Budget Variance Reports

Budget Variance Reports

For this three-part activity, you will work in groups assigned by the mentor. Each group will be collaborating within a private group forum in Moodle. Upon completing all three parts of the exercise, please combine Parts 1, 2, and 3 into one submission. Each group member should submit the final deliverable using the assignment submission link in Moodle. A grading rubric for this activity can be found in the Evaluation Rubrics folder in Moodle.

The budget scenario used in Financial Exercise 2 is for Happy Valley Nursing Home, a 66 bed skilled nursing facility in Pennsylvania. Happy Valley provides short-term skilled nursing care and long-term care for adults with disabilities and older adults. The facility has one nursing unit, 4S, with a census of 56 patients in the month of June 2019.

The facility must follow the Pennsylvania Department of Health’s Division of Long Term Care Regulations for all aspects of its operations and the provision of care. These regulations also define the staffing (nursing services) requirements for all long-term care facilities in Pennsylvania.[unique_solution]

Part 1: Budget Labor Variance Report

In Part 1 of the exercise, you evaluate the nursing staffing budget for Happy Valley Nursing Home and actual performance through a labor variance reporting activity.

1. Review the staffing statistics for Happy Valley’s June 2019 performance in the Labor Statistics and Variance Worksheet (Excel spreadsheet).

2. Consulting Chapter 5 in your textbook, complete a labor variance report using the Labor Statistics and Variance Worksheet provided. Calculate and fill in all of the blank cells in the worksheet before completing the narrative summary.Note: A labor variance report includes an evaluation of all types of labor hours worked (regular staff, contract staff, and overtime) related to the census. Nursing leaders assess the details of the data to look for trends.

3. Include a one-page narrative highlighting your conclusions based on the labor variance assessment. Additionally, consider the staffing (nursing services) requirements of the Pennsylvania Department of Health’s Division of Long Term Care Regulations and the following prompts as part of your evaluation and narrative.
   1. What types of hours are over or under budget? What could be the cause of those variances?
   2. Is there a difference between RN/LPN trends and Aide trends?
   3. What could be the causes of those differences? How would that impact the care on the unit?
   4. What is the impact of the labor data on nursing care hours? What could be the implications of that observation?
   5. Are there regulatory standards related to nursing staffing? How does this assessment compare to those standards?
   6. What are the proposed next steps that the nursing leader needs to take based on this assessment?

Part 2: Budget Salary Variance Report

In Part 2 of the exercise, you evaluate a nursing salary budget for Happy Valley Nursing Home and actual performance through a salary variance reporting activity.

1. Review the salary statistics for Happy Valley’s June 2019 performance in the Salary Statistics and Variance Worksheet (Excel spreadsheet).

2. Consulting Chapter 5 in your textbook, complete a salary variance report using the Salary Statistics and Variance Worksheet provided. Calculate and fill in all of the blank cells in the worksheet before completing the narrative summary.Note: A salary variance report includes an evaluation of all types of salary hours and dollars across all staff categories (regular staff, contract staff, and overtime) related to the census. Nursing leaders assess the details of the data to look for trends.

3. Include a one-page narrative highlighting your conclusions based on the salary variance assessment. Additionally, consider the staffing (nursing services) requirements of the Pennsylvania Department of Health’s Division of Long Term Care Regulations and the following prompts as part of your evaluation and narrative.
   1. What types of salary lines are over or under budget? What could be the cause of those variances?
   2. Is there a difference between RN/LPN trends and Aide trends? What could be the causes of those differences? How would that impact the care on the unit?
   3. What impact would you expect to see in the salary dollars if you just considered the actual to budget nursing care hours? What are your observations after reviewing the data?
   4. What are the implications of the salary variance on the overall organization?
   5. What are the proposed next steps that the nursing leader needs to take based on this assessment?

Part 3: Nursing Sensitive Indicators Case Application

Using the labor and salary variance reports completed in Parts 1 and 2, evaluate the linkages between nursing staffing considerations and nursing sensitive indicators of quality and patient safety. Begin by downloading the Fall-Data-NSQI-Scenario (Excel file) and the presentation slides (PDF file) for Nurse Sensitive Outcome Indicators: What They Are and How They Are Measured and Benchmarked. Use these resources to complete the Nursing Sensitive Indicators Case Application. Please consider the fall data for 4S to be current for the purposes of the assignment.

Quality Case Scenario—Patient Falls

Brought up in a staff meeting by a concerned nurse: “We didn’t have any falls for six months last year and in the last five months it feels like we have had way too many. I think it is because we have been staffing tight.”

Consider the nursing leader’s approach to understanding the link between nursing-sensitive indicators and budgetary staffing decisions:

• What questions do you need to ask?
• What data do you need to begin exploring these issues?
• Who do you need to include in the discussion?
• Who are the internal and external stakeholders who will influence or be influenced by this discussion?
• In addition to staffing, what other factors could be influencing the patient fall rate on this unit?

Consider the nursing leader’s role in analyzing data for nursing sensitive indicators and financial performance as they draw conclusions and make financial decisions:

• What data do you need?
• What do you hope to learn from the data?
• What trends would you expect to see?
• What questions do you have?
• What additional data or information do you need?

Summarize your responses to the question prompts. Document your response using the SBAR Tool template from the Institute for Health Improvement (IHI). You will need to login to your IHI account to access the template. Include two scholarly articles from professional peer-reviewed journals to support your responses to these questions. [MO 3.1, MO 3.2]