100 in 2014. There is expected to be an industry wide increase in radiology supplies costs of 6.5% in the next budget year.
2012 2013 2014 2015
Supplies $ 79,866 $ 86,480 $ 96,959
Supplies $395,205 $405,222 $410,100
Present Position Control Plan
NURSING JOB CLASSIFICATION LISTING
POSITION TITLE AUTHORIZED POSITIONS
Director of Nursing 1 ft
Assistant Director 2 ft
Nurse Supervisors 4 ft
Head Nurse 8 ft
Staff Nurses RN 80 ft
LPN 25 ft
Nurses Aides 10 ft
Orderlies 6 ft
Unit Desk Clerks 6 ft
Secretary 1 ft
Department Head 1 ft
Med Technologist 12 ft
Lab Tech 4 ft
Lab Assistant 2 ft
Secretary 1 ft
Gross Revenue Projected for the 2014-2015 budget year is as follows:
In Patient $30,675,000
Out Patient $36,878,000
Current Reimbursement Formulas:
In Patient Out Patient
Medicare $5760/case 38% of Charge
HMO $1215.00/pat day 31% of Charge
Other Insurance 7675.00/discharge 42.5% of Charge
Expected length of stay (LOS) in 2015 is 3.4.
- Describe the mission, assumptions and objectives for the upcoming budget year for the departments involved. (Nursing, Laboratory, Pharmacy & Radiology)
- Establish statistics volume projections for the budget year 2015 for all four (4) departments.
- Establish a position control plan for the new Psychiatric Unit (Part of Nursing )
- Establish a position control plan for nursing, and laboratory.
- Complete supplies expense item for nursing, laboratory & radiology for 2015.
- Project the expected net revenue for all Medicare, HMO, and all Other Insurance patients.