HEALTHCARE FINANCE AND REIMBURSEMENT (Assessment 4 Operating Budget Proposal)

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526

		Actual			Monthly	Variance
		Month 1	Month 2	Month 3	Budget	Mo 3 to budget
	Medicare-Revenue
	Medicare A	67,861	40,297	21,315	89,300	(67,985)
	Contr-Medicare A	(47,784)	(28,570)	(15,124)	- 0	(15,124)
	Contractual PT-Medicare A	18,304	10,311	4,976	- 0	4,976
	Contractual OT-Medicare A	17,289	9,680	4,715	- 0	4,715
	Contractual SLP-Medicare A	11,809	6,451	3,540	- 0	3,540
	Contractual NTA-Medicare A	21,692	11,065	5,968	- 0	5,968
	Contractual NUR-Medicare A	51,045	22,433	11,188	- 0	11,188
	Contractual Adj-Sequestration Part A	- 0	- 0	(308)	(797)	489
	Contractual Adj-Part A Crossover/MXA	(2,865)	(1,895)	(2,161)	(3,600)	1,439
	VBP Withhold-Medicare	- 0	- 0	- 0	(1,786)	1,786
	VBP Incentive-Medicare	- 0	- 0	- 0	1,072	(1,072)
						- 0
	Total Medicare-Revenue	137,351	69,772	34,109	84,189	(50,080)
						- 0
	Managed Care-Revenue					- 0
	Managed Care	67,341	48,031	48,793	64,991	(16,198)
	Managed Care-Capitation	15,600	10,800	10,800	4,695	6,105
	Contr-Managed Care	8,417	(980)	(6,719)	- 0	(6,719)
	Contractual PT-Managed Care	3,090	4,700	4,623	- 0	4,623
	Contractual OT-Managed Care	2,886	4,357	4,236	- 0	4,236
	Contractual SLP-Managed Care	1,445	1,489	1,495	- 0	1,495
	Contractual NTA-Managed Care	5,063	7,005	3,094	- 0	3,094
	Contractual NUR-Managed Care	5,301	7,545	5,679	- 0	5,679
	Contractual Adj-Sequestration Mgd Care	- 0	- 0	(247)	- 0	(247)
						- 0
	Total Managed Care-Revenue	109,143	82,947	71,754	89,686	(17,932)
						- 0
	Medicaid Revenue					- 0
	Medicaid	578,814	723,362	654,314	863,341	(209,027)
	Contr-Medicaid	(22,794)	(27,917)	(26,901)	- 0	(26,901)
						- 0
	Total Medicaid-Revenue	556,020	695,445	627,413	863,341	(235,928)
						- 0
						- 0
						- 0
	Medicaid Mgd Skilled-Revenue					- 0
	Managed Medicaid Skilled	8,148	9,021	8,730	12,653	(3,923)
	Contractual-Managed Medicaid Skilled	(309)	(342)	(331)	(351)	20
						- 0
	Total Medicaid Mgd Skl-Revenue	7,839	8,679	8,399	12,302	(3,903)
						- 0
	Hospice-Revenue					- 0
	Hospice	15,423	32,010	44,760	17,821	26,939
	Contr-Hospice	(2,057)	(1,213)	(2,765)	- 0	(2,765)
						- 0
	Total Hospice-Revenue	13,366	30,797	41,995	17,821	24,174
						- 0
						- 0
						- 0
						- 0
						- 0
						- 0
						- 0
						- 0
						- 0
						- 0
						- 0
						- 0
						- 0
						- 0
						- 0
						- 0
						- 0
						- 0
						- 0
						- 0
						- 0
	Prior Year Revenue Adjust	(2,298)	(514)	(2,481)	- 0	(2,481)
	Implicit price concessions	(2,529)	800	(3,456)	(10,131)	6,675
						- 0
	Total Other Revenue	16,491	11,903	5,667	(10,131)	15,798
						- 0
	Total Revenue	840,210	899,543	789,337	1,057,208	(267,871)
						- 0
						- 0
	Nursing Admin					- 0
	Salaries & Wages	22,183	16,663	19,007	24,266	5,259
	Salaries & Wages OT	4,105	2,863	2,784	- 0	(2,784)
	Bonus-Vacant Shift	4,635	5,103	5,279	- 0	(5,279)
	Bonus-Sign-on	987	1,356	2,365	- 0	(2,365)
	Bonus-Other	1,507	1,643	1,473	- 0	(1,473)
	Employee Time Off - Vacation	294	534	863	1,462	599
	Medical Director	5,000	5,000	5,000	5,000	- 0
	Pharmacy Consultant	1,467	1,531	1,368	1,117	(251)
	Travel - Auto Expenses	21	1,016	462	79	(383)
						- 0
	Total Nursing Admin	40,199	35,709	38,601	31,924	(6,677)
						- 0
	Nursing					- 0
	Salaries & Wages-Registered Nurse	26,558	28,607	33,011	34,068	1,057
	Salaries & Wages-Licensed Practical Nurses	22,192	28,816	21,343	40,967	19,624
	Salaries & Wages-Certified Nurses Assistant	64,324	80,383	69,369	94,150	24,781
	Salaries & Wages-Certified Medical Aides	7,796	7,060	17,193	13,965	(3,228)
	Salaries & Wages-Nurse Aide in Training	324	1,856	7,548	- 0	(7,548)
	Salaries & Wages-Nurse Unit Manager	9,652	10,417	11,415	11,493	78
	Salaries & Wages OT-Registered Nurse	14,779	17,812	15,632	9,194	(6,438)
	Salaries & Wages OT-Licensed Practical Nurses	16,669	30,318	14,765	17,631	2,866
	Salaries & Wages OT-Certified Nurses Assistant	16,106	31,265	12,638	4,509	(8,129)
	Salaries & Wages OT-Certified Medical Aides	1,192	3,576	3,345	- 0	(3,345)
	Salaries & Wages OT-Nurse Aide in Training	1	- 0	- 0	- 0	- 0
	Salaries & Wages OT-Nurse Unit Manager	2,290	2,432	3,074	- 0	(3,074)
	Bonus-Vacant Shift	40,244	86,060	54,588	- 0	(54,588)
	Bonus-Referral	- 0	1,571	286	- 0	(286)
.	Bonus-Sign-on	2,357	4,178	7,714	- 0	(7,714)
	Bonus-Other	4,589	(245)	9	- 0	(9)
	Employee Time Off - Vacation	4,896	3,230	5,901	14,667	8,766
	Contracted Pool Nursing Services	47,954	53,789	57,359	- 0	(57,359)
	Equipment Repairs/Maintenance	- 0	- 0	- 0	42	42
	Minor Equipment	457	911	776	1,197	421
	Waste Disposal Services (Medical)	232	349	340	200	(140)
	Recruiting Expense	246	256	236	27	(209)
	Other Contracted Services	18	18	18	5	(13)
	Forms	269	157	74	29	(45)
	Supplies	405	240	398	285	(113)
						- 0
	Total Nursing Expense	283,550	393,056	337,032	242,429	(94,603)
						- 0
						- 0
	Administrative					- 0
	Salaries & Wages	27,952	35,039	27,810	25,768	(2,042)
	Salaries & Wages OT	4,192	5,255	4,171	350	(3,821)
	Bonus-Vacant Shift	1,000	250	475	- 0	(475)
	Bonus-Other	1,200	2,500	750	- 0	(750)
	Employee Time Off - PTO	652	674	490	1,524	1,034
						- 0
						- 0
						- 0
						- 0
	Equipment Rental	355	355	355	246	(109)
	Equipment Repairs/Maintenance	- 0	- 0	- 0	63	63
	Minor Equipment	425	- 0	- 0	75	75
	Telephone	2,098	2,924	1,793	2,068	275
	Auditing Fees	- 0	720	720	420	(300)
	Legal Fees	3	61	6	1,062	1,056
	Marketing and Promotion	209	141	(12)	352	364
	Recruiting Expense	3	- 0	129	225	96
						- 0
	Other Contracted Services	1,768	1,543	1,757	2,087	330
	Payroll Processing Fees	461	92	99	141	42
	Postage and Freight	258	344	97	120	23
	Supplies	1,199	605	256	428	172
	Licenses and Fees	2,797	2,797	3,348	4,368	1,020
	Sales and Use Tax	835	886	219	1,140	921
	Travel - Lodging	- 0	582	- 0	115	115
	Travel - Meals & Entertainment	- 0	158	337	7	(330)
	Auto Repairs and Expense	8	8	8	667	659
	Continuing Education/Seminars	- 0	- 0	- 0	133	133
	Dues and Subscriptions	1,145	1,150	1,183	1,027	(156)
	Employee Benefits - Other	- 0	- 0	124	133	9
	Employee Recognition	157	77	171	46	(125)
	Pay Card Rebates	- 0	- 0	- 0	- 0	- 0
	Uniforms	743	- 0	- 0	- 0	- 0
	Auto Insurance	299	299	299	299	- 0
	Insurance - Other	- 0	720	- 0	159	159
						- 0
	Total Administrative Expense	47,759	57,180	44,585	43,023	(1,562)
						- 0
	Dietary					- 0
	Salaries & Wages	23,017	25,271	24,213	22,638	(1,575)
	Salaries & Wages OT	5,702	6,040	5,881	332	(5,549)
	Bonus-Vacant Shift	1,061	(232)	- 0	- 0	- 0
	Bonus-Other	- 0	(2)	152	- 0	(152)
	Employee Time Off - PTO	602	647	409	1,516	1,107
	Dishes and Utensils	2,257	44	254	86	(168)
	Food Cost	15,000	15,000	15,000	15,000	- 0
	Equipment Rental	243	243	250	241	(9)
	Equipment Repairs/Maintenance	594	- 0	- 0	208	208
	Minor Equipment	557	1,149	455	143	(312)
	Supplies	1,476	195	242	86	(156)
						- 0
	Total Dietary	50,509	48,355	46,856	40,250	(6,606)
						- 0
	Laundry & Housekeeping					- 0
						- 0
	Laundry					- 0
	Salaries & Wages	8,377	8,656	8,377	8,100	(277)
	Salaries & Wages OT	1,256	1,298	1,256	332	(924)
	Bonus-Vacant Shift	1,061	(232)	- 0	- 0	- 0
	Bonus-Other	- 0	(2)	152	- 0	(152)
	Employee Time Off - PTO	602	647	409	1,516	1,107
	Supplies	26	32	45	38	(7)
						- 0
	Total Laundry	11,322	10,399	10,239	9,986	(253)
						- 0
	Housekeeping					- 0
	Salaries & Wages	12,566	12,984	12,566	11,850	(716)
	Salaries & Wages OT	1,885	1,947	3,029	1,777	(1,252)
	Bonus-Vacant Shift	1,061	(232)	- 0	- 0	- 0
	Bonus-Other	- 0	(2)	152	- 0	(152)
	Employee Time Off - PTO	602	647	409	1,516	1,107
	Linens and Bedding	- 0	244	- 0	86	86
	Minor Equipment	74	56	60	35	(25)
	Supplies	123	178	165	143	(22)
						- 0
	Total Housekeeping	16,311	15,822	16,381	15,407	(974)
						- 0
						- 0
	Plant Operations & Maintenance					- 0
	Salaries & Wages	5,201	5,997	6,952	5,252	(1,700)
	Salaries & Wages OT	609	328	1,602	550	(1,052)
	Employee Time Off - PTO	176	165	180	470	290
						- 0
						- 0
						- 0
						- 0
						- 0
						- 0
	Equipment Rental	76	143	198	83	(115)
	Equipment Repairs/Maintenance	77	373	77	422	345
	Minor Equipment	281	477	1,041	308	(733)
	Building Repairs & Maintenance	2,569	5,357	3,053	729	(2,324)
	Grounds Repairs & Maintenance	553	553	1,340	643	(697)
	Supplies	565	134	386	703	317
	Travel - Auto Expenses	20	25	17	2	(15)
	Electricity	5,408	5,142	3,858	4,017	159
	Natural Gas/Heating Oil	2,354	2,300	2,305	1,725	(580)
	Pest Control	1,329	546	577	573	(4)
	Waste Disposal Services (Routine)	691	567	567	557	(10)
	Water and Sewage	5,107	8,622	7,384	4,813	(2,571)
	Other Contracted Services	2,404	18	18	826	808
						- 0
	Total Plant Operations	21,434	24,257	29,537	21,673	(7,864)
						- 0
	Rehab					- 0
	Salaries & Wages	15,812	17,168	15,142	13,963	(1,179)
	Salaries & Wages OT	1,312	848	2,247	75	(2,172)
	Bonus-Vacant Shift	1,357	357	1,276	- 0	(1,276)
	Bonus-Referral	775	- 0	- 0	- 0	- 0
	Bonus-Other	1,357	347	875	- 0	(875)
	Employee Time Off - PTO	495	491	1,502	1,166	(336)
	Travel - Auto Expenses	45	29	67	57	(10)
						- 0
	Total Social Services	21,153	19,240	21,109	15,261	(5,848)
						- 0
						- 0
	Pharmacy					- 0
	Pharmacy-IV	1,100	764	1,357	462	(895)
	Drugs Non-Chargeable OTC	2,309	1,630	1,758	1,608	(150)
	Legend Drugs	19,571	14,579	18,764	11,358	(7,406)
						- 0
	Total Pharmacy	22,980	16,973	39,953	13,428	(26,525)
						- 0
						- 0
						- 0
	Ancillary Services					- 0
						- 0
	Rehab					- 0
	Minor Equipment	112	91	125	57	(68)
	Supplies	1,047	194	436	143	(293)
						- 0
	Total Rehab	1,159	285	561	200	(361)
						- 0
	Medical Supplies					- 0
						- 0
	Total Medical Supplies	1,188	1,335	1,426	570	(856)
						- 0
	Laboratory					- 0
						- 0
	Total Laboratory	370	479	596	399	(197)
						- 0
	Respiratory Therapy					- 0
	Equipment Rental	1,304	1,565	1,169	884	(285)
	Other Contracted Services	1,204	1,456	970	855	(115)
						- 0
	Total Respiratory	2,508	3,021	2,139	1,739	(400)
						- 0
						- 0
	Radiology					- 0
						- 0
	Total Radiology	294	792	1,561	1,140	(421)
						- 0
						- 0
						- 0
						- 0
	Other Ancillaries					- 0
	Blood Glucose Testing Exp	313	578	47	285	238
	Oxygen and Oxygen Supplies	3,883	2,375	818	1,283	465
	Transportation Services	1,057	16,557	6,400	2,565	(3,835)
						- 0
	Total Other Ancillaries	5,373	19,510	7,265	4,133	(3,132)
						- 0
						- 0
	Medical Records					- 0
	Salaries & Wages	2,936	3,282	3,154	2,821	(333)
	Salaries & Wages OT	353	534	229	56	(173)
	Bonus-Vacant Shift	75	450	275	- 0	(275)
	Employee Time Off - PTO	120	125	120	257	137
	Forms	35	65	78	43	(35)
	Supplies	27	43	76	54	(22)
						- 0
	Total Medical Records	3,546	4,499	3,932	3,231	(701)
						- 0
	Central Supply					- 0
	Salaries & Wages	2,253	2,269	2,467	3,130	663
	Salaries & Wages OT	338	340	370	469	99
	Employee Time Off - PTO	122	176	198	286	88
	Disposable Briefs Expense	2,883	5,325	4,414	3,278	(1,136)
	Supplies	6,377	10,005	4,460	2,850	(1,610)
	Total Central Supply	11,973	18,115	11,909	10,013	(1,896)
						- 0
						- 0
	Property Taxes					- 0
	Personal Property Tax	367	367	367	367	- 0
	Real Property Tax	3,708	3,708	3,708	3,708	- 0
						- 0
	Total Property Taxes	4,075	4,075	4,075	4,075	- 0
						- 0
	Other Expense					- 0
	Cable TV	2,557	2,558	2,663	2,048	(615)
	Total Other Expense	2,557	2,558	2,663	2,048	(615)
						- 0
	Workers Comp Expense	4,200	4,199	4,199	4,197	(2)
	Group Health Expense	9,192	2,971	9,689	9,452	(237)
						- 0
	Total Expenses	560,493	254,065	622,399	474,578	(147,821)
						- 0
	EBITDA	279,717	645,478	166,938	582,630	(415,692)
						- 0
						- 0
						- 0
							10% reduction goal is $58,000 per month
	Total Nursing S&W	228,935	333,810	270,012	211,913	(58,099)
	Other Salary & Wages
	Salaries & Wages	5,760	6,319	(1,053)	- 0	1,053
	Salaries & Wages-Director of Nursing	8,846	2,844	12,920	7,926	(4,994)
	Salaries & Wages-Assistant Director of Nursing	- 0	- 0	- 0	5,665	5,665
	Salaries & Wages-MDS Nurse	5,231	4,561	6,801	7,438	637
	Salaries & Wages-Central Supply	2,253	(269)	- 0	- 0	- 0
	Salaries & Wages-Administrator	12,362	18,857	11,538	9,963	(1,575)
	Salaries & Wages-Office & Clerical	15,589	16,182	15,269	16,615	1,346
	Salaries & Wages-Admissions	4,462	4,939	2,231	4,513	2,282
	Salaries & Wages-Director/Supervisor	10,379	10,786	10,592	12,505	1,913
	Salaries & Wages-Staff	15,379	16,837	14,592	18,475	3,883
	Salaries & Wages OT	4,165	2,181	(640)	637	1,277
	Salaries & Wages OT-Central Supply	4,066	(423)	- 0	- 0	- 0
	Salaries & Wages OT-Office and Clerical	2,695	(231)	3,029	- 0	(3,029)
	Salaries & Wages OT-Director/Supervisor	1,296	504	1,926	- 0	(1,926)
	Salaries & Wages OT-Staff	2,255	2,198	3,013	- 0	(3,013)
	Bonus-Vacant Shift	9,339	4,557	(914)	- 0	914
	Bonus-Referral	(774)	- 0	- 0	- 0	- 0
	Bonus-Sign-on	(952)	- 0	- 0	- 0	- 0
	Bonus-Other	2,944	(717)	153	- 0	(153)
	Bonus-PBJ	- 0	- 0	- 0	- 0	- 0
	Employee Time Off - Vacation	6,790	4,113	7,315	20,558	13,243
	Employee Time Off - Sick	2,051	1,406	2,841	2,732	(109)
	Employee Time Off - Holiday	- 0	- 0	- 0	- 0	- 0
	Employee Time Off - PTO	- 0	6,950	(1,863)	1,283	3,146
	Employee Time Off - Other	(171)	- 0	- 0	- 0	- 0
	Total Other Salary & Wages	113,965	101,594	87,750	108,310	20,560
	Fringe Benefits
	Payroll Tax Expense-FICA	25,960	32,759	27,124	24,498	(2,626)
	Payroll Tax Expense-FUTA	504	349	280	634	354
	Payroll Tax Expense-SUTA	195	259	108	- 0	(108)
	Payroll Tax Expense-Other	- 0	- 0	- 0	1,729	1,729
	Employee Benefits - Other	- 0	- 0	124	300	176
	Employee Benefits Expense - Health	9,510	2,338	9,513	9,356	(157)
	Employee Benefits Expense - Life	65	84	88	96	8
	Employee Benefits Expense - Other	(383)	549	87	- 0	(87)
	Workers Compensation Insurance	4,200	4,199	4,199	4,197	(2)
	Total Fringe Benefits	40,051	40,537	41,523	40,810	(713)
	Controllable
	Disposable briefs	2,883	5,325	4,414	3,278	(1,136)
	Supplies-Nursing	- 0	240	398	285	(113)
	Supplies-Administrative	1,199	605	256	428	172
	Supplies-Dietary	1,476	195	242	86	(156)
	Supplies-Hkpg&Laundry	26	32	- 0	143	143
	Supplies-Plant	565	134	386	703	317
	Supplies-Central Supply	6,377	10,005	4,460	2,850	(1,610)
	Supplies-Central Supply Rebate	(2,261)	(2,579)	(2,311)	(1,026)	1,285
	Supplies-Other	436	300	72	114	42
	Blood Glucose Testing Exp	313	578	47	285	238
	Dishes and Utensils	2,257	44	254	86	(168)
	Personal Items Expense	- 0	- 0	69	29	(40)
	Linens and Bedding	- 0	244	- 0	86	86
	Total Controllable Cost	13,271	15,123	8,287	7,347	(940)
	Food Cost	5	- 0	- 0	- 0	- 0
	Other Pt Care (less Therapy)
	Transportation services	1,057	16,557	6,400	2,565	(3,835)
	Equipment Rental-Respiratory	1,304	1,565	1,169	884	(285)
	Contracted Srvcs-Lab	370	127	214	399	185
	Contracted Srvcs-Radiology	294	792	1,561	1,140	(421)
	Total Other PT Care	3,025	19,041	9,344	4,988	(4,356)
	Patient Equipment Rental
	Equip Rental-Complex Med	2,332	2,672	2,680	285	(2,395)
	Total Patient Equipment Rental	2,332	2,672	2,680	285	(2,395)
	Other Ancillary Services
	Contracted Srvcs-Respiratory	1,204	1,456	970	855	(115)
	Contracted Srvcs-IV	- 0	- 0	- 0	- 0	- 0
	Enteral Supplies-non-qualified	1,529	1,400	1,267	713	(554)
	Oxygen & Oxygen Supplies	3,883	2,375	818	1,283	465
	Total Other Anc Service	6,616	5,231	3,055	2,851	(204)
	Utilities
	Electricity	5,408	5,142	3,858	4,017	159
	Natural Gas/Heating Oil	2,354	2,300	2,305	1,725	(580)
	Water and Sewage	5,107	8,622	7,384	4,813	(2,571)
	Total Utilities	12,869	16,064	13,547	10,555	(2,992)
	Part A Therapy Expense	11,608	11,226	13,059	9,304	(3,755)
	Managed Care Therapy Exp	4,948	4,476	5,925	6,248	323
	Other Therapy Exp (Other PPD)
	Other Contracted Srvs-Gen-Medicaid	7,083	6,954	7,227	- 0	(7,227)
	Other Contracted Srvs-Gen-Hospice	32	32	38	- 0	(38)
	Other Contracted Services-Genesis	- 0	- 0	- 0	1,474	1,474
	Total Oth Therapy Exp(Oth PPD)	7,115	6,986	7,265	1,474	(5,791)
	Medicare Part B (MPPD)**	2,359	3,632	1,695	1,890	(195)
	Medicare Part B Revenue**	7,794	16,875	11,266	16,633	(5,367)
	Medicare Part B Expense**	5,435	13,243	9,571	14,743	5,172
	Pharmacy Prescription (MMPPD)	10,263	4,445	9,238	10,894	1,656
	Pharmacy - Prescription	9,171	4,853	8,681	11,457	2,776
	Pharmacy - IV	11	148	300	462	162
	Pharmacy - Rebate	1,081	(555)	257	(1,025)	(1,282)