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NURS FPX 6216 Assessment 4 Preparing and Managing a Capital Budget Name Capella university NURS-FPX 6216 Advanced Finance and Operations Management Prof. Name Date Preparing and Managing a Capital Budget In today’s healthcare environment, investing in capital acquisitions is crucial for maintaining and enhancing technology and facilities. This paper focuses on creating a capital budget for a major facility renovation aimed at improving the nurses’ lounge in a 50-bed step-down unit. The goal is to enhance staff satisfaction, morale, and productivity. The capital budget will outline the costs, justification, and impact on the organization’s financial health, showcasing the importance of strategic capital investments in healthcare. Description of Capital Acquisition A systematic approach will be followed to design the capital budget for the nurses’ lounge renovation, including needs assessment, feasibility analysis, cost estimation, implementation planning, and management. Studies indicate that an improved work environment significantly enhances staff morale and productivity by reducing stress, increasing job satisfaction, and fostering a sense of well-being among employees (Donley, 2021). Resources such as financial reports, market analysis, and stakeholder feedback (e.g., exit interviews and patient surveys) were accessed. Collaboration with other executives, staff members, finance departments, and external consultants ensured a comprehensive planning process. The renovation aims to modernize the lounge with comfortable seating, updated amenities (e.g., kitchen facilities), new lockers, and high-speed internet access. Aesthetically, the lounge will feature soothing colors, ample natural light, and ergonomic furniture to reduce stress (McCorquodale, 2022). The ergonomic furniture is designed to provide comfort and support, enhancing health and productivity (Mileski et al., 2024). The renovation will also expand the lounge’s capacity to accommodate 10-12 nurses simultaneously. Phased scheduling ensures minimal disruption to the unit’s operations (Pomare et al., 2022). Justification of the Need for the Capital Acquisition The nurses’ lounge renovation will benefit the nursing staff by providing a modern, comfortable, and well-equipped space for relaxation and healing. A positive work environment reduces stress and burnout, leading to enhanced job satisfaction and higher staff morale (Monroe et al., 2021). Not renovating the lounge could result in continued low staff morale and increased burnout, which negatively affects nurse retention and productivity. Financially, the costs of recruitment, training, and treating adverse events due to errors could be high. Improved staff well-being contributes to better patient care by increasing nurse productivity and reducing errors, as nurses can take essential breaks and fulfill their nutritional needs (Dias & Dawson, 2020). The renovation aligns with the unit’s mission to provide excellent patient care and retain staff. A lack of investment in the work environment could lead to higher error rates, decreased patient care quality, and compromised patient satisfaction. The response from executive leaders is expected to be positive, recognizing the long-term benefits for staff wellness and patient care. Preparation of the Capital Budget The capital budget for the renovation aims to enhance the work environment and support staff well-being in the step-down unit. By investing in a comfortable and functional space, the renovation seeks to improve nurse satisfaction and, consequently, patient care (Michelon et al., 2021). Renovating the nurses’ lounge will cost $75,800, which includes expenses for furniture ($20,000), kitchen amenities ($8,000), décor ($5,000), lighting ($3,000), flooring ($6,000), lockers ($4,000), miscellaneous items ($2,000), labor ($12,000), and a contingency reserve ($5,800) for unexpected expenses. According to surveys, 71% of staff who spend time in refreshing and relaxing rooms report feeling renewed (Mileski et al., 2024). Table: Capital Budget for Nurses’ Lounge Renovation Expense Category Description Estimated Cost Furniture Ergonomic chairs, adjustable desks, comfortable sofas, tables, and storage units $20,000 Amenities Kitchen appliances, coffee machine, microwave, refrigerator, and dining area essentials $8,000 Paint and Décor Soothing paints, wall art, and decorations $5,000 Lockers Personal lockers for nurses with secure storage $4,000 Lighting Energy-efficient, adjustable lighting fixtures $3,000 Flooring Durable, easy-to-clean flooring $6,000 Miscellaneous Curtains, rugs, and other minor items $2,000 Labor Costs for contractors, construction workers, and installation services $12,000 Contingency Reserved for unexpected expenses (10% of total) $5,800 Total Estimated Cost $75,800 Areas of Uncertainty and Knowledge Gaps The preparation of the budget involves several uncertainties and knowledge gaps that could impact the estimated costs. Material and labor prices may vary, so current quotes and potential price increases must be accounted for (Gold et al., 2022). The quality and timeliness of work from contractors and suppliers also need verification through references and performance reviews. The impact of the renovation on staff productivity and morale should be monitored to assess its effectiveness. A contingency fund (10% of the total budget) has been included to cover unforeseen expenses, ensuring the project stays within budget (Ammar et al., 2023). Description of the Process for Calculating Costs Various approaches were used to calculate the costs for the capital budget, including discussions with the finance department head. Market research helped estimate the costs of materials. Vendor quotes and previous renovation project data were key in determining expenses. Consulting with facilities management teams, construction contractors, and procurement specialists ensured accurate cost estimation (Chen et al., 2021). The bottom-up costing method was employed, where individual components of the renovation (e.g., furniture, amenities, labor) were estimated separately, then aggregated to determine the total budget (Špacírová et al., 2020). Contingencies for unexpected costs were added, and estimates were verified against historical data to address discrepancies that could arise from vendor pricing or project complexities (Ammar et al., 2023). Presentation of Plan for Budget Management A budget management plan is critical to ensure expenditures are controlled and aligned with financial allocations, preventing cost overruns. The plan includes collaboration with financial analysts, administrative staff, and a budget committee to manage the budget effectively. Regular budget reviews and audits will track expenses and ensure they remain within planned limits. A detailed cost-tracking system will be implemented to monitor expenditures in real-time. Fixed-price contracts with vendors will prevent unexpected cost increases (Musiega et al., 2023). A contingency fund will be established to address unforeseen expenses and maintain financial flexibility. Regular monitoring of budget performance will ensure alignment with the financial plan (Kaplan & Gallani, 2022).

NURS FPX 6216 Assessment 3 Budget Negotiations and Communication Name Capella university NURS-FPX 6216 Advanced Finance and Operations Management Prof. Name Date Budget Negotiations and Communication This paper outlines an executive summary justifying the operating budget developed for St. Anthony Medical Center (SAMC), focusing on a 35-bed unit. The primary goal is to secure funding in an environment with limited resources by presenting a strategic plan, addressing staff productivity goals, and justifying the associated costs. The budget aligns with SAMC’s mission, ensuring fiscal responsibility while maintaining high standards of patient care. This summary demonstrates the effectiveness of the proposed budget in securing funding for operational needs and highlights how it supports SAMC’s overall goals. Strategic Plan for Profitability and Success SAMC’s strategic plan for its 35-bed unit focuses on ensuring profitability and fiscal success by carefully balancing operational costs with revenue-generating strategies. The projected net revenue for the unit is $1,350,000, with total expenses of $202,000. SAMC faces challenges such as high staff turnover, which leads to increased workload and inefficient shift management. The unit primarily caters to elderly patients, requiring careful and critical care that necessitates sufficient staffing levels to avoid burnout and uphold high care standards. A key element of the plan is optimizing staff productivity through targeted training and resource allocation, directly improving patient care and operational efficiency (Bhati, 2023). Additionally, utilizing advanced data analytics to monitor financial performance and patient outcomes allows for real-time adjustments to the budget, ensuring continuous alignment with SAMC’s mission and goals. However, to enhance the plan, certain knowledge gaps need to be addressed. For instance, obtaining detailed patient demographic data would improve demand forecasting, which is critical for staffing and supply chain management (Geiger et al., 2023). Also, comparing SAMC’s financial performance with similar healthcare facilities through benchmarking data will help refine assumptions and identify cost-saving opportunities. Additionally, establishing clear metrics to evaluate the impact of staff productivity initiatives on financial performance and patient satisfaction is crucial, as these areas are currently underdeveloped (De Rosis et al., 2022). By addressing these gaps through ongoing data collection and feedback, SAMC can refine its strategic plan, ensuring fiscal responsibility and quality care delivery. Plan for Staff Productivity Goals SAMC’s workforce management plan aims to meet staff productivity goals while maintaining budgetary constraints. This plan focuses on reducing staff turnover, optimizing scheduling, and enhancing staff development, thereby ensuring efficient resource utilization without compromising care quality (Koruca et al., 2023). SAMC recognizes the challenges posed by high turnover and the over-reliance on overtime, which strains both the budget and staff productivity. To address this, SAMC will implement workforce management software to automate scheduling and forecast potential overtime costs. This tool will improve shift allocation, ensuring that staffing levels are optimized in line with patient needs while minimizing unnecessary overtime (Koruca et al., 2023). Research indicates that work-life balance is vital for healthcare staff, including physicians, nurses, and technicians, as it promotes consistent and careful care delivery (Sánchez et al., 2020). By automating scheduling, SAMC will reduce manual errors and enhance shift distribution, improving work-life balance and reducing burnout and turnover. SAMC will also align its staff development efforts with the hospital’s needs by offering educational and certification opportunities to enhance competencies. These initiatives, focusing on critical care, nursing specialties, and surgical operations, aim to improve patient outcomes and support SAMC’s mission to provide high-quality healthcare services (Xuecheng et al., 2022). Additionally, SAMC plans to invest in digital solutions, such as electronic health records (EHR) and telehealth, to streamline operations and improve patient care in the long term. Although these technologies involve initial costs, they are expected to reduce administrative burdens, enhance data accuracy, and improve patient outcomes through better access to information and remote care options (Paul et al., 2023). Rationale for Rejecting Alternative Approaches One alternative approach that was considered and rejected is increasing staffing levels to meet productivity goals. However, within the current budget constraints, this option would significantly increase salary and benefit expenses, without necessarily leading to a proportional improvement in productivity. The focus, instead, is on optimizing current staff through better management and development rather than merely increasing the number of personnel (Gal et al., 2022). Another alternative, outsourcing clinical services, was also rejected due to concerns over quality. While outsourcing can offer short-term savings, it undermines the continuity and consistency of care, which can damage patient trust. Patients generally prefer continuity of care provided by familiar staff, rather than outsourced personnel, making this approach less feasible for SAMC (Berry et al., 2021). Equipment and Service Cost Justification Justifying equipment and service costs within SAMC’s budget involves essential expenditures to maintain operational efficiency and provide high-quality patient care. The budget allocates $30,000 for medical supplies and $8,000 for facility rent. These expenditures are critical for maintaining the hospital’s ability to serve patients effectively. Research shows that inefficient systems can cost up to 10% of patient-generated revenue, so investing in modern equipment and services is expected to improve both operational efficiency and patient outcomes (Bravo et al., 2021). SAMC also allocates $13,000 for outsourced services, including cleaning and IT services, which are necessary for maintaining a reliable and clean operational environment. These services contribute to the overall capacity to meet patient needs efficiently (Bravo et al., 2021). While these costs may seem substantial, they are integral to SAMC’s mission of providing high-quality healthcare services. For example, modern IT services improve data management, reduce administrative burdens, and facilitate better access to patient information, all of which improve care coordination and reduce errors (Cabán et al., 2022). The assumptions underlying these budgeted costs include stable patient volumes and market conditions, which are necessary for accurate forecasting. Investing in modern equipment and services is anticipated to lead to improved operational efficiency, enhanced staff productivity, and better patient outcomes. The Linkage Between the Organization’s Mission and the Project SAMC’s mission is to provide high-quality, patient-focused care. The organization’s financial goal is to maintain fiscal responsibility, while its strategic goal is to provide optimal, patient-centered care

NURS FPX 6216 Assessment 2 Preparing and Managing an Operating Budget Name Capella university NURS-FPX 6216 Advanced Finance and Operations Management Prof. Name Date Preparing and Managing an Operating Budget The operating budget for St. Anthony Medical Center outlines projected revenue and expenses for the upcoming year. The hospital anticipates generating $37 million in total revenue from inpatient and outpatient services. However, after accounting for insurance adjustments, charity care, and unpaid bills, the net revenue is estimated to be $31.3 million. The hospital expects total expenses of $34 million, resulting in a budget deficit of $2.7 million. The primary costs contributing to the deficit include staff salaries, medical supplies, and equipment rentals. The hospital’s budget prioritizes essential needs while ensuring high-quality care for patients. The goal is to assess how the hospital plans its finances, control costs, and improve patient care. By evaluating key areas of spending, the hospital aims to balance its resources and deliver optimal care while staying within budget constraints. Operating Budget Components The operating budget consists of several key components: revenue, expenses, and adjustments such as insurance and charity care. Revenue refers to the hospital’s expected earnings from inpatient services, outpatient care, and other health-related services. Expenses encompass salaries, medical supplies, equipment rentals, utilities, and other operational costs. Data used to develop the budget comes from historical patient records, previous budgets, and input from hospital staff. Factors such as hospital goals, policies, and competition for funding influence the budget’s formation. The operating budget for a 35-bed unit includes projections for both incoming revenue and outgoing expenses. It is structured to allocate resources efficiently to meet patient care needs while managing costs effectively (Wang & Anderson, 2021). Table 1: Revenues Category Amount in Dollars Details Inpatient Revenue $22,000,000 Health Care: $12,000,000; Surgical Procedures: $8,000,000; Diagnosis: $2,000,000 Outpatient Revenue $15,000,000 Consultations: $6,000,000; Diagnostics: $4,000,000; Ambulatory Services: $5,000,000 Total Patient Services Revenue $37,000,000 Sum of Inpatient Revenue + Outpatient Revenue Contractual Adjustments -$4,500,000 Insurance Modifications: -$3,500,000; Other Adjustments: -$1,000,000 Charity and Uncompensated Care -$1,200,000 Charitable Care: -$800,000; Unpaid Services: -$400,000 Net Patient Services Revenue $31,300,000 Total Revenue after Adjustments and Charity Care Table 2: Expenses Category Amount in Dollars Details Salaries and Wages $18,500,000 General Care Staff: $8,000,000; Surgery Staff: $6,000,000; Diagnostics Staff: $2,500,000; Managerial Costs: $2,000,000 Supplies $7,200,000 Surgical Instruments: $3,500,000; Diagnostic Equipment: $2,000,000; General Care Supplies: $1,700,000 Rentals and Leases $3,500,000 Equipment Leases: $2,000,000; Structure Rentals: $1,500,000 Purchased Services – Utilities $1,600,000 Electricity: $900,000; Water: $400,000; Other Utilities: $300,000 Depreciation Expense $3,200,000 Equipment Depreciation: $1,800,000; Building Depreciation: $1,400,000 Total Budget Expenses $34,000,000 Sum of all expenses listed above Excess over Revenue -$2,700,000 Net Revenue minus Total Expenses Budget Briefing The St. Anthony Medical Center operating budget is designed to manage its finances effectively for the upcoming year. With a projected revenue of $37,000,000 from inpatient and outpatient services, and after accounting for adjustments, the net revenue is expected to be $31,300,000. The budget also outlines total expenses of $34,000,000, resulting in a $2,700,000 deficit. The primary expenses are staff salaries, medical supplies, and equipment rentals. The budget emphasizes cost control, especially in areas with high expenses, such as overtime and staffing, to maintain high-quality patient care. The 35-bed unit must carefully manage its limited resources to meet patient needs, considering the large costs associated with staffing and medical supplies (Wang & Anderson, 2021). Uncertainties and Data Gaps Some uncertainties in the budget may affect its accuracy. Patient volume projections are not entirely clear, which complicates revenue estimations. Additionally, more detailed information about payment sources such as private insurance, Medicaid, and Medicare is required to improve revenue forecasting. Data on charity care and unpaid bills could help further refine revenue adjustments. The hospital also faces challenges related to staff overtime and turnover rates, which affect salary expenses. Precise data on supplies used per patient type and potential changes in energy costs due to market rates or regulatory changes could also introduce variability into the budget’s planning. Designing and Creating the Budget The budget for the unit was carefully designed to meet operational goals while managing costs. Revenue and expense projections were based on expected patient volume, supply needs, and staff requirements. Due to limited data on future trends, assumptions about patient admissions, supply needs, and staffing were made. The budget balances patient care demands with available resources, ensuring that necessary expenses are covered without compromising quality. Staffing shortages and overtime were carefully analyzed to reflect the current workforce situation. Equipment, maintenance, and utilities costs were also included to ensure smooth operations throughout the year. Staffing and Workload Considerations Staffing needs were calculated based on the unit’s patient load and current staff shortages, which contribute significantly to overtime costs. The budget includes salaries for 20 full-time staff and temporary workers to fill vacant positions. Overtime, a major expense, is carefully estimated using past trends. Workloads were assessed to determine if additional hiring is necessary. The aging population in the unit adds complexity to care, increasing the demand for staff. Balancing patient safety with manageable workloads is a priority, and the budget includes training costs to help retain staff and reduce turnover. Factors Affecting the Budget Several external factors influence the budget, including staff shortages, overtime costs, and the healthcare needs of an aging population. Equipment rentals and maintenance costs were included to ensure operational efficiency. Rising utility rates and supply costs also play a role in shaping budget allocations. Changes in healthcare policies or insurance reimbursements could further impact revenue and expenses. The need for staff training and turnover management is another significant consideration in the budget (Waitzberg et al., 2021). These variables make the budget dynamic, requiring regular updates and flexibility to adapt to new challenges. Data Reliability and Missing Items While data on salaries, supplies, and utilities is reliable, estimates for patient volume and overtime costs remain uncertain. Charity care and unpaid bills data from previous years is helpful but may not reflect future needs accurately. Projections for overtime and temporary staffing are based on current

NURS FPX 6216 Assessment 1 Instructions: Mentor Interview Name Capella university NURS-FPX 6216 Advanced Finance and Operations Management Prof. Name Date Mentor Interview Financial governance by nurse leaders plays a vital role in optimizing resource allocation and maintaining the economic stability of healthcare institutions. As highlighted by Dong et al. (2021), the expertise of nursing leaders in financial management significantly contributes to the overall success of healthcare organizations. This study focuses on the importance of financial management knowledge among nurse leaders and its influence on the operational success of medical facilities. A comprehensive interview with Kimberly, an experienced nursing leader at Maplewood Community Hospital (MCH), provides valuable insights into budget formulation, financial strategies, and challenges faced in the healthcare sector. Comparison of Operating and Capital Budget Management Managing operational and capital budgets involves distinct approaches, each addressing different financial needs within a healthcare facility. The operational budget focuses on covering ongoing, recurring expenses essential for day-to-day operations, including employee salaries, utilities, medical supplies, and routine maintenance (Gaffney et al., 2023). In contrast, the capital budget involves long-term financial planning for major investments, such as purchasing new medical equipment, renovating facilities, and expanding services, with a focus on supporting future growth (Gaffney et al., 2023). For leaders like Kimberly at MCH, managing an operational budget involves balancing expenditures and income to ensure smooth operations while staying within financial constraints. This includes overseeing staff overtime, optimizing revenue through efficient billing practices, and adjusting patient volumes (Cerullo et al., 2022). Kimberly’s approach emphasizes strict cost control and regular financial reviews, which are crucial for maintaining the hospital’s economic stability. By setting budgetary limits on non-essential spending and conducting periodic audits, she ensures responsible financial management (Cerullo et al., 2022). Financial management techniques, such as Cost-Benefit Analysis (CBA) and variance analysis, are essential for both operating and capital budgets. Kimberly uses variance analysis to track discrepancies between forecasted and actual spending, making necessary adjustments to ensure financial stability. Managing an operational budget is particularly challenging due to the unpredictability of expenses and the need to maintain productivity within financial constraints. Kimberly combats this by setting up emergency reserve funds and utilizing data analytics to optimize operational efficiency and minimize waste (Nguyen et al., 2024). NURS FPX 6216 Assessment 1 Instructions: Mentor Interview Managing a capital budget requires a strategic, long-term approach, focusing on high-cost investments like medical technologies. Kimberly plans for purchases based on projected Return on Investment (ROI) and uses CBA to assess the financial impact of these investments, such as the introduction of advanced diagnostic imaging systems (DiCesare et al., 2021). A major challenge in capital budgeting is forecasting long-term financial needs and justifying investments to stakeholders. Nurse leaders must balance short-term operational requirements with long-term growth and sustainability, ensuring that both budget types are managed effectively to secure the financial health of the organization (DiCesare et al., 2021). The variability in patient volumes and associated costs presents uncertainty in managing the operational budget. In contrast, capital budgets require accurate forecasting of long-term economic needs and expected ROI, which involves significant risk. Additionally, shifts in healthcare regulations and technological advancements—such as changing reimbursement rates and the introduction of new technologies—complicate both budget types and require ongoing adaptability (Thusini et al., 2022). Resource Allocation for Equipment, Labor, and Services Effective resource allocation for labor, equipment, and services is essential to optimizing the operational success of a healthcare facility. Kimberly emphasizes the use of specialized software and data analytics to forecast staffing needs based on patient volume predictions and historical data. By implementing flexible staffing models and utilizing productivity metrics, she ensures optimal labor distribution during peak hours (Thusini et al., 2022). For equipment allocation, Kimberly uses rigorous inventory management practices, including regular audits and analysis of usage data, to maintain an adequate supply of necessary medical equipment. By collaborating with clinical staff and the finance department, she can identify equipment needs and adjust expenditures using CBA to ensure that investments align with organizational priorities, such as purchasing new diagnostic equipment (Karamshetty et al., 2021). Service allocation follows a similar process, where Kimberly uses data from health records and patient satisfaction surveys to assess service performance and cost-effectiveness, ensuring resources are allocated efficiently (Thusini et al., 2022). Collaborative decision-making is at the heart of Kimberly’s approach, involving stakeholders from various departments to ensure that resource distribution aligns with the institution’s strategic goals. Labor allocation depends on accurate forecasting of patient volumes and productivity, while equipment allocation relies on consistent inventory management. Service allocation assumes that historical usage data can predict future needs, though unexpected factors may require flexibility (Karamshetty et al., 2021). Planning for Profitability and Fiscal Success Achieving profitability and fiscal success requires a systematic and strategic approach to budget creation and management. Kimberly’s method emphasizes aligning budget decisions with the healthcare facility’s economic goals and vision. This approach involves engaging key stakeholders across departments to ensure that budget distributions support projects that enhance revenue and improve cost efficiency (Anderson et al., 2020). Ongoing financial evaluations and performance analyses are essential for monitoring progress and implementing necessary adjustments. Kimberly stresses the importance of variance analysis to identify and address budget discrepancies promptly, minimizing the negative impact on financial results (Pham et al., 2020). Discretionary expenditures, while offering flexibility in resource allocation, can pose risks to financial stability. Kimberly underscores the importance of making thoughtful decisions about elective spending to avoid budget overruns and ensure long-term fiscal health (Anderson et al., 2020). Evaluating a Nurse Leader’s Approach to Budget Management A SWOT analysis can be used to assess Kimberly’s approach to budget management. Kimberly’s strengths lie in her focus on expense management, regular financial reviews, and proactive measures to address budget discrepancies. Her collaborative approach fosters transparency and aligns budget allocations with organizational objectives, contributing to financial stability (Więckowska et al., 2022). However, her strategy faces limitations in managing unforeseen costs arising from crises, which could jeopardize financial stability. Addressing this weakness requires enhanced contingency planning and broader financial literacy across the organization

NURS FPX 6226 Assessment 3 Name Capella university NURS-FPX6226 Advanced Operations and Finance Management Prof. Name Date

NURS FPX 6226 Assessment 2 Name Capella university NURS-FPX6226 Advanced Operations and Finance Management Prof. Name Date