Posted: November 23rd, 2016

# How might the adoption of an EHR affect staffing needs, operating budget creation, and forecasting needs for future budget periods?

Week 3 Assignment 1 HCA301 Healthcare Finance Assignment 1 Resources Read/review the following resources for this activity: •Textbook: Chapter 10, 11, 13, 14 •Lecture 1, 2 •File: HCA301 Week 3 Assignment 1 Template.xlsx (in Course Documents) Introduction Analyzing costs is both an important and a difficult aspect of a healthcare financial manager’s job duties. Understanding costs and their components can aid financial managers in increasing profits for the healthcare organization and ensuring future successes of the organization. Activity Instructions Use the financial information for Metropolis Health System (MHS) located in Chapter 28 and Appendix 28-A to complete the following analyses: 1. Use the following charts to calculate liquidity ratios, solvency ratios, and profitability ratios for MHS: Liquidity Ratios Numerator Denominator Ratio Current Quick Days Cash on Hand (DCOH) Days Receivables Solvency Ratios Numerator Denominator Ratio Debt Service Coverage (DSCR) Liabilities to Fund Balance Profitability Ratios Numerator Denominator Ratio Operating Margin (%) Return on Total Assets (%) 1.Use the template (in Course Documents) to Common Size the MHS statement of revenue and expenses from financial statements located in Appendix 28-A. 2. Why are these calculations important and how can they be used in the decision-making process of healthcare financial managers? Writing Requirements (APA format) •Provide all calculations required by the questions for each scenario. Include any narrative required to support or explain your calculations. •1-inch margins •Double spaced •12-point Times New Roman font •Title page with topic and name of student Liquidity Ratios Numerator Denominator Ratio Current Quick Days Cash on Hand DCOH Days in Receivables Solvency Ratios Numerator Denominator Ratio Debt Service Coverage Ratio DSCR #DIV/0! Liabilities to Fund Debt 0.526 Profitability Ratios Numerator Denominator Ratio Operating Margin #DIV/0! Return on Assets #DIV/0! HCA301 Healthcare Finance Assignment 1 Resources Read/review the following resources for this activity: · Textbook: Chapter 7, 8, 9 · Lecture 1, 2 Introduction Analyzing costs is both an important and a difficult aspect of a healthcare financial manager’s job duties. Understanding costs and their components can aid financial managers in increasing profits for the healthcare organization and ensuring future successes of the organization. Activity Instructions Review each scenario and complete the questions for each. Include all calculations and provide any narrative needed to support your calculations. Scenario 1: The Metropolis Health System (MHS) has a system-wide training course for nurse aids. The course requires a packet of materials that MHS calls the training pack. Due to turnover and because the course is system-wide, there is a monthly demand for new packs. In addition, the local community college also obtains the training packs used in their credit courses from MHS. The education coordinator needs to know how much of the cost is fixed and how much of the cost is variable for these training packs. She decides to use the high-low method of computation. · Question 1:Using the monthly utilization information presented below, find the fixed and variable portion through the high-low method. (10 points) Month Number of Training Packs Cost January 1,000 \$6,200 February 200 \$1,820 March 250 \$2,350 April 400 \$3,440 May 700 \$4,900 June 300 \$2,730 July 150 \$1,470 August 100 \$1,010 September 1,100 \$7,150 October 300 \$2,850 November 250 \$2,300 December 100 \$1,010 · Question 2:The education coordinator decides that the community college packs may be unduly influencing the high-low computation. She decides to rerun the results, omitting the community college volume. Month Total Number of Training Packs Total Cost Community College Number Packs Community College Cost January 1,000 \$6,200 200 \$1,240 February 200 \$1,820 March 250 \$2,350 April 400 \$3,440 May 700 \$4,900 300 \$2,100 June 300 \$2,730 July 150 \$1,470 August 100 \$1,010 September 1,100 \$7,150 300 \$1,950 October 300 \$2,850 November 250 \$2,300 December 100 \$1,010 a. Using the monthly utilization information presented here, and omitting the community college training packs, find the fixed and variable portion of costs through the high-low method. Note that the college only acquires packs in three months of the year: January, May, and September. These dates coincide with the start dates of their semesters and summer school. (5 points) b. The reason the education coordinator needs to know how much of the cost is fixed is because she is supposed to collect the appropriate variable cost from the community college for their packs. For her purposes, which computation do you believe is better? Why? (5 points) Scenario 2: The Mental Health program for the Community Center has just completed its fiscal year end. The program director determines that his program has revenue for the year of \$1,200,000. He believes his variable expense amounts to \$205,000 and he knows his fixed expense amounts to \$1,100,000. · Question 1:Compute the contribution margin for the Community Center Mental Health Program. What does the result tell you about the program? (10 points) · Question 2:Compute the profit-volume ratio for the Community Center Mental Health Program. What does the result tell you about the program? (10 points) Scenario 3: Assume that MHS purchased equipment for \$600,000 cash on April 1 (the first date of its fiscal year). This equipment has an expected life of 10 years. The salvage value is 10% of cost. No equipment was traded in on this purchase. · Question 1:Compute the straight-line depreciation for this purchase (10 points) · Question 2:Compute the double-declining balance depreciation for this purchase. (10 points) Writing Requirements (APA format) · Provide all calculations required by the questions for each scenario. Include any narrative required to support or explain your calculations. · 1-inch margins · Double spaced · 12-point Times New Roman font · Title page with topic and name of student Assignment 2: Small Group Project Resources Read/review the following resources for this activity: · Textbook: Chapter 10, 11, 12, 13, 14 · Lecture 1, 2 · Minimum of 1 outside resource in addition to the textbook Introduction Healthcare financial managers rarely work in isolation. They must work with other departments to accurately capture needs and costs, as well as each other to ensure forecasts and total financial statement analyses are accurate. Working with a group, whether in the office or through electronic communication, requires practice and patience. Activity Instructions Background The Chief Financial Officer at Sample General Hospital has just discovered that the hospital’s Chief of Medical Staff’s son Jason, a student at the local community college, is paid \$100 per week year-round for grounds maintenance at the hospital’s Outpatient Center. The CFO, no fan of the Chief of Medical Staff, now wants you to prepare a report that compares the relative costs of lawn care at each of three locations: the hospital itself, the outpatient center, and the hospital-affiliated nursing home down the block. Relevant Information Working with these facilities, your group has compiled the following background information for these three facilities. Introduction to the Three Facilities Sample General Hospital is an older, 100-bed hospital. The new Outpatient Center, built last year, is across the street and the Golden Age Nursing Facility is down one block, on the corner. The hospital is located in the mid-western Sunbelt; there is occasional frost in the winter but no snow. Grounds Maintenance Tasks That Should Be Performed At All Three Sites · Mowing and edging · Walk sweeping · Raking leaves · Blowing off parking lot · Flower bed maintenance (where necessary) · Hedge trimming and minor tree pruning (major tree trimming is performed by a contractor on an as-needed basis and thus should be disregarded) The following figure provides a map that illustrates the layout of the grounds for each facility and their proximity to each other. Grounds Maintenance Arrangements for the Three Facilities The current grounds maintenance arrangements vary among the three facilities as follows: 1. Sample Hospital uses its Maintenance Department employees for grounds care. The hospital pays these employees \$15 per hour plus 15% employee benefits; it is estimated they spend 1,000 hours per year on grounds maintenance work. Another estimated 120 hours per year are spent on maintaining the lawn care equipment. The employees use a riding lawn mower, edger and blower, all owned by the hospital. The hospital just bought a new mower for \$2,995 less a ten percent discount. It is expected that the mower should last for five years. 2. The hospital’s Chief of the Medical Staff’s son Jason, a student at the local community college, is paid \$100 per week year round for grounds maintenance at the hospital’s Outpatient Center. A friend sometimes helps, but when that happens Jason son pays him out of his weekly \$100. It takes about one and a half hours to mow, edge and blow. Jason uses his dad’s riding mower and blower, but Jason recently bought his own edger. Jason also buys fertilizer for the grass twice a year. 3. The Nursing Facility contracts with a landscape service on a seasonally adjusted sliding scale. The landscape service is paid \$600 per month from April to October (mowing season); \$400 per month for February, March and November; and \$200 per month for November, December and January. The landscape service provides all their own equipment. They also provide fertilizer and provide annuals to plant in the flower beds every quarter. Sample Hospital Property Description The grounds to be maintained are as follows: · The front lawn is grass in two sections on either side of the front entrance. Each section is about 50’ by 60’. · There is a hedge along the front of the building that is about 50’ on either side of the front entrance. · There are two small matching flower beds on either side of the front entrance. · Another strip of grass along side of the building is 30’ by 100’. · A third small strip of grass about 5’ by 25’ is by the Emergency entrance. · The walkway dimensions are as follows: about 50’ of front walk; about 30’ of staff entrance walk, both of which are 5’ wide. · The Emergency Department’s paved patient drop-off area is about 25’ by 30’. · The parking lot surface is about 200’ by 250’. Along one side are overhanging trees that drop leaves and debris and are a constant sweeping problem. These are the only trees on the hospital site. Outpatient Center Property Description The grounds to be maintained are as follows: · There is a strip of grass at the front of the building that is 12’ wide and 65’ long, split in the middle by a walkway 5’ wide. · There is a strip of grass at the back of the building between the building and the parking lot that is 5’ wide and 50’ long · All the rest of the property is paved. Nursing Center Property Description Golden Age Nursing Center occupies one whole block. The grounds have many large trees. Flowerbeds have been planted around the trees as well as along the front walk and entrance. There are also two secured patio areas at the side of the building screen by hedges and each has a small bed of annuals. Because of the unique design of the building grounds maintenance requires considerable handwork. Required Assignment Review the available information for grounds maintenance at the three facilities. Decide how to convert this information into comparable data. Then prepare a report, based on your assumptions, that presents comparable costs of grounds care. Also, provide your assessment of what the best future course of action should be. Additional financial information and financial statements can be found in Appendix 28-A of your text. Consider the costs at each site and report costs as well as recommendations to reduce costs while maintaining grounds for the three locations. Writing Requirements (APA format) · 3-4 pages (approx. 300 words per page), not including title page or references page · 1-inch margins · Double spaced · 12-point Times New Roman font · Title page with topic and name of student · References page (minimum of 2 resources) HCA301 Healthcare Finance Assignment Resources Read/review the following resources for this activity: · Textbook: Chapter 17, 18 · Lecture 1, 2 · File: HCA301 Week 5 Assignment Template.xlsx (in Course Documents) · Minimum of 2 outside resources in addition to the textbook (at least 1 must be a TU Library resource). Introduction As we have discussed this week, forecasts and budgets in healthcare organizations are rarely 100% accurate due to difficulties in forecasting from unknown patient needs and healthcare law changes. Activity Instructions Background Greenview Hospital operated at 120 percent of normal capacity in two of its departments during the year. It operated 120 percent times 20,000 normal capacity direct labor nursing hours in routine services and it operated 120 percent times 20,000 normal capacity equipment hours in the laboratory. The lab allocates overhead by measuring minutes and hours the equipment is used; thus equipment hours. Assumptions: For Routine Services Nursing: · 20,000 hours x 120% = 24,000 direct labor nursing hours. · Budgeted Overhead at 24,000 hours = \$42,000 fixed plus \$6,000 variable = \$48,000 total. · Actual Overhead at 24,000 hours = \$42,000 fixed plus \$7,000 variable = \$49,000 total. · Applied Overhead for 24,000 hours at \$2.35 @ = \$56,400. For Laboratory: · 20,000 hours x 120% = 24,000 equipment hours. · Budgeted Overhead at 24,000 hours = \$59,600 fixed plus \$11,400 variable = \$71,000 total. · Actual Overhead at 24,000 hours = \$59,600 fixed plus \$11,600 variable = \$71,200 total. · Applied Overhead for 24,000 hours at \$3.455 @ = \$82,920. Required Activity 1. Use the template (in Course Documents) to complete the following worksheets to calculate volume variance, budget variance, and net variance. (40 points) 2. Discuss 3-4 possible benchmarks for each Routine Services Nursing and the Laboratory. How can reaching these benchmarks affect income and expenses for each department and how would these benchmarks be included in a variance and/or sensitivity analysis? (30 points) Writing Requirements (APA format) · 2-3 pages (approx. 300 words per page), not including worksheets, title page or references page · 1-inch margins · Double spaced · 12-point Times New Roman font · Title page with topic and name of student · References page (minimum of 2 resources) Worksheet 1: Volume Variance Routine Nursing Services Laboratory Applied Overhead Costs Less: Budgeted Overhead Costs Volume Variance 0 0 Worksheet 2: Budget Variance Routine Nursing Services Laboratory Budgeted Overhead Costs @ 24,000 Hours Less: Actual Overhead Costs Budget Variance 0 0 Worksheet 3: Net Variance Routine Nursing Services Laboratory Volume Variance 0 0 Less: Actual Overhead Costs 0 0 Budget Variance 0 0 HCA301 Healthcare Finance Assignment 1 Resources Read/review the following resources for this activity: · Textbook: Chapter 12, 19, 20, 21 · Lecture 1, 2 · File: HCA301 Week 6 Assignment 1 Template.xlsx (in Course Documents) · Minimum of 2 outside resources in addition to the textbook Introduction The concept of the time value of money is important in capital expenditure decisions as the present value of future cash flows must offset the present cost of the asset. Activity Instructions Cost of owning and cost of leasing tables are reproduced below. Using the appropriate table from the Chapter 12 Appendix and the template (in Course Documents), record the present value factor at 10% for each year and compute the present value cost of owning and the present value of leasing. Which alternative is more desirable at this interest rate? Do you think your answer would change if the interest rate were six percent instead of ten percent? Writing Requirements (APA format) · 1-inch margins · Double spaced · 12-point Times New Roman font · Title page with topic and name of student @10% Complete yellow cells, Green will calculate the Sum Cost of Owning – Anywhere Clinic – Comparative Present value For Profit Cost of Owning: Year 0 Year 1 Year 2 Year 3 Year 4 Year 5 Net Cash Flow Present Value Factor @ 10% n/a Present Value 0 0 0 0 0 Total Present Value cost of Owning 0 Cost of Leasing – Anywhere Clinic – Comparative Present value For Profit Cost of Owning: Year 0 Year 1 Year 2 Year 3 Year 4 Year 5 Net Cash Flow 0 Present Value Factor @ 10% n/a Present Value 0 0 0 0 0 Total Present Value cost of Leasing 0 Differential in Own versus Lease 0 @6% Complete yellow cells, Green will calculate the Sum Cost of Owning – Anywhere Clinic – Comparative Present value For Profit Cost of Owning: Year 0 Year 1 Year 2 Year 3 Year 4 Year 5 Net Cash Flow Present Value Factor @ 6% n/a Present Value 0 0 0 0 0 Total Present Value cost of Owning 0 Cost of Leasing – Anywhere Clinic – Comparative Present value For Profit Cost of Owning: Year 0 Year 1 Year 2 Year 3 Year 4 Year 5 Net Cash Flow 0 Present Value Factor @ 6% n/a Present Value 0 0 0 0 0 Total Present Value cost of Leasing 0 Differential in Own versus Lease 0 Read/review the following resources for this activity: · Textbook: Chapter 19, 20, 21 · Lecture 1, 2 Introduction As we have learned this week, the decision to purchase or lease can become quite complicated and requires a significant amount of data and analysis. Activity Instructions Background Metropolis Health System has to do something about their ambulance situation. They have to (a) buy a new ambulance; (b) lease a new one; or (c) renovate an existing ambulance that MHS already owns. Rob Lackey, the Assistant Controller, has been asked to gather pertinent information in order to make a decision. So far Rob has found these facts: 1. It will cost at least \$250,000 to purchase a new ambulance, although the cost varies widely depending upon the amount of the emergency equipment contained on the vehicle. 2. In order to renovate the existing vehicle, it will cost at least \$100,000 to purchase and install a new “box”. (In other words, a new emergency-equipped body is installed on the existing chassis.) Rob has found this existing ambulance has an odometer reading of 80,000 miles. The vehicle will also need a new fuel pump and new tires, but he believes these items would be recorded as repair and maintenance operating expenses and thus would not be included in his calculations. 3. Lease terms for ambulances also vary widely, but so far Rob believes a cost of \$60,000 per year is a ballpark figure. Required How much more information should Rob have before he begins to make any calculations? Make a list. Which alternative do you believe would be best? Give your reasons. Writing Requirements (APA format) · 1-2 pages, not including title or references page · 1-inch margins · Double spaced · 12-point Times New Roman font · Title page with topic and name of student Resources Read/review the following resources for this activity: · Textbook: Chapter 24, 25, 26 · Lecture 1, 2 · File: Peer Evaluation Form (in Course Documents) · Minimum of 6 outside resources in addition to the textbook Introduction As we have learned this week, changes in healthcare laws and reporting regulations add a significant financial burden to both large and small healthcare organizations. Activity Instructions Working with your small groups, answer the following three questions. Consider the costs of each question and how healthcare organizations can reasonably manage these major changes. 1. Locate additional information about electronic health records systems that are being sold to physicians based on their qualification under the Health Information Technology for Economic and Clinical Health (HITECH) incentive program. Attempt to determine what the net cost of hardware, software and installation would be for an average physician practice. Compare this cost with the payments that an eligible physician who is a meaningful electronic health records user would receive over a five-year period. Determine the approximate net technology cost to the physician after such incentive payments. Also determine and discuss what start-up costs other than the technology costs may be incurred by the physician. In addition, discuss how the analysis for this type of capital investment project would be completed and included in a capital budget. 2. Meaningful use training is an important aspect of EHR adoption. Locate advertising that offers training related to meaningful use and/or meaningful users. What level or type of professional do they target? What does the advertising promise? How might the adoption of an EHR affect staffing needs, operating budget creation, and forecasting needs for future budget periods? What are some additional analyses that must be completed by financial managers on monthly reports following the implementation of the EHR system? 3. Locate some articles and/or government web sites that describe the ICD-10-CM and ICD-10-PCS Diagnosis Codes and tools for their implementation over a period of years. Write a summary of whether the materials you have found fully explain the breadth and depth of the transition challenge for managers who must live through the transition. How might the new ICD requirements affect staffing needs, cash flow concerns, operating budget creation, and forecasting needs for future budget periods? Writing Requirements (APA format) · 8-10 pages, not including title or references page · 1-inch margins · Double spaced · 12-point Times New Roman font · Title page with topic and name of student · References page (minimum of 6 resources)

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