Ambulatory Surgical Unit

Baptist Hospital is a 175-bed community hospital serving a rural area of Jacksonville. It is located 30 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:

Medical/Surgical 130

Pediatrics 20

ICCU 10

OB 15

Total 175

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 a Internist. These recruitment efforts filled two major needs of the institution. It is estimated that in today’s current marketplace surgeons are expected to increase inpatient admissions to a acute care community hospital by 1.5% 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:

Medicare 51%

Blue Cross 16%

Medical Asst 08%

HMO 10%

Commercial INS 07%

Other 05%

Self Pay 03%

Total 100%

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 a slight 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:

Establish a separate distinct 15-bed inpatient psychiatric unit.
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.
Recruit a general surgeon and a Internist.
Purchase an additional CT scanner which is expected to increase current radiology volumes by 3.25%.

THREE DEPARTMENTS ARE INVOLVED IN OUR BUDGET EXERCISE. THEY ARE NURSING, LABORATORY, PHARMACY AND OUTPATIENT/AMBULATORY SERVICES.

STATISTICAL DATA

2012 2013 2014 2015

Admissions In Pt (Nursing) 7,395 7,400 7,370

Laboratory Test 399,330 411,810 421,564

Pharmacy Rx 99,832 100,011 99,642

Radiology Exams 68,222 69,124 68,950

Laboratory spent $79,866 on supplies in 2012. They spent $86,480 in 2013 and $96,959 in 2014. 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 inflation. 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.

LABORATORY EXPENSES

2012 2013 2014

Supplies $79,866 $86,480 $96,959

RADIOLOGY EXPENSES

Supplies $395,205 $405,222 $410,100

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

15 pt

LPN 25 ft

10 pt

Nurses Aides 10 ft

Orderlies 6 ft

Unit Desk Clerks 6 ft

4 pt

Secretary 1 ft

LABORATORY

Department Head 1 ft

Med Technologist 12 ft

2 pt

Lab Tech 4 ft

Lab Assistant 2 ft

Secretary 1 ft

PARIENT REVENUE

Gross Revenue Projected for the 2014-2015 budget year is as follows:

In Patient $30,675,000

Out Patient $36,878,000

Total $67,553,000

Current Reimbursement Formulas:

In PatientOut Patient

Medicare $5760/case 38% of Charge

HMO $1215.00/pat day 31% of Charge

Other Insurance $7655.00/discharge 42.5% of Charge

Expected length of stay (LOS) in 2015 is 3.4

INSTRUCTIONS:

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 expense item for laboratory & radiology for 2015.
Project the expected net revenue for all Medicare, HMO, and all Other Insurance patients.