Module 3 Assignment – Finance and Budgeting
PART 1 PAPER: Based on your proposed organization and structure for the GAH and the Community Clinic, we will now focus on financing and budgeting issues.In order to do so, we will need to define the following requirements and assumptions:Cost of facility construction, initial medical equipment, and instrumentation, will not be calculated as they will be fully paid by the state as a grant.All senior patients will be above the age of 65, and will have only the Federal Medicare health insurance. Research the major constructs of Medicare health coverage as defined by the Medicare Prospective Payment System.The hospital and clinic will be financially balanced, that is, income from Medicare payments will cover in full all operating costs.Medicare Prospective Payment SystemThe hospital is reimbursed by the government per procedure and/or treatment by a predefined sum and not by the actual expenses performed for and on a particular patient.For example a patient requiring open heart surgery will utilize the services of physicians, nurses, OR, laboratory, pharmacy, and occupies a hospital bed on average for six days. If a certain patient is discharged after four days, the hospital will still be paid the six-day amount. Hence, the incentive to operate efficiently and effectively, enabling the hospital to save money.Prepare (based on the table provided), a forecast of profit or loss for GAH for the first year of operation.Conclusions and Recommendations.PART 2 POWERPOINT 10-15 slides based on above paperDo not attempt to dazzle your audience with psychedelic visual effects, multi colors, and eye-boggling animations.Do not just copy and paste your case text into the slides.Focus on the content and what message you want to get across to the board.Think Audience – Ensure that all slides are viewable (i.e., relevant text in viewable font size.)one picture is worth a thousand words include graphs, diagrams, etc., as appropriate.Do not use all caps except for titles.Keep the background consistent and subtle.Use only enough text when using charts or graphs to explain; clearly label the graphic.Keep the design clean and uncluttered. Leave empty space around the text and graphics.Check the spelling and grammar.The number of slides per module should be about 10-15.Prepare and submit the sectional/modular slides for each moduleFinance and Budgeting Conclusions and Recommendations
Golden Age
Hospital
Executive
Summary
?
Older people need special care
?
It is important to have a hospital and a community clinic
for them
?
It is vital to integrate the services and functions of the
two
?
Integration of services and the physicians will help cut
cost and maximize profit
?
Technological system should be used across to share
information easily
Introduction
?
Older people frequently require medical care
?
It is vital to have a hospital that specializes in the
elderly
?
Older patients represent about 40% of overall
patients in a hospital
?
A lot of hospital resources are used in caring for
the elderly
?
There is a need for the elderly to find specialized
care.
Malnutrition problems
The spread of infectious
diseases
Accidents and injury risks
Coordination issues in case of
multiple ailments.
Delirium as a result of confusion
from the new environment.
Common risks
for seniors in a
regular
hospital
Need for a senior hospital
TO OFFER SPECIALIZED
CARE FOR OLDER
PEOPLE
TO PRESERVE A SENSE
OF FAMILIARITY
TO ADDRESS THE
CHALLENGES OF
AGING
TO HANDLE THE
INCREASING
POPULATION OF
OLDER PEOPLE
TO PROVIDE
SPECIALIZED CARE FOR
THE INDIVIDUAL NEEDS
OF THE AGED.
Common Causes of Hospitalization Among Older People
Circulatory disorders
Respiratory disorders
Physical disabilities
Chronic diseases
Mental illnesses
Diabetes
Hypertension
Common
medical
conditions
among older
people
Arthritis
Pathological fractures
Degenerative diseases
Heart diseases
Cancer
Difference between a care home for the aged and a senior hospital
In care homes, people are
given care services, a hospital
for seniors offers treatment to
the aged
People in care homes are
generally in good health but
need care as a result of age or
cognitive problems, in hospitals
for seniors, people are ill,
requiring specialized care.
In care homes, individuals may
stay there forever even after
getting stabilized, in hospital for
seniors, individuals remain
there for a limited period while
unwell and get out after
feeling better.
Regions to be served by GAH
Aliso Viejo
San Juan
Capistran
Ladera Ranch
Rancho Santa
Margarita
Laguna Hills
Mission Viejo
Laguna Niguel
Lake Forest
Laguna
Woods
The individual
needs required
by this
population
?
Social services
?
Patience and understanding
?
Access of both medication and specialized care for
their age
?
Specialized health care for the management of
dementia
?
Physiotherapy services
?
Psychotherapy services
?
Cardiovascular-related care
Conclusions and
Recommendations
?
A hospital for seniors is an essential part of the society
?
The aged population require specialized care due to their unique
health issues
?
Improved health services have led to an increase in the aged
population
?
Developing a medical center and a community clinic will ensure
continued care
?
Counselling sections should also be implemented for this
population.
Treatment A at $10,000,
Treatment B at $35000,
Treatment X at $12,000,
Treatment Y at $10,000
Treatment BQ at $ 20,000,
Treatment J at $ 30,000
Treatment PK at $40,000
Treatment PN at $ 25,000
Treatment C at $15,000$ total
cost of19, 850,000 with a total
gain of $ 1,395,000.
Treatments
being used
Organizational Structures and Functions
SHARED MANAGEMENT
FUNCTIONS AND
SERVICES
SHARING OF AUXILIARY
SERVICES
COMMUNITY CLINIC TO
HAVE A MINI PHARMACY
FOR EMERGENCIES
MAIN STRUCTURE BLOCKS
TO BE IN GAH
Organizational Structures and Functions Continued
INTEGRATION OF PHYSICIANS
INTEGRATION OF SERVICES
WILL HELP MINIMIZE COSTS
THUS MAXIMIZE PROFIT
MISSION IS TO OFFER HIGHEST
AND TIMELY QUALITY CARE
FOR THE WHOLE OF THEIR LIVES.
Organizational Diagram
Mission Viejo Hospital
Administrator/man
agement team
Children
s hospital
Auxiliary services
manager
Mission
Hospital
GAH/Community
Clinic
Hospital Size
Recommended is a 90 bed capacity for the Golden
Age Hospital
A 30 bed capacity for the Community Clinic
Current capacity for mission hospital is 530 beds so
recommended 90 for GAH is enough
Major services to be offered
Improved cardiology
and oncology
services
Caregiver resilience
Counseling services
Management of
weight and sleep
Major Services to be offered continued
Primary care services
Weight and sleep
management
Rehabilitation services
long-term care
Occupational and
physical therapy
Integration of Hospital and Physicians
HOSPITALS AND
PHYSICIANS HAVE A
SYMBIOTIC
RELATIONSHIP
INTEGRATION
INCREASES
BARGAINING POWER
INTEGRATION BRINGS
MORE PROFIT
INTEGRATION WILL
MAKE TECHNOLOGY
CONSTANT
PHYSICIANS WILL
BECOME STAFF THUS
OFFER QUALITY CARE
Conclusion and
Recommendations
?
To achieve their mission GAH and community clinic to
work as one entity
?
Have a common management team with power
decentralization
?
Common budget to cut on cost
?
Integrate the technological system for easy information
sharing
?
Ensure evidence-based care
References
?
Ciliberto, F., & Dranove, D. (2005). The effect of
physician-hospital affiliations on hospital prices
in
California. Journal of Health Economics, 25, 29-38
?
Cuellar, A.E., & Gertler, P. J. (2006). Strategic
integration of hospitals and physicians. Journal of
Health Economics, 25(1): 1-28.
?
Hold J. et al., (2019). Healthcare needs of older adults: in their
own words. Journal of Educational Gerontology, Volume 45,
2019 – Issue 1 Pages 1-10 | Published online: 04 Feb 2019. URL:
https://doi.org/10.1080/03601277.2019.1571690
?
Shrivastava S. B., Shrivastava P. S. & Ramasamy, (2013).
Healthcare of Elderly: Determinants, Needs, and Services. Int J
Prev Med. 2013 Oct; 4(10): 12241225.
URL:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843313/
?
State of California, (2010). Mission Hospital Regional
Medical Center. Retrieved from,
http://gis.oshpd.ca.gov/atlas/places/facility/1063012
62.
?
Stats about all US Cities, real estate relocation info, city-data.com
Running Head: GOLDEN AGE HOSPITAL MANAGEMENT STRUCTURE
Golden Age Hospital Organizational Structure
1
GOLDEN AGE HOSPITAL MANAGEMENT STRUCTURE
2
Organizational Structure and Budgets
Treatments being used
In the proposed Golden Age Hospital (GAH), various treatments will be used, each with
a varying cost. They include Treatment A at $10,000, Treatment B at $35000, Treatment X at
$12,000, Treatment Y at $10,000, Treatment BQ at $ 20,000, Treatment J at $ 30,000, Treatment
PK at $40,000 Treatment PN at $ 25,000 and Treatment C at $15,000. With the various
estimations of the treatments that would be offered, it would cost the hospital a total of $ 19,
850,000 with a total gain of $ 1,395,000. (explanation of treatments in Table 4)
Organizational Structures and Functions
The Community Clinic will be affiliated to the GAH, and they, therefore, may have some
integration in the management structure as well as the functions of the management team and the
sharing of services being offered. The Community Clinic can be situated in a place that is within
reach from the GAH. The location will enable the sharing of such amenities like the radiological
department instead of having each with its radiology department. Patients can be transported
every morning to the GAH for radiological services (the State of California, 2010). They can
also have a standard laboratory where investigations can be done together. Those in the
Community clinic will have their specimens collected from the hospital; then, they are taken for
examination in the GAH. They can share the central pharmacy situated in the hospital, but the
community clinic should have their mini pharmacy too for emergency drugs.
The GAH and the Community Clinic can also share the services of the management team
where we can have one administrator as the chairperson to the management team. He/she will
then appoint a deputy for the GAH and the Community Clinic, who will run the institutions with
team leaders under them. The main structure blocks for administration will be situated in the
GOLDEN AGE HOSPITAL MANAGEMENT STRUCTURE
3
GAH. Additionally, the deputy of the Community clinic and their team leaders will have their
administrative offices in the community clinic as well as the houses where the senior population
will be admitted.
The physicians, as well as other healthcare professionals who will be working in the
GAH, will also be affiliated and work in the community clinic. They will be reviewing and
treating patients in the GAH where they will be situated and will go to the community clinic
when they are required to evaluate patients there. The physicians will be reporting to the
administrator, and all their employment matters will be under GAH (Ciliberto & Dranove, 2005).
The integration of the services, as well as the structure blocks, will help to minimize the cost of
operating the two institutions.
Given that the main objective of GAH is to give care to the senior population, the
hospital must design a mission statement. The mission statement for GAH and the community
clinic will be one which is to offer the older population with the highest and timely quality care
for the whole of their lives.
Organizational Diagram
Mission Viejo Hospital
Childrens
Hospital
Mission
Hospital
Department
of medicine
Pediatric
medicine/S
urgery
Department
of surgery
Pediatric Nursing
Golden Age
Hospital
Department
of Nursing
GOLDEN AGE HOSPITAL MANAGEMENT STRUCTURE
Acute care/Intensive
care/PACU
4
Community
Clinic
Geriatric
medicine
Geriatric
surgery
Geriatric
Nursing
Acute
care/Intensive
care/PACU
Director administration to include
patient management, records, billing
Acute care/Intensive
care/Outpatient
services
Administrator Auxiliary services including
laboratory, pharmacy, laundry
Hospital Size and Services offered
The hospital size that is recommended is that of a 90-bed capacity while the community
clinic can have a 30-bed capacity. The size will be enough for the total population in the Mission
Viejo area since most of them are below the age of 50. The hospital size will also be manageable
for the physicians who will integrate the services in both the GAH and the Community clinic.
The current bed capacity for the Mission Viejo Hospital is 582, with 530 beds for adults. 3% of
these patients are beneficiaries of Medicare (the State of California, 2010). Given that the bed
capacity for the hospital is low, the recommended bed capacity for GAH and the community
clinic.
GOLDEN AGE HOSPITAL MANAGEMENT STRUCTURE
5
Major Services to be offered
The primary services that will be provided in the GAH and the community clinic include
cardiology and oncology services that are improved. These two are prevalent conditions that the
senior population suffers from frequently. Caregiver resilience and counseling services on endof-life care will also be offered. These are clients who are nearing death, and they, therefore,
need to be prepared for it, together with their relatives. The caregivers also need to be counseled
on being resilient and patient with these patients. Management of weight and sleep on an
outpatient basis should also be offered since, with old age, patients may not be able to take care
of their weight and also suffer from sleep disorders.
Rehabilitation and long-term care should also be incorporated into an essential
component of care. The senior population suffers from many conditions that require
rehabilitation services. Primary care services should also be offered for patients who will be
suffering from other common ailments as the general population. The other service that will be
provided is an occupational and physical therapy that is enhanced. The senior community may be
fragile to take part in physical exercise and therefore require being involved in physical and
occupational therapy.
Integration of Hospital and Physicians
The healthcare industry is characterized by symbiotic relations between hospitals and
physicians (Cuellar & Gertler, 2006). The alliance between the two increases bargaining power
and, therefore, an increase in charges, which results in more profit for the organization, making
the full hospital integration. The relationship may, however, not have considerable impacts on
efficiency. The need for technology will be constant across the institution as a result of the
GOLDEN AGE HOSPITAL MANAGEMENT STRUCTURE
6
integration. The physicians will become staff of the organization and will, therefore, focus on
providing quality care to the patients without looking at the costs incurred.
Conclusion and Recommendations
To ensure their mission is achieved, GAH and the community clinic should work as one
entity. They should have a joint management team with the decentralization of power, as well as
a current budget, which will help to cut on the cost of running the institution. The technological
system should be integrated to enhance information sharing between the distinct departments.
Also, the organization should ensure that their care is evidence-based, and the delivery of highquality care should be one of its cultures.
GOLDEN AGE HOSPITAL MANAGEMENT STRUCTURE
7
Table 1 EXPLANATION OF TREATMENTS
TREATMENT NAME
TREATMENT TYPE
DESCRIPTION OF
TREATMENT
ALL INCLUSIVE
DEMENTIA CARE
MEDICATION AND
EDUCATION FOR ALL
DIABETIC SYMPTOMS
A
DEMENTIA SUPPORT
X
DIABETES CARE
B
IMPACT
C
CARDIOCARE
BQ
GRACE
HOME BASED CARE THAT
IDENTIFIES NEEDS OF
PATIENTS BEFORE THEY
NEED HOSPITALIZATION
J
AIM
BRIDGES THE GAP
BETWEEN PEOPLE WHO
ARE SERIOUSLY ILL BUT
DO NOT NEED 24-7 CARE
PK
EVERCARE
HIGHLY TRAINED
PROFESSIONALS WORK
WITH AT RISK
INDIVIDUALS TO ALLOW
THEM TO NOT BE FULLY
HOSPITALIZED
Y
PSYCHOTHERAPY
USEFUL FOR ALL
PATIENTS ON AN AS
NEEDED BASIS
PN
PACE
CREATING AN ADULT
DAYCARE CENTER THAT
ALLOWS FOR DIFFERENT
LEVELS OF SOCIALIZING
EVIDENCE BASED CARE
FOR MAJOR DEPRESSION
FOCUSES ON DISORDERS
OF THE HEART AND
CIRCULATORY SYSTEM
(Institute of Medicine (US) Committee on the Future Health Care Workforce for Older
Americans, 1970)
GOLDEN AGE HOSPITAL MANAGEMENT STRUCTURE
8
References
Ciliberto, F., & Dranove, D. (2005). The effect of physician-hospital affiliations on hospital
prices in California. Journal of Health Economics, 25, 29-38
Cuellar, A.E., & Gertler, P. J. (2006). Strategic integration of hospitals and physicians. Journal of
Health Economics, 25(1): 1-28.
Hold J. et al., (2019). Healthcare needs of older adults: in their own words. Journal of
Educational Gerontology,Volume 45, 2019 – Issue 1 Pages 1-10 | Published online: 04
Feb 2019. URL: https://doi.org/10.1080/03601277.2019.1571690
Institute of Medicine (US) Committee on the Future Health Care Workforce for Older
Americans. (1970, January 1). New Models of Care. Retrieved February 9, 2020, from
https://www.ncbi.nlm.nih.gov/books/NBK215407/
Shrivastava S. B., Shrivastava P. S. & Ramasamy, (2013). Healthcare of Elderly: Determinants,
Needs, and Services. Int J Prev Med. 2013 Oct; 4(10): 12241225.
URL:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843313/
Stats about all US Cities, real estate relocation info, city-data.com
State of California, (2010). Mission Hospital Regional Medical Center. Retrieved from,
http://gis.oshpd.ca.gov/atlas/places/facility/106301262.
GAH Project Tables
Case 1 Survey Table
Item #
A
To be filled by the student
Survey item
1
2
3
4
Add at
least 10
more
items
6
7
8
9
10
11
12
13
Is a special GAH medical center needed?
Is a special community clinic needed in addition to the
GAH?
Is an outpatient service needed?
Is a dementia focused service needed?
Is community support program needed?
Is there need for a standard laboratory?
Are there needs for cardiology and oncology services?
Are there needs for counselling services?
Is there need for rehabilitation services?
Is there need for physical and occupational services?
Are there needs for a patient diet program?
Are services of peer educators needed?
Is there a need for management integration?
B
Results – To be filled by the Instructor
On a scale of 1-10, where:
10= very much needed, and
1 = not needed
Case 3 Budget Table please fill the empty spaces
#
A
To be filled by the
student
B
To be filled by
the student
C
Filled by Instructor
Service / Treatment
Estimated
Medicare
reimbursement
to GAH. (each
10 to 60
thousands of
dollars)
$10,000
Projected number of
procedures/treatments
performed annually
D
To be filled
by the
student
Total
income
B*C
75
$750,000
80%
$10,000
$35,000
$12,000
$10,000
$20,000
$30,000
$40, 000
$25,000
$15,000
85
50
200
150
50
100
60
75
110
$850,000
$1750,000
$2,400,000
$1,500,000
$1,000,000
$3,000,000
$2,400,000
$2,075,000
$1,650,000
$250,000
75%
110%
80%
90%
120%
100%
75%
85%
95%
Example Treatment ABC
1
2
3
4
5
6
7
8
9
10
Total
Treatment A
Treatment X
Treatment B
Treatment C
Treatment BQ
Treatment J
Treatment PK
Treatment Y
Treatment PN
Miscellaneous expenses
$16,875,000
E
Filled by
Instructor
F
To be filled by
the student
GAH
GAH projected
projected
annual gain (or
performance
loss).
relative to
D D*E
federal
standards
$150,000 (do
not add this
line to total)
$212,500
$-175,000
$480,000
$150,000
$-200,000
$0
$600,000
$311,250
$82,500
-$375, 000
(minus)
$ 1,461,250
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