Managing Your Departmental BudgetSeptember 24, 2014

Revenue Sources Main Sources

– Medicaid– Medicare– Private Pay– Insurance– MSHO

Medicaid• States set the rate

– Most States, payments do not cover expenses

– ND is cost-based reimbursed– Rate equalization in MN and ND

• Pays for semi-private room– Some allowances for private

room reimbursement

Medicare• Set by Federal Government• Includes therapies, lab, x-ray,

pharmacy• Premium Payer

– Provides a Margin

• Does not pay for private room• Length of Stay (LOS)

– 20-25 days typical

Major Expense Categories

51%

11%

9%

8%

1%4% 6%

4%6%

PercentageSalariesBenefitsPurchased SvcsSuppliesInsuranceUtilitiesDepreciationInterestOther

Labor Expense Management

• Nursing Labor – Flexing hours– Adjusting for Census and Case Mix

Budget #1 #2 #3Budgeted Hours/RD 3.2 3.2 3.2 3.2 Census 50.0 45.0 50.0 52.0 Case Mix 1.1 1.1 1.0 1.2

SRD* Hours 176.0 158.4 160.0 199.7

*SRD - Standardized Resident Days

Labor Expense Management

• Other Departments should flex labor, too!

Non-Salary Expense Management

• Supplies– Food– Nursing Supplies– Linens

• Purchased Services• Other

Income Statement - SNFFor the Month Ended August 31, 2014

Current Current Current Current YTD YTD YTD YTD VarianceActual Budget Variance APD BPD Description Actual Budget Variance APD BPD from BPD

REVENUE$96,513.06 $104,935.00 ($8,421.94) $181.76 $178.16 REVENUE - PRIVATE PAY $191,022.60 $209,870.00 ($18,847.40) $182.97 $178.16 $4.81134,866.95 124,498.16 10,368.79 210.73 182.55 REVENUE - MEDICAID 266,492.36 248,996.32 17,496.04 190.90 182.55 8.35

66,715.03 92,891.50 (26,176.47) 441.82 461.00 REVENUE - MEDICARE A 115,667.97 185,783.00 (70,115.03) 422.15 461.00 (38.85)26,634.68 12,896.00 13,738.68 324.81 416.00 REVENUE - CONTRACTED INSURANCE 52,691.78 25,792.00 26,899.78 424.93 416.00 8.9327,614.77 10,664.00 16,950.77 190.45 172.00 REVENUE - MSHO - MEDICAID 36,613.09 21,328.00 15,285.09 188.73 172.00 16.7322,521.30 43,074.50 (20,553.20) 375.36 397.00 REVENUE - MSHO - MC A 49,374.16 86,149.00 (36,774.84) 385.74 397.00 (11.26)12,210.52 9,039.78 3,170.74 7.59 5.40 REVENUE - MEDICARE B 16,948.73 18,079.56 (1,130.83) 5.36 5.40 (0.04)

2,925.48 628.50 2,296.98 1.82 0.38 REVENUE - MSHO - MC B 3,301.17 1,257.00 2,044.17 1.04 0.38 0.67449.15 0.00 449.15 0.28 0.00 PRIOR YEAR REVENUE ADJUSTMENTS (18,760.53) 0.00 (18,760.53) (5.94) 0.00 (5.94)

----------------- ------------------ ----------------- ------------ ------------ ------------------- ------------------ ------------------- ------------ ------------ --------------390,450.94 398,627.44 (8,176.50) 242.67 238.13 TOTAL REVENUE - CARE 713,351.33 797,254.88 (83,903.55) 225.74 238.13 (12.38)(9,525.61) 4,353.52 (13,879.13) (5.92) 2.60 OTHER OPERATING INCOME 85,760.72 8,707.04 77,053.68 27.14 2.60 24.54

----------------- ------------------ ----------------- ------------ ------------ ------------------- ------------------ ------------------- ------------ ------------ --------------380,925.33 402,980.96 (22,055.63) 236.75 240.73 TOTAL REVENUE 799,112.05 805,961.92 (6,849.87) 252.88 240.73 12.15========= ========== ========= ======= ======= ========== ========== ========== ======= ======= ========

OPERATING EXPENSES130,922.83 141,306.45 10,383.62 81.37 84.41 NURSING 267,131.84 282,612.90 15,481.06 84.54 84.41 (0.12)

14,188.14 13,944.69 (243.45) 8.82 8.33 OTHER CARE 26,374.42 27,889.38 1,514.96 8.35 8.33 (0.02)43,036.87 42,033.38 (1,003.49) 26.75 25.11 ANCILLARIES 78,385.75 84,066.76 5,681.01 24.81 25.11 0.3034,037.26 34,946.44 909.18 21.15 20.88 CULINARY 66,722.22 69,892.88 3,170.66 21.11 20.88 (0.24)

5,052.43 4,218.93 (833.50) 3.14 2.52 LAUNDRY 9,284.06 8,437.86 (846.20) 2.94 2.52 (0.42)7,835.73 7,491.09 (344.64) 4.87 4.47 HOUSEKEEPING 16,028.65 14,982.18 (1,046.47) 5.07 4.47 (0.60)

18,811.32 16,448.81 (2,362.51) 11.69 9.83 PLANT OPERATIONS 151,699.28 34,348.82 (117,350.46) 48.01 10.26 (37.75)35,011.25 36,688.55 1,677.30 21.76 21.92 GENERAL & ADMINISTRATIVE 70,415.51 70,896.10 480.59 22.28 21.18 (1.11)

9,710.17 5,887.35 (3,822.82) 6.03 3.52 PROVISION FOR DOUBTFUL ACCOUNTS 12,867.42 11,774.70 (1,092.72) 4.07 3.52 (0.56)832.50 0.00 (832.50) 0.52 0.00 FUND RAISING 1,665.00 0.00 (1,665.00) 0.53 0.00 (0.53)

44,965.04 47,596.93 2,631.89 27.95 28.43 PAYROLL TAXES AND BENEFITS 92,078.76 95,193.86 3,115.10 29.14 28.43 (0.71)52,644.78 52,636.72 (8.06) 32.72 31.44 PROPERTY RELATED 105,289.56 105,273.44 (16.12) 33.32 31.44 (1.88)

0.00 62.50 62.50 0.00 0.04 INTEREST 0.00 125.00 125.00 0.00 0.04 0.043,675.67 3,291.00 (384.67) 2.28 1.97 DEPRECIATION, AMORTIZATION, ACCRETION 7,351.34 6,582.00 (769.34) 2.33 1.97 (0.36)

262.00 467.12 205.12 0.16 0.28 OTHER 424.00 934.24 510.24 0.13 0.28 0.14----------------- ------------------ ----------------- ------------ ------------ ------------------- ------------------ ------------------- ------------ ------------ --------------400,985.99 407,019.96 6,033.97 249.21 243.14 TOTAL OPERATING EXPENSES 905,717.81 813,010.12 (92,707.69) 286.62 242.83 (43.78)

(20,060.66) (4,039.00) (16,021.66) (12.47) (2.41) NET INCOME(LOSS) FROM OPERATIONS (106,605.76) (7,048.20) (99,557.56) (33.74) (2.11) (31.63)----------------- ------------------ ----------------- ------------ ------------ ------------------- ------------------ ------------------- ------------ ------------ --------------

(20,060.66) (4,039.00) (16,021.66) (12.47) (2.41) NET INCOME(LOSS) (106,605.76) (7,048.20) (99,557.56) (33.74) (2.11) (31.63)========= ========== ========= ======= ======= ========== ========== ========== ======= ======= ========

Cost by DepartmentFor the Month Ended August 31, 2014

Current Current Current Current VarianceActual Budget Variance APD BPD from BPD Description

NURSING120.00 0.00 (120.00) 0.07 0.00 (0.07) ?-20000-620-500 Nursing Consultant975.00 910.00 (65.00) 0.61 0.54 (0.06) ?-20000-620-510 Pharmacy Consultant600.00 600.00 0.00 0.37 0.36 (0.01) ?-20000-620-600 Medical Director

3,515.00 3,515.40 0.40 2.18 2.10 (0.08) ?-20000-630-000 Supplies - Nursing3,891.01 2,845.80 (1,045.21) 2.42 1.70 (0.72) ?-20000-630-050 N.S. Incontinency Supplies

139.51 418.50 278.99 0.09 0.25 0.16 ?-20000-630-100 Non-Prescription Drugs1,479.41 594.52 (884.89) 0.92 0.36 (0.56) ?-20000-630-200 Minor Equipment-Nursing

0.00 339.73 339.73 0.00 0.20 0.20 ?-20000-630-500 Office Supplies-Nursing120.46 142.68 22.22 0.07 0.09 0.01 ?-20000-640-000 Purchased Services-Nursing

0.00 254.79 254.79 0.00 0.15 0.15 ?-20000-670-100 Equipment Repairs-Nursing445.00 445.00 0.00 0.28 0.27 (0.01) ?-20000-690-000 Dues & Subscriptions-Nursing

1.71 84.93 83.22 0.00 0.05 0.05 ?-20000-690-100 Travel-Nursing123.98 152.88 28.90 0.08 0.09 0.01 ?-20000-690-300 Equipment Leases-Nursing422.26 390.68 (31.58) 0.26 0.23 (0.03) ?-20000-690-500 Miscellaneous-Nursing

Cost Management Tools

Cost Control Log

Master Account List Month Days Census Total Patient Days

Benedictine Health CenterNOTE: All yellow items are input here August 31 114 3,534 and populate cells in other tabs

Expense Account Account Number PPD Budget Spent Variance

Nrsg Supplies 1-20000-630-000 4.22 14,913.48 12,980.59 1,933Nrsg Incontinen 1-20000-630-050 1.77 6,255.18 8,064.10 (1,809)Nrsg Non-Presc Drugs 1-20000-630-100 0.55 1,943.70 954.49 989Nrsg Oxygen 1-20000-630-150 0.01 35.34 - 35Nrsg Minor Eqpt 1-20000-630-200 0.64 2,261.76 1,984.95 277

Budget Control Sheet

Budget Control Sheet Month: January

Account # : Number of Days in Current Month31

Account Name: Current Month Projected Average Census 53

(input in highlighted cells) Current Month PPD Expense Budget$3.10

This Month's Budget Amount:$5,093.30

Date Amount Purchased Remaining Balance Vendor/Item(s) Purchase/Comments2/2/2008 5.00 5088.30 tape2/5/2008 26.00 5062.30 supplies

250.00 4812.30 depends7.00 4805.30

250.00 4555.304725.50 (170.20)

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The End

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