Departmental Budget Preparation for Nursing Home Essay

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Volume Projection

This paper presents the budget for a proposed senior center called Elderly Acres Nursing Home that is based on the demographics of two counties, Buffalo and Yorkshire. The projected volume of clients for Elderly Acres was calculated based on the National Bureau of Statistics (NBS) census reports. The NBS reports that the number of people who are above 65 years of age (senior) in Buffalo and Yorkshire Counties is 938,450. This translates to 15% of the entire population in Buffalo and Yorkshire. Compared to the national average of 11.6%, the proportion of the senior population in these two counties is high. Since not all senior citizens have chronic conditions, it is projected that only 30% of the elderly population in the two counties needs assisted living care. The rest of the population (70%) is healthy enough to care for itself. In addition, others are already under family support systems.

Based on the above considerations, the target population for Elderly Acres is estimated to be 346,440 clients. The figure includes the elderly population within Yorkshire and Buffalo Counties with chronic conditions and lacking family support. However, since not all patients within this region can easily access our services, an area equivalent to a 30-minute drive from Elderly Acres premises (neighborhoods) is more accurate and realistic. The number of those living within a 30-minute drive is projected to be 136,906. However, not all these potential clients can afford full-time care at Elderly Acres. It is projected that only 10% of the target population living within the locality will need full-time care. This translates to a potential patient population of 13,691. It is important to note that the future of this business is likely to be affected by the shift in population trends. However, while the total population in our area of operation is expected to decrease, the population of people who are above 65 years in the US is projected to rise (Hamilton, Strobino & Guyer, 2008). Therefore, our business projects a 3% business increase over the next five years.

Therefore, the target population for the Elderly Acres is senior citizens residing within Yorkshire and Buffalo. This will comprise of people above 65 years of age, earning between $28,000 and $70,000, living within a 30-minute drive from the center, and in need of full-time assisted care. The projected patient volume of the unit is 13,961 people. This figure was arrived at based on the population census done by the National Bureau of Statistics. It represents the approximate number of people from the target population who will be able to access our services. The projected volume of clients was calculated based on their demographic characteristics. These included the ability to pay (income), age (above 65 years), location/accessibility, lack of family/community support, and demand for full-time care services.

One of the rationales for arriving at the projected client figure (13,691) is that the demand for elderly care services is rising. In the past, the practice of taking the elderly home to recuperate or receive specialized care used to be accompanied by a lot of stigmas. Families had enough financial resources and time to take of elderly relatives in their homes. Moreover, women were not involved in demanding careers and therefore could find time to provide primary care to the elderly. However, changes in family dynamics have increased the demand for residential care services. Moreover, when the demographic characteristics of the target population, such as income, income, and location, are taken into consideration, 13,691 people are expected to benefit from our services.

Staffing Pattern

As aforementioned, the target population is the senior citizens living within Yorkshire and Buffalo counties. Therefore, the proposed staffing pattern is based on a projected patient population of 13,961 people. Appropriate staffing patterns improve the quality of care and health outcomes of both the patient and the nurse (Szczepura, Nelson & Wild, 2008). According to Kelly and Tazbir (2014), staffing pattern is very important to any organization, especially startups, for a number of reasons. First, the pattern would help understand the number of employees needed for every task to ensure that no task goes unassigned to staff members. Second, it helps in understanding the tasks that should be undertaken in order to avoid cases of overlap of roles. Finally, the pattern would help the management determine the amount of money it would need to pay its employees. In the previous research, it was determined that, of the target elderly population, 13,691 people are expected to use our facilities. This includes individuals living within a 30-minute drive from our facility. It is important to ensure that there is enough staff to offer quality care for this group. Given the fact that there are other similar organizations within this market, it is our responsibility to ensure that we offer excellent service to our clients. The staffing pattern below was developed based on the findings of the initial research.

Staffing Pattern for Elderly Acres

Staffing Pattern for Elderly Acres

The staff at this facility will comprise the management and the nursing staff. The nursing staff will comprise three categories of nurses: RNs, LPNs, and nursing aides. It is projected that the facility will need a nursing staff mix of 9 RNs, 3 LPNs, and 12 nursing aides. This staff mix is based on the care needs of a projected patient volume of 13,691.

Criteria for developing this Pattern

It has been mentioned that this document is crucial to a young organization such as Elderly Acres. It would be important to understand how the staffing pattern was developed. The pattern identified four categories of staff that would be needed for the daily running of this facility. The first three categories were individuals whose services were directly needed for the care of the patients. Registered nurses formed the bulk of those needed for service delivery to our patients. We needed a higher number of registered nurses for reasons that will be explained in the next section of the paper. We also needed a number of licensed practical nurses to assist the registered nurses. Nurse aides were also needed to play a vital role in managing patients’ needs within the facility. They would help with other services such as cleaning or laundry services. They can also help in running errands within the facility that do not require the attention of a registered nurse.

The last category had the management unit. This category was included in this staffing pattern to help develop a comprehensive understanding of the relevant stakeholders who will be involved in running this facility. It is important to note that their working hours were not included when calculating the total patient hours. This was so because they are not directly involved in caring for the patients. Their presence within the facility would not reflect directly on the hours given to the patients. Instead, their role within the organization would be to supervise the activities of other employees.

This staffing pattern was based on a detailed understanding of the requirements needed within this facility. Of the four categories of people identified, it is important to note that the management unit was not considered part of the team workers when determining patient hours. The main reason for their inclusion in the above pattern was to enhance understanding of the budget that would be needed to pay all the employees. Including them in this table would make it easy to understand specific financial needs in terms of money that will have to be paid to the employees of the firm.

The rationale for the Criteria

According to Akhtar (2004), employees are the most important asset of an organization because they are responsible for the implementation of policies developed by the top management unit. They are the wheels upon which an organization rolls towards its set goals and objectives. Most organizations have been affected by poor planning of the workforce. Such incidents of work overlaps are common in such cases, meaning that some duties will not be addressed within the intended period.

Using the above staffing pattern would help the firm achieve the best service delivery to all the patients who visit the facility, irrespective of the time of the day. The pattern is designed to ensure that there are five nurses in the facility at every time of the day. There will be three nursing officers, one nurse aide, and one licensed practical nurse. The nurse aide and licensed practical nurse will assist the registered nurses. This ratio will also help ensure that activities of the nurse aide and licensed practical nurse are closely monitored to avoid any issue that may have a negative impact on the clients when they are being served.

This pattern is also conscious of the strained budget that the firm has to operate within during the initial days of operation. This organization will be depending on the proceeds from its activities because it does not have any alternative sources of funding. It would be more appropriate to have more nurse aides perform most of the less complex activities that do not require the attention of a registered nurse. However, the associated costs are prohibitive. This firm may not be able to meet such high expenses during its early days of operations. The pattern is flexible, and therefore, can always be adjusted whenever there is a need for this to happen. However, the status of this firm would need a lean workforce that the management can afford to pay without a lot of problems. It is important to note that the need for an adequate and efficient workforce was not sacrificed for a less expensive workforce (Finkler & McHugh, 2008). The first determinant that was used had its basis on the ability of these nursing officers to address various tasks within this organization

Operating Budget

Salary Budget

Job TitleHourly Wage ($)Medical Insurance ($ p.a.)Overtime/HourlyMileage (1.7 miles/hrProfessional Fees
Residential Home Manager50560026000
Registered Nurses (9)48720046001700
Licensed Practice Nurse (3)36430036004100
Nursing Aides (12)10542036003200
Orderlies9452026000
Hair Dressers8627516000
Personal care aides8300026000
Cashier/Billing Clerk7360016000
Services Coordinator12670036000

Non-Salary Budget

Item DescriptionUnitsCost per Unit ($)Total Cost ($)
Unit Supplies
Computers103,000300,000
Fax Machine2200400
Copier215003000
Phone System42,50010,000
Laser Printer11,0001000
Badges301003000
Uniforms301504500
office supplies101001000
Patient/Medical supplies202004000
Other Expenses
Consultant Fee3000
Education and training6000
Equipment10000
Educational material1200
Travel Expenses1500
Utility Connections500
Insurance Premiums5000
Bank/Legal Fees5000
Miscellaneous5000
Total Estimated Annual Startup costs$364100

Capital Budget

The budget lists the items necessary for the unit to function properly. The quantity required for each item and the total cost is also provided.

ItemsUnitsCost per Unit ($)Total Cost ($)
Medical Necessity Items
Intellivue Patient Monitors31125033750
Mac 5000 EKG Machine210,00020000
Bladder Scan113,00013000
Zoll M-series biphasic defibriller11350013500
Telemetry Transmitter135003500
Bedside Lab Analyzer3400012000
MedFusion IV Pump57003500
Medical Gas Blenders230006000
Portable Ultrasound machines430000120000
NeoBlue Phototherapy lights3400012000
Cordless MiniDriver22000040000
Ligasure11500015000
Cystoscopy Instruments11100011000
Hysteroscopy set190009000
OR system3600018000
Kidney Resectoscope160006000
Gyn Cysto Tray11000010000
Non-Medical Items
Stretchers1013000130000
Medication Carts2600012000
Ice Machines230006000
Carpeting Client Room310003000
Carpet for office110001000
Over-bed Tray Tables45002000
Beside cabinet44001600
Guest chairs102002000
Wheelchairs4200800
Heat on Demand Activator170007000
Gas Oven145004500
Conference Room Chairs202004000
Food Slicer150005000
Gas Boiler124002400
Imaging Chair315004500
Cold Food Table190009000
Cold Food Merchandiser145004500
Technology Items
Patient tracking system1400000400000
Hawlett Packard Printer112001200
PACS Work stations Upgrade1260000260000
NOELLE Interactive Maternal and neonatal Birthing Stimulator11500015000
Laptop115001500
Color Printers213002600
Monitor (PC)520001000
New Vendor-dependent applications1620000620000
Desktop Work Station212502500
Encore VXP System1115000115000
Handheld Scanner220004000
Information Network1165000165000
Speech Recognition (SpeechQ)16300063000
ReDoc Documentation12100021000
Electronic Medical Record13500035000

Justification for the Purchase of the Capital Items

The medical items included in the capital budget are necessary for patient care. Elderly patients have complex health needs that require specialized care (Nies & Berman, 2004). The medical items will be used in physical assessment and monitoring of each patient’s health status. On the other hand, the non-medical items listed in the capital budget will aid in the provision of care by the nursing aides. The technology items will help enhance the quality of health care delivery.

References

Akhtar, R. (2004). India: Health care patterns and planning. New Delhi: A P H Publishing Corp.

Finkler, S. A., & McHugh, M. L. (2008). Budgeting concepts for nurse managers. St. Louis: Elsevier.

Hamilton, B. E., Strobino, D. M., & Guyer, B. (2008). Annual summary of vital statistics: 2008. Pediatrics, 119(2), 345-360.

Nies, H. & Berman, C. (2004). Integrating Services for Older People: A Resource Book for Managers. European Health Management Association (EHMA): Dublin.

Szczepura, A., Nelson, S. & Wild, D. (2008). Improving care in residential care homes: a literature review. York: Joseph Rowntree Foundation

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