Assignment questions: Post answers in Forums Module VI. See calendar for due date. 1. Discuss steps in developing the unit or department budget. Who all is involved? 2. How is the cost of nursing care incorporated into a budget? 3. How does a nursing unit determine how many nurses are needed for a 12 month period? 4. Differentiate among various types of budgets: fixed, variable, capital budgets. 5. Describe how to calculate hours necessary to equate to one FTE.

6.1 Module VI Overview

Budget, Finance, Staffing,

Scheduling, FTEs

Learning Objectives

Module VI concentrates on the following course outcomes—

· Identify the human, fiscal and material resources necessary to efficiently achieve quality health care outcomes.

· Definitions of financial terms often used in healthcare will be identified. Different types of budgets and budget preparation will be reviewed. The role of the nurse manager in the budget process will be discussed in detail, as well as ethical issues associated with budgets in healthcare.

Reading Assignment

Sullivan: Chapters 14, 15, 16

American Nurses Association Policy Statement on Workplace Advocacy: (Links to an external site.)


Budget and Finance

Financial issues in healthcare often seem remote to the nurse and the nurse must have an understanding of financial matters of the health care delivery system, including the viability of the workplace, and the opportunities to optimize healthcare for the welfare of their patient. Key behaviors needed by nurse managers and those who care for groups of patients is ability to: understand the budgeting process; recognize general types of budgets; distinguish between direct and indirect costs; be familiar with the steps of a typical budgetary process and cost out nursing services. Different types of budgets include: operating budget, performance budget, capital budget, expense budget, zero-based budget, product line budget, cash budget. Operational plans, cost center, expense, revenue and profit are other key concept that will be addressed in the readings.

A budget is a formal plan for managing financial resources. The budget document indicates the expected income and expected expenses of an organization, department, or individual. It provides a method of tracking cost and, therefore, a way to examine where saving s could be made. The total organizational budget is usually separated into two distinct sections: the operating budget and the capital budget.

Budget planning procedures vary from organization to organization. However, some parts of the process are common to all organizations. These include steps to gather information before budget preparation such as making an environmental assessment, stating mission and goals, making assumptions about the future setting operational objectives, obtaining the budget guidelines, preparing budget manuals and budget projections packages (last year’s budgets, sets of forms all used in estimating future expenses).

Environmental assessment for budget purposes includes the environments that are both internal and external to the organization. As part of the internal assessment, the budget planners will identify the strengths and weaknesses of the organization. The external environment takes into account the changing needs of the population, shifts in third-party payment patterns, reimbursement, service contracts and loss or gain of physicians/programs and mergers.

With the economic climate of health care in turmoil, greater attention is being given to reduce cost while maintaining or improving the quality of care. The nursing budget can account for as much as half an organization’s total expenses nurse managers at all levels are facing significant pressure to become proficient in the budgeting process, to allocate resources, and control and monitor expenses.