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Managing Your Departmental Budget September 24, 2014. Revenue Sources. Main Sources Medicaid Medicare Private Pay Insurance MSHO. Medicaid. States set the rate Most States, payments do not cover expenses ND is cost-based reimbursed Rate equalization in MN and ND - PowerPoint PPT Presentation
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Managing Your Departmental BudgetSeptember 24, 2014
Revenue Sources Main Sources
– Medicaid– Medicare– Private Pay– Insurance– MSHO
Medicaid• States set the rate
– Most States, payments do not cover expenses
– ND is cost-based reimbursed– Rate equalization in MN and ND
• Pays for semi-private room– Some allowances for private
room reimbursement
Medicare• Set by Federal Government• Includes therapies, lab, x-ray,
pharmacy• Premium Payer
– Provides a Margin
• Does not pay for private room• Length of Stay (LOS)
– 20-25 days typical
Major Expense Categories
51%
11%
9%
8%
1%4% 6%
4%6%
PercentageSalariesBenefitsPurchased SvcsSuppliesInsuranceUtilitiesDepreciationInterestOther
Labor Expense Management
• Nursing Labor – Flexing hours– Adjusting for Census and Case Mix
Budget #1 #2 #3Budgeted Hours/RD 3.2 3.2 3.2 3.2 Census 50.0 45.0 50.0 52.0 Case Mix 1.1 1.1 1.0 1.2
SRD* Hours 176.0 158.4 160.0 199.7
*SRD - Standardized Resident Days
Labor Expense Management
• Other Departments should flex labor, too!
Non-Salary Expense Management
• Supplies– Food– Nursing Supplies– Linens
• Purchased Services• Other
Income Statement - SNFFor the Month Ended August 31, 2014
Current Current Current Current YTD YTD YTD YTD VarianceActual Budget Variance APD BPD Description Actual Budget Variance APD BPD from BPD
REVENUE$96,513.06 $104,935.00 ($8,421.94) $181.76 $178.16 REVENUE - PRIVATE PAY $191,022.60 $209,870.00 ($18,847.40) $182.97 $178.16 $4.81134,866.95 124,498.16 10,368.79 210.73 182.55 REVENUE - MEDICAID 266,492.36 248,996.32 17,496.04 190.90 182.55 8.35
66,715.03 92,891.50 (26,176.47) 441.82 461.00 REVENUE - MEDICARE A 115,667.97 185,783.00 (70,115.03) 422.15 461.00 (38.85)26,634.68 12,896.00 13,738.68 324.81 416.00 REVENUE - CONTRACTED INSURANCE 52,691.78 25,792.00 26,899.78 424.93 416.00 8.9327,614.77 10,664.00 16,950.77 190.45 172.00 REVENUE - MSHO - MEDICAID 36,613.09 21,328.00 15,285.09 188.73 172.00 16.7322,521.30 43,074.50 (20,553.20) 375.36 397.00 REVENUE - MSHO - MC A 49,374.16 86,149.00 (36,774.84) 385.74 397.00 (11.26)12,210.52 9,039.78 3,170.74 7.59 5.40 REVENUE - MEDICARE B 16,948.73 18,079.56 (1,130.83) 5.36 5.40 (0.04)
2,925.48 628.50 2,296.98 1.82 0.38 REVENUE - MSHO - MC B 3,301.17 1,257.00 2,044.17 1.04 0.38 0.67449.15 0.00 449.15 0.28 0.00 PRIOR YEAR REVENUE ADJUSTMENTS (18,760.53) 0.00 (18,760.53) (5.94) 0.00 (5.94)
----------------- ------------------ ----------------- ------------ ------------ ------------------- ------------------ ------------------- ------------ ------------ --------------390,450.94 398,627.44 (8,176.50) 242.67 238.13 TOTAL REVENUE - CARE 713,351.33 797,254.88 (83,903.55) 225.74 238.13 (12.38)(9,525.61) 4,353.52 (13,879.13) (5.92) 2.60 OTHER OPERATING INCOME 85,760.72 8,707.04 77,053.68 27.14 2.60 24.54
----------------- ------------------ ----------------- ------------ ------------ ------------------- ------------------ ------------------- ------------ ------------ --------------380,925.33 402,980.96 (22,055.63) 236.75 240.73 TOTAL REVENUE 799,112.05 805,961.92 (6,849.87) 252.88 240.73 12.15========= ========== ========= ======= ======= ========== ========== ========== ======= ======= ========
OPERATING EXPENSES130,922.83 141,306.45 10,383.62 81.37 84.41 NURSING 267,131.84 282,612.90 15,481.06 84.54 84.41 (0.12)
14,188.14 13,944.69 (243.45) 8.82 8.33 OTHER CARE 26,374.42 27,889.38 1,514.96 8.35 8.33 (0.02)43,036.87 42,033.38 (1,003.49) 26.75 25.11 ANCILLARIES 78,385.75 84,066.76 5,681.01 24.81 25.11 0.3034,037.26 34,946.44 909.18 21.15 20.88 CULINARY 66,722.22 69,892.88 3,170.66 21.11 20.88 (0.24)
5,052.43 4,218.93 (833.50) 3.14 2.52 LAUNDRY 9,284.06 8,437.86 (846.20) 2.94 2.52 (0.42)7,835.73 7,491.09 (344.64) 4.87 4.47 HOUSEKEEPING 16,028.65 14,982.18 (1,046.47) 5.07 4.47 (0.60)
18,811.32 16,448.81 (2,362.51) 11.69 9.83 PLANT OPERATIONS 151,699.28 34,348.82 (117,350.46) 48.01 10.26 (37.75)35,011.25 36,688.55 1,677.30 21.76 21.92 GENERAL & ADMINISTRATIVE 70,415.51 70,896.10 480.59 22.28 21.18 (1.11)
9,710.17 5,887.35 (3,822.82) 6.03 3.52 PROVISION FOR DOUBTFUL ACCOUNTS 12,867.42 11,774.70 (1,092.72) 4.07 3.52 (0.56)832.50 0.00 (832.50) 0.52 0.00 FUND RAISING 1,665.00 0.00 (1,665.00) 0.53 0.00 (0.53)
44,965.04 47,596.93 2,631.89 27.95 28.43 PAYROLL TAXES AND BENEFITS 92,078.76 95,193.86 3,115.10 29.14 28.43 (0.71)52,644.78 52,636.72 (8.06) 32.72 31.44 PROPERTY RELATED 105,289.56 105,273.44 (16.12) 33.32 31.44 (1.88)
0.00 62.50 62.50 0.00 0.04 INTEREST 0.00 125.00 125.00 0.00 0.04 0.043,675.67 3,291.00 (384.67) 2.28 1.97 DEPRECIATION, AMORTIZATION, ACCRETION 7,351.34 6,582.00 (769.34) 2.33 1.97 (0.36)
262.00 467.12 205.12 0.16 0.28 OTHER 424.00 934.24 510.24 0.13 0.28 0.14----------------- ------------------ ----------------- ------------ ------------ ------------------- ------------------ ------------------- ------------ ------------ --------------400,985.99 407,019.96 6,033.97 249.21 243.14 TOTAL OPERATING EXPENSES 905,717.81 813,010.12 (92,707.69) 286.62 242.83 (43.78)
(20,060.66) (4,039.00) (16,021.66) (12.47) (2.41) NET INCOME(LOSS) FROM OPERATIONS (106,605.76) (7,048.20) (99,557.56) (33.74) (2.11) (31.63)----------------- ------------------ ----------------- ------------ ------------ ------------------- ------------------ ------------------- ------------ ------------ --------------
(20,060.66) (4,039.00) (16,021.66) (12.47) (2.41) NET INCOME(LOSS) (106,605.76) (7,048.20) (99,557.56) (33.74) (2.11) (31.63)========= ========== ========= ======= ======= ========== ========== ========== ======= ======= ========
Cost by DepartmentFor the Month Ended August 31, 2014
Current Current Current Current VarianceActual Budget Variance APD BPD from BPD Description
NURSING120.00 0.00 (120.00) 0.07 0.00 (0.07) ?-20000-620-500 Nursing Consultant975.00 910.00 (65.00) 0.61 0.54 (0.06) ?-20000-620-510 Pharmacy Consultant600.00 600.00 0.00 0.37 0.36 (0.01) ?-20000-620-600 Medical Director
3,515.00 3,515.40 0.40 2.18 2.10 (0.08) ?-20000-630-000 Supplies - Nursing3,891.01 2,845.80 (1,045.21) 2.42 1.70 (0.72) ?-20000-630-050 N.S. Incontinency Supplies
139.51 418.50 278.99 0.09 0.25 0.16 ?-20000-630-100 Non-Prescription Drugs1,479.41 594.52 (884.89) 0.92 0.36 (0.56) ?-20000-630-200 Minor Equipment-Nursing
0.00 339.73 339.73 0.00 0.20 0.20 ?-20000-630-500 Office Supplies-Nursing120.46 142.68 22.22 0.07 0.09 0.01 ?-20000-640-000 Purchased Services-Nursing
0.00 254.79 254.79 0.00 0.15 0.15 ?-20000-670-100 Equipment Repairs-Nursing445.00 445.00 0.00 0.28 0.27 (0.01) ?-20000-690-000 Dues & Subscriptions-Nursing
1.71 84.93 83.22 0.00 0.05 0.05 ?-20000-690-100 Travel-Nursing123.98 152.88 28.90 0.08 0.09 0.01 ?-20000-690-300 Equipment Leases-Nursing422.26 390.68 (31.58) 0.26 0.23 (0.03) ?-20000-690-500 Miscellaneous-Nursing
Cost Management Tools
Cost Control Log
Master Account List Month Days Census Total Patient Days
Benedictine Health CenterNOTE: All yellow items are input here August 31 114 3,534 and populate cells in other tabs
Expense Account Account Number PPD Budget Spent Variance
Nrsg Supplies 1-20000-630-000 4.22 14,913.48 12,980.59 1,933Nrsg Incontinen 1-20000-630-050 1.77 6,255.18 8,064.10 (1,809)Nrsg Non-Presc Drugs 1-20000-630-100 0.55 1,943.70 954.49 989Nrsg Oxygen 1-20000-630-150 0.01 35.34 - 35Nrsg Minor Eqpt 1-20000-630-200 0.64 2,261.76 1,984.95 277
Budget Control Sheet
Budget Control Sheet Month: January
Account # : Number of Days in Current Month31
Account Name: Current Month Projected Average Census 53
(input in highlighted cells) Current Month PPD Expense Budget$3.10
This Month's Budget Amount:$5,093.30
Date Amount Purchased Remaining Balance Vendor/Item(s) Purchase/Comments2/2/2008 5.00 5088.30 tape2/5/2008 26.00 5062.30 supplies
250.00 4812.30 depends7.00 4805.30
250.00 4555.304725.50 (170.20)
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