NUR 621: Financial Management in Healthcare Systems
Topic 1 Assignment: Operational Budget Presentation
PART 1: ASSIGNMENT INSTRUCTIONS
Assignment Overview
As a Nurse Manager in today's healthcare environment, you must demonstrate financial
literacy and leadership in resource allocation. This assignment simulates the real-world
responsibility of developing, defending, and communicating an operational budget for a
nursing unit. You will analyze data, make evidence-based staffing decisions, identify
cost efficiencies, and articulate the connection between financial resources and quality
patient outcomes.
Scenario: Westwood Medical Center – 3-West Medical-Surgical Unit
Organizational Context
Westwood Medical Center (WMC) is a 285-bed, not-for-profit community hospital in a
suburban setting. The hospital has experienced moderate growth in medical-surgical
admissions (4% increase year-over-year) and is committed to achieving Magnet®
recognition. The organization's strategic priorities for the upcoming fiscal year (FY
2026) include:
1. Reducing hospital-acquired conditions by 15%
2. Improving nurse satisfaction and retention (current turnover: 18%)
3. Achieving operational margin of 3.5%
4. Enhancing patient experience scores (HCAHPS) to 75th percentile
Unit Profile: 3-West Medical-Surgical Unit
, ● Bed capacity: 32 beds (all private rooms)
● Average daily census (ADC): 28.4 patients (current FY)
● Average length of stay (ALOS): 4.2 days
● Patient population: Adults with medical conditions (COPD, CHF, diabetes, renal
disease) and post-surgical patients (orthopedic, general surgery)
● Current nurse-sensitive quality metrics:
○ Hospital-acquired pressure injuries (HAPI): 2.8 per 1,000 patient days
(benchmark: <1.0)
○ Falls with injury: 3.2 per 1,000 patient days (benchmark: <2.0)
○ Central line-associated bloodstream infections (CLABSI): 1.5 per 1,000
line days
○ Catheter-associated urinary tract infections (CAUTI): 2.1 per 1,000
catheter days
Your Role
You were promoted to Nurse Manager of 3-West six months ago. Your predecessor left
the unit with a $47,000 unfavorable variance in the last quarter of FY 2025, primarily due
to excessive agency nurse usage and supply waste. The Chief Nursing Officer (CNO)
and Chief Financial Officer (CFO) have emphasized that your FY 2026 budget must
demonstrate fiscal responsibility while supporting quality improvement initiatives.
Assignment Tasks
Task 1: Develop a Proposed Operational Budget (35% of grade)
Using the Case Study Data Packet (provided in Part 3), create a comprehensive
operational budget for FY 2026. Your budget must include three major categories:
A. Personnel Budget (Salary & Wages)
● Calculate required FTEs (Full-Time Equivalents) for RNs, LPNs, and Unlicensed
Assistive Personnel (UAP) based on:
○ Projected patient days (account for 4% volume increase)
○ Patient acuity levels (provided in data packet)
, ○ Required staffing ratios (state regulations and organizational policy)
○ Non-productive time (benefits, vacation, sick leave, education—typically
15-18%)
● Justify your staffing mix (percentage of RN/LPN/UAP hours)
● Include premium pay (overtime, weekend differentials, charge nurse pay)
● Address how you will reduce agency nurse usage (major source of prior deficit)
B. Supply & Non-Salary Budget
● Itemize major supply categories:
○ Medical/surgical supplies (dressings, IV supplies, catheters)
○ Linens and environmental services
○ Medications (unit stock)
○ Personal protective equipment (PPE)
○ Office and administrative supplies
● Account for inflation factors (provided in data packet)
● Propose one specific cost-saving initiative with projected savings
C. Capital Budget Request
● Identify one capital item (cost <$5,000) that supports quality/safety
● Provide justification linking to strategic goals or quality metrics
Format: Submit as a detailed spreadsheet or table with line-item breakdowns,
calculations, and explanatory notes.
Task 2: Create a Staff Presentation (25% of grade)
Develop an 8-10 slide PowerPoint presentation designed for your unit staff. The
presentation must:
TableCopy
Slide Required Content
Topic 1 Assignment: Operational Budget Presentation
PART 1: ASSIGNMENT INSTRUCTIONS
Assignment Overview
As a Nurse Manager in today's healthcare environment, you must demonstrate financial
literacy and leadership in resource allocation. This assignment simulates the real-world
responsibility of developing, defending, and communicating an operational budget for a
nursing unit. You will analyze data, make evidence-based staffing decisions, identify
cost efficiencies, and articulate the connection between financial resources and quality
patient outcomes.
Scenario: Westwood Medical Center – 3-West Medical-Surgical Unit
Organizational Context
Westwood Medical Center (WMC) is a 285-bed, not-for-profit community hospital in a
suburban setting. The hospital has experienced moderate growth in medical-surgical
admissions (4% increase year-over-year) and is committed to achieving Magnet®
recognition. The organization's strategic priorities for the upcoming fiscal year (FY
2026) include:
1. Reducing hospital-acquired conditions by 15%
2. Improving nurse satisfaction and retention (current turnover: 18%)
3. Achieving operational margin of 3.5%
4. Enhancing patient experience scores (HCAHPS) to 75th percentile
Unit Profile: 3-West Medical-Surgical Unit
, ● Bed capacity: 32 beds (all private rooms)
● Average daily census (ADC): 28.4 patients (current FY)
● Average length of stay (ALOS): 4.2 days
● Patient population: Adults with medical conditions (COPD, CHF, diabetes, renal
disease) and post-surgical patients (orthopedic, general surgery)
● Current nurse-sensitive quality metrics:
○ Hospital-acquired pressure injuries (HAPI): 2.8 per 1,000 patient days
(benchmark: <1.0)
○ Falls with injury: 3.2 per 1,000 patient days (benchmark: <2.0)
○ Central line-associated bloodstream infections (CLABSI): 1.5 per 1,000
line days
○ Catheter-associated urinary tract infections (CAUTI): 2.1 per 1,000
catheter days
Your Role
You were promoted to Nurse Manager of 3-West six months ago. Your predecessor left
the unit with a $47,000 unfavorable variance in the last quarter of FY 2025, primarily due
to excessive agency nurse usage and supply waste. The Chief Nursing Officer (CNO)
and Chief Financial Officer (CFO) have emphasized that your FY 2026 budget must
demonstrate fiscal responsibility while supporting quality improvement initiatives.
Assignment Tasks
Task 1: Develop a Proposed Operational Budget (35% of grade)
Using the Case Study Data Packet (provided in Part 3), create a comprehensive
operational budget for FY 2026. Your budget must include three major categories:
A. Personnel Budget (Salary & Wages)
● Calculate required FTEs (Full-Time Equivalents) for RNs, LPNs, and Unlicensed
Assistive Personnel (UAP) based on:
○ Projected patient days (account for 4% volume increase)
○ Patient acuity levels (provided in data packet)
, ○ Required staffing ratios (state regulations and organizational policy)
○ Non-productive time (benefits, vacation, sick leave, education—typically
15-18%)
● Justify your staffing mix (percentage of RN/LPN/UAP hours)
● Include premium pay (overtime, weekend differentials, charge nurse pay)
● Address how you will reduce agency nurse usage (major source of prior deficit)
B. Supply & Non-Salary Budget
● Itemize major supply categories:
○ Medical/surgical supplies (dressings, IV supplies, catheters)
○ Linens and environmental services
○ Medications (unit stock)
○ Personal protective equipment (PPE)
○ Office and administrative supplies
● Account for inflation factors (provided in data packet)
● Propose one specific cost-saving initiative with projected savings
C. Capital Budget Request
● Identify one capital item (cost <$5,000) that supports quality/safety
● Provide justification linking to strategic goals or quality metrics
Format: Submit as a detailed spreadsheet or table with line-item breakdowns,
calculations, and explanatory notes.
Task 2: Create a Staff Presentation (25% of grade)
Develop an 8-10 slide PowerPoint presentation designed for your unit staff. The
presentation must:
TableCopy
Slide Required Content
