Chapter 12: Managing Costs and Budgets Yoder-Wise:

In preparing a budget, the nurse manager needs to anticipate the cost of benefits. Based on the usual cost of benefits, how much should a nurse manager include for a total full-time salary cost of $312,000?

$46,800-$93,600

A staff nurse regularly works two 12-hour shifts each week and one 8-hour shift every other week. How many FTEs is this position?

0.7

During the budgeting process, nurse managers are typically responsible for which of the following? (Select all that apply.)

1. Developing unit operation objectives 2. Justifying capital equipment requests 3. Negotiating budget with other managers and administration

Which of the following are considered variable costs? (Select all that apply.)

1. Supplies 2. Medication and treatment supplies

RN 1: 5 weeks vacation, 3 education, 3sick days. RN 2: 6 weeks vacation, 3-day conference, 2-day workshop. RN 3: 3 weeks of orientation, 4 weeks vacation. RN 4: 6 weeks vacation, 2 weeks sick time, 3 days. RN 5: 5 weeks vacation, 5 sick day. RN 6: 6 weeks vacation

10,848

In preparing her budget, a nurse manager determines that she needs to budget for six FTE RN positions in the upcoming year. Based on a 40-hour week, this means that the nurse manager has determined that the budget will provide for _____ hours.

12,480 paid

The difference between a nurse practitioner's charge of $45 for an office visit and the insurance company's payment of $34 is:

A contractual allowance.

Because of the complexity of reimbursement systems and its implications for the services available to patients, the nurse has a key role in:

Advocacy for patients with regard to services required and services utilized.

Within a healthcare environment, where the gap between revenues and costs can mean the difference between sustainability of an organization and nonsustainability of an organization or services, it is critical for nurse managers to:

Balance value-added services against costs and revenues.

A nurse manager is planning to request three new infusion pumps at a cost of approximately $1500 each. This item would typically be included in which budget?

Capital

A nurse manager is planning to request three new infusion pumps at a cost of approximately $1500 each. What would BEST support the capital request?

Cost comparisons; how much and how often infusion pumps are used; condition of existing pumps

After a major flu vaccination campaign, an agency bills a private insurance company for allowable costs for administration of each vaccination according to the schedule established by the insurance company for reimbursement. This is an example of which major payment method?

Cost-based reimbursement

A nurse manager discovers that the actual number of visits per patient in a home health service is 3.8 visits per day when the standard is 5 visits per day. Based on this information, the nurse manager:

Decides that more information is needed before a conclusion can be reached.

The primary reason for calculating productive hours paid instead of simply calculating work paid per year is that productive hours enable the manager to:

Determine the number of hours available for patient care.

The chief nursing officer works with her nurse managers by helping them understand how to develop and implement a budget. A nurse manager can best describe a budget as a:

Financial plan.

After reviewing her monthly budget report, the nurse manager sees that she has a negative variance, which prompts her to change the staffing schedule. A negative or unfavorable variance in a monthly expense report may result from:

Higher than expected client acuity.

Mrs. A. with a fractured hip. Mrs. A. is stable but requires assistance with bathing, transfer, and mobility, and this will present stress for Mr. A., who was hospitalized with a mild myocardial infarction last year. Considering their means and health concerns

Home care

The chief nursing office of a Magnet hospital has conducted a study of ways to improve healthcare services. Healthcare services that add value for clients:

Minimize costs.

An example of an initiative that may reduce total healthcare costs would be:

Offering nurse practitioner-led clinics that educate parents about nonpharmacologic strategies for managing ear infections.

A nurse manager approves two staff nurses to attend a national conference. When reviewing the budget, the nurse manager looks at which line item?

Operating budget

Which of the following factors is not implicated in rising healthcare costs?

Rising Medicare costs

In a nurse managers' meeting, the chief nursing officer encourages the managers to brainstorm ways to reduce costs. Nurse managers have the greatest impact on reducing costs by managing:

Staffing.

Physicians reluctant to discharge. The hospital administration pressures the physicians to discharge patients sooner and to be more consistent with the number of hospitalization days specified within the DRGs. Which of the following would most likely prompt the action of administrators?

The hospital is incurring a deficit related to a gap between the PPS and the DRGs and costs of care.

Of the following, which is the most effective strategy that a nurse manager could employ to reduce unnecessary costs in specific healthcare settings?

Training nurses on accurate documentation of supplies used for patient care

As an experienced nurse manager who is new to an organization, it would be important to:

Understand the budget timetable and level of involvement expected of individual managers in budget preparation.

The chief nursing office continues to seek ways to improve healthcare services to clients and to save the hospital money. Capitation provides incentives for healthcare providers to control costs by:

Using fewer services per client.