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Sunnyside Nursing Home Presentation

 Sunnyside Nursing Home Presentation

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Sunnyside Nursing Home is an independent 200-bed nursing home in a community in southern New Jersey. The average daily census for the nursing home was 140 in 2015, 2016, and the first half of 2017. In late 2016, the nursing home became licensed to provide in-patient hospice services, which has been quite successful. In 2017, the nursing home started marketing their hospice services, with an average census of 10 patients and, in July 2017, finally saw an exponential increase in hospice utilization.

The Assignment is composed of two parts, and both must be submitted. Be sure to submit the PowerPoint presentation as the first part and then upload the Excel spreadsheet as the second part of the Assignment.

To Prepare:

  • Review the Week 4 Sunnyside Nursing Home Staffing Plan provided in this week’s Learning Resources
    • Review each tab to analyze the financial situation in Sunnyside Nursing Home.
    • 2 West Staffing Plan
      • Review the staffing plan and the Table of Terms to get familiar with the mechanics of variable staffing
    • Actual Staffing
      • Complete the missing cells to determine the total variance
      • Review this tab and focus on the census and number of staff required. Think about the impact of using agency staff and overtime on the current staff
    • Table
      • Complete the Table to determine the impact on the budget due to the increase of hospice patients
    • Hospice
      • Review this tab to determine the impact of adding the new hospice patients to 2 West
  • Use formulas or copy and paste as shown in the media to ensure accuracy as you complete the sheets (if needed )
  • Based on the information and calculations derived in your spreadsheet, reflect on your findings as you prepare to develop a PowerPoint presentation

 

 

 

 

 

The Assignment (9-slide PowerPoint Presentation):

The Assignment Template provided can help guide you in creating this presentation. Please address the following in your presentation:

  • Briefly describe Sunnyside Nursing Home from the information calculated in your completed spreadsheets.
  • Differentiate between capacity, utilization, performance, and financial indicators utilized at Sunnyside Nursing Home.
  • Summarize key variances (positive or negative) you uncovered during your analysis (data only) of Nursing Unit 2 West. Focus on the most significant variance items.
  • What do you believe led to the variances you identified?
  • Because certain line items in a budget are more controllable than others, what actions might you recommend to the Sunnyside Nursing Home administrator to help the healthcare manager manage the sudden and sustained increase in patient census in hospice patients?
  • Is the increase in that patient population a financially sound investment for Sunnyside? Why or why not? (Review the Hospice tab on the spreadsheet for ideas.)
  • What top three recommendations would you make as you conclude your presentation and why?
  • Make sure to follow APA guidelines and support your presentation with references.

Sunnyside Nursing Home Presentation

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Title Slide Name Course Id Date  Briefly describe Sunnyside Nursing Home from the information calculated in your completed spreadsheets. Sunnyside Nursing Home Description  Differentiate between: ◦ ◦ ◦ ◦ Capacity Utilization Performance Financial indicators Sunnyside Nursing Home Specifics  Summarize key variances (positive or negative) you uncovered during your analysis (data only) of Nursing Unit 2 West. Sunnyside Nursing Home Variances Focus on the most significant variance items.  What do you believe led to the variances you identified?  Sunnyside Nursing Home Variances Because certain line items in a budget are more controllable than others, what actions might you recommend to the Sunnyside Nursing Home administrator to help the healthcare manager manage the sudden and sustained increase in patient census in hospice patients? Sunnyside Nursing Home Staff Variances cont. Is the increase in that patient population a financially sound investment for Sunnyside? Why or why not? Sunnyside Nursing Home Staff Variances cont. What top three recommendations would you make as you conclude your presentation and why? Sunnyside Nursing Home Staff Variances cont. Sunnyside Nursing Home Presentation
 Be sure to support your work with specific citations from the Learning Resources and additional scholarly sources. ◦ Note: You may want to add an additional slide for references. References Variable Nursing Staffing Plan for the LTC & Hospice Unit 2 West Census 45-50 37-44 29-36 21-28 < 21 RN 2 2 1 1 1 Nursing FTE Hire Plan RN 4.2 LPN 4.2 C.N.A. 12.6 Days LPN 3 2 2 1 0 C.N.A. 6 5 4 3 2 RN 1 1 1 1 1 Evenings LPN 3 2 1 1 1 C.N.A. 6 5 4 3 3 RN 1 1 1 1 1 The ADC of 2 West is currently 24. The hiring plan is based on that census. ADC 21-28 ADC 29-36 ADC 37-44 ADC 45-50 RN 4.2 RN 4.2 RN 5.6 RN 5.6 LPN 4.2 LPN 4.2 LPN 8.4 LPN 11.2 C.N.A. 12.6 C.N.A. 16.8 C.N.A. 19.6 C.N.A. 31.7 Note: As the census goes up, the staffing requirement increases, especially the C.N.A. role. Census 38-50 21-37 Nights LPN 2 2 1 1 1 Variable Rehab Staffing LTC & Hospice Unit 2 West Days Eves Rehab FTE Hire Plan PT PTA PT PTA PT 1.4 1 2 0 2 PTA 1.4 1 1 0 1 C.N.A. 5 4 4 3 2 RN LPN C.N.A. PT PTA ADC FTE LTC Hospice Note: The budgeted annual ADC of
 Sunnyside Nursing Home Presentation The hiring plan for the staff is Variable staffing FTE require Category X number needed X For example: The ADC of 2 West is 24; the Each category is multiplied by This FTE count is the number RN LPN C.N.A. PT PTA Overview of Terms Registered Professional Nurse (Sets the Nursing Care Plan & monitors quality of care) Licensed Practical Nurse (works under the direction of the RN; provides treatments & meds.) Certified Nursing Assistant (works under the direction of the RN & LPN; provides most of the physical care) Physical Therapist (Sets the Rehab plan for the patient) Physical Therapy Aide (Works under the direction of the PT; follows the rehab care plan) Average Daily Census is the number of patients on the unit; the staff is deployed based on this census Full-time Equivalent or 2,080 hours annually. This is the basis for the hiring plan to ensure enough staff. Long-Term Care is care provided in a nursing home to a resident who lives there full time Hospice is end-of-life care that is provided to a patient close to death from CHF, cancer, renal disease, etc. Note: The budgeted annual ADC of Unit 2 West is 24. The hiring plan for the staff is based on the FTE numbers in the grids for ADC 21-28. Variable staffing FTE requirements are calculated as follows: Category X number needed X 8 hours x 7 days per week divided by 40 hours (1 FTE) For example: The ADC of 2 West is 24; the active staffing budget is based on that census. Sunnyside Nursing Home Presentation
Each category is multiplied by the total number of each job category needed for 24 hours. This FTE count is the number of peple needed to provide care and does not include paid time off or fixed staffing members. 3 RNs X 8 hr shift X 7 days/week divided by 40 = 4.2 FTE 3 LPNs X 8 Hr shift X 7 days per week divided by 40 = 4.2 FTE 9 C.N.As X 8 hr. shift X 7 days/week divided by 40 = 12.6 FTE 1 PT X 8 hr shift X 7 days/week divided by 40 = 1.4 FTE 1 PT X 8 hr shift X 7 days/week divided by 40 = 1.4 FTE Sunnyside Nursing Home Actual FTE versus Budget Sept 3-9 2017 LTC & Hospice 2 West (50 beds) Actual Staffing Actual ADC Date Census 3-Sep 32 4-Sep 36 5-Sep 42 6-Sep 44 7-Sep 46 8-Sep 46 9-Sep 34 Days RN LPN C.N.A. PT PTA 1 2 4 1 1 1 2 4 1 1 2 2 5 1 2 2 2 5 1 2 6 1 2 6 1 2 4 1 1 RN LPN C.N.A. PT PTA 1 1 4 0 1 1 1 4 0 1 Evenings 1 2 5 0 2 1 2 5 0 2 1 3 6 0 2 1 3 6 0 2 1 1 4 0 1 RN LPN C.N.A. PT PTA 1 1 4 0 0 1 1 4 0 0 1 2 4 0 0 1 2 4 0 0 1 2 5 0 0 1 2 5 0 0 1 1 4 0 0 LPN 3 2 2 1 0 Days C.N.A. 6 5 4 3 2 Nights Census 45-50 37-44 29-36 21-28 < 21 RN 2 2 1 1 1 Budget ADC 40 24 Actual Shifts Budgeted Used Shifts 6 7 8 8 34 21 7 7 11 7 Actual Shifts Budgeted Used Shifts 7 7 13 7 34 21 0 0 11 7 Actual Shifts Budgeted Used Shifts 7 7 11 7 30 21 0 0 0 0 Variable Nursing Staffing Plan for the LTC & Hospice Unit 2 West Evenings PT PTA RN LPN C.N.A. PT 1 2 1 3 6 0 1 2 1 2 5 0 1 1 1 1 4 0 1 1 1 1 3 0 1 1 3 Sunnyside Nursing Home Presentation
– Actual ADC Varience 16 Varience Shifts -1 0 13 0 4 Varience Shifts 0 6 13 0 4 Varience Shifts 0 4 9 0 0 PTA 2 2 1 1 – Shifts Staffing Variance Summary Budget Actual Actual Overtime Overtime Agency Shifts Shifts Shifts 3 35 30 Category RN LPN C.N.A. PT PTA 0 1 1 0 0 Days 2 2 5 0 4 2 6 8 0 0 Evenings RN LPN C.N.A. PT PTA 0 0 1 0 0 0 4 5 0 4 0 2 8 0 0 Nights RN LPN C.N.A. PT PTA RN 1 1 1 1 1 Nights LPN 2 2 1 1 1 0 0 0 0 0 C.N.A. 5 4 4 3 2 0 4 5 0 0 0 0 4 0 0 Impact on the OT and Agency Use on the Budget Job Category RN LPN C.N.A. PTA OT Shift Rate $351.84 $232.80 $128.64 $198.00 B C Table to Complete 12 13 14 15 Agency Shift Rate $440.00 $280.00 $176.00 N/A D E F OT Actual Spend Job Category OT Shifts Budgeted OT Spend Budgeted OT Actual Shifts RN LPN C.N.A. PTA 0 1 2 0 $0.00 $232.80 $257.28 $0.00 2 10 15 8 $ 703.68 G H I Agency Agency Combined OT & Actual Shifts Actual Spend Agency Shifts 2 8 20 0 $ 880.00 4 Sunnyside had to ask current staff to work OT and also had to hire agency/contract staff to meet the gap in staffing. Review the staffing variance that has occurred. 1) What is the financial impact of the 35 shifts that were used? 2) Agency/contract staff cost more than OT, but Sunnyside had to fill in the gap. Consider the financial and social impact of hiring agency. 3) How many additional FTE’s of each category should be added to the staff? 4) What recommendations will you make to the nurse manager to manage this growth in census untiil new staff are hired? J K Combined OT & Agency Spend Additioinal FTE used $ 1,583.68 0.8 he gap in staffing. ncial and social impact of hiring agency. ntiil new staff are hired? Nursing FTE Hire Plan RN 4.2 LPN 4.2 C.N.A. 12.6 PTA 0 Impact of Hospice Census Growth on 2 West Budget ADC 24 # Staff Each Day RN 3.0 LPN 3.0 C.N.A. 9.0 Actual ADC 40 # Staff Each Day RN 4.0 LPN 6.0 C.N.A. 14.0 Daily Salary Spend Budget* RN $703.68 LPN $465.60 C.N.A. $771.84 Total Spend $1,941.12 Job Category RN LPN C.N.A Daily Salary Spend Actual* RN $938.24 LPN $931.20 C.N.A. $1,200.64 Total Spend $3,070.08 Proportion Analysis of Census Payer Bud Medicaid 18% Self Pay 32% Hospice 50% Resident Type Income versus Bedside Care Spend Budgeted Overview Daily revenue Resident Type per Resident $285.00 Medicaid $600.00 Self Pay $495.00 Hospice Total Budgeted Census 5 9 10 24 Total Daily Revenue $1,425.00 $5,400.00 $4,950.00 $11,775.00 Actual Daily Staff Spending Hourly Rate $29.32 $19.40 $10.72 Actual Census 5 9 26 40 Total Daily Revenue $1,425.00 $5,400.00 $12,870.00 $19,695.00 Actual Daily Staff  Spending Sunnyside has to make changes to the staffing plan to care for the new Hospice volume. Sunnyside Nursing Home Presentation
Review the table above to answer the following questions for your PPT. 1) What is the financial impact of the additional Hospice patients? 2) Should Sunnyside continue with this patient service line? 3) What is the impact of the proprtion of Hospice patients in the new model, compated to the Medicaid and private-pay patients? 4) This table only considers the actual staff caring for the patients. What other costs does Sunnyside have in order to run their business? *The staffing does not include the FTE needed to cover paid time off or fixed staffing members. Analysis of Census Actual 13% 23% 65% … Sunnyside Nursing Home Presentation