| Course | NR 533 Financial Management in Healthcare Organizations |
|---|---|
| Week | 4 |
| Paper type | Operating budget draft |
| Length | About 1,130 words, 3 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Nurse Executive |
| Updated | September 2026 |
Free sample paper for NR 533 Week 4
Operating Budget Draft: Next Year's Expense Plan for a 12-Bed Palliative Care Unit, Built From a Stated Forecast of 3,800 Patient Days Down Through Worked Hours, Benefits, Supplies and Drugs, With Every Assumption Kept in View
Student Name
College of Nursing, Chamberlain University
NR 533: Financial Management in Healthcare Organizations
Instructor Name
Month Day, Year
Operating Budget Draft: Next Year's Expense Plan for a 12-Bed Palliative Care Unit, Built From a Stated Forecast of 3,800 Patient Days Down Through Worked Hours, Benefits, Supplies and Drugs, With Every Assumption Kept in View
Purpose
This draft sets out next fiscal year's operating expense budget for the inpatient palliative care unit, twelve beds, where I am manager. It is built in one direction, from a volume forecast down to each expense line, so that anyone reviewing it can see which lines move if the forecast is wrong. Next year's volume is a guess, and every line beneath it inherits that guess. The draft therefore states the forecast and its assumptions first, then shows how each line is calculated from them, and closes with the lines most sensitive to error. Revenue is not included; the unit's revenue depends on payer contracts negotiated by the finance office and is addressed in a separate reimbursement brief.
The Volume Forecast
The unit recorded 3,540 patient days in the twelve months ending in March, an average daily census of 9.7. I forecast 3,800 patient days for next year, an average daily census of 10.4, for three stated reasons.
First, one of the two hospices that refer patients to us for general inpatient care closed its own inpatient facility in February. Its referrals to us rose from about 9 patient days a month to about 26 in February and March. I assume this continues, which adds about 200 patient days a year. Second, the palliative consult service has increased transfers of comfort-care patients from intensive care, which added about 60 patient days over the last year and is expected to continue at that level. Third, I assume no other change in referral patterns and no change in length of stay, which has averaged 6.1 days for three years.
The forecast is capped by physical capacity. At 12 beds, 3,800 patient days means an average occupancy of 87%, which is high for a unit whose admissions cannot be scheduled. If demand exceeds this, patients will wait in other units rather than add days here, so the budget does not plan beyond 3,800. The forecast will be checked against actual patient days each month, and if the first quarter runs more than 5% away from plan in either direction, I will bring a revised forecast to the finance office rather than wait for the year-end variance to show it.
Staffing
Nursing is planned at a standard of 11.5 hours worked for each patient day, combining registered nurses and nursing assistants. The standard has been reviewed against the unit's actual hours and patient needs, and I am not proposing to change it. At 3,800 patient days, it produces 43,700 worked hours.
Worked hours are not paid hours. Nurses also take vacation, sick time and education days. Over the last year, non-productive time was 12% of paid hours, so paid hours are worked hours divided by 0.88, or 49,659. That is about 23.9 full-time equivalent positions.
The average hourly salary, blending registered nurses and nursing assistants and including shift differentials, was $55.60 in March after a differential increase in January. I have applied the hospital's planned 3% merit increase, giving $57.30 for next year. Salaries are therefore 49,659 hours at $57.30, or $2,845,466. Benefits are calculated at the hospital's rate of 31% of salaries, or $882,094.
Supplies, Pharmaceuticals and Other Expenses
Medical supplies averaged $38 per patient day this year. The purchasing department projects 2.6% inflation, so I have budgeted $39 per patient day, or $148,200.
Pharmaceuticals averaged $95 per patient day this year, excluding March, when several obstruction patients and a morphine shortage lifted it to $123. I have budgeted $96 per patient day, or $364,800. This includes a projected 4% increase in drug prices and a reduction of about $3 per patient day from the unit's waste reduction measures, including shorter infusion bags for patients expected to die within hours to days and restocking emergency kits only with what was used.
Other expenses include education and conferences ($12,000) and minor equipment below the capital threshold ($6,500), for a total of $18,500. Specialty mattress rentals, which cost the unit about $14,000 this year, are not budgeted, because I will request the purchase of two low-air-loss mattresses as capital equipment.
The Draft Budget
Table 1 summarizes the draft.
Table 1
Draft Operating Expense Budget, Next Fiscal Year
| Line | Basis | Amount |
|---|---|---|
| Salaries | 49,659 paid hours at $57.30 | $2,845,466 |
| Benefits | 31% of salaries | $882,094 |
| Medical supplies | 3,800 patient days at $39 | $148,200 |
| Pharmaceuticals | 3,800 patient days at $96 | $364,800 |
| Other expenses | Education and minor equipment | $18,500 |
| Total operating expense | $4,259,060 | |
| Expense per patient day | $1,120.81 |
Sensitivity
Financial planning for nursing units depends on knowing which assumptions carry the most weight (Finkler et al., 2013). Three assumptions matter most here.
Volume. Staffing, supplies and pharmaceuticals all scale with patient days, so about 99% of the budget depends on the forecast. If the closed hospice reopens its inpatient facility, patient days might fall back to about 3,600, reducing expenses by about $224,000. The staffing office can adjust schedules within a pay period, so this risk is manageable if volume is reviewed monthly.
Non-productive time. If sick leave rose to last winter's peak, non-productive time could reach 14%, adding about $86,000 in salaries and benefits, since paid hours would rise to cover the same worked hours.
Drug costs. Pharmaceuticals are the least predictable line. A single month with several patients needing high-cost infusions, like March, adds $8,000 to $10,000. I have not budgeted for such months, but I will report them separately when they occur, so that they are not mistaken for poor control.
Relationship to Cost per Day
The draft's expense per patient day of $1,120.81 covers only the unit's direct expenses. It does not include the facility costs and administrative overhead that the finance office allocates, which the unit's cost per day worksheet estimated at about $543 a day. Together they bring the full cost of a day to about $1,660 next year, higher than this year's worksheet figure because of the merit increase and drug inflation. Palliative care has been associated with lower total hospital costs for seriously ill patients when their care is compared with usual care (May et al., 2018), so the unit's cost should be read in the context of the hospital's wider spending. But the full cost should inform the hospice contract renewal, because the current daily rate is well below it.
References
Finkler, S. A., Jones, C. B., & Kovner, C. T. (2013). Financial management for nurse managers and executives (4th ed.). Elsevier.
May, P., Normand, C., Cassel, J. B., Del Fabbro, E., Fine, R. L., Menz, R., Morrison, C. A., Penrod, J. D., Robinson, C., & Morrison, R. S. (2018). Economics of palliative care for hospitalized adults with serious illness: A meta-analysis. JAMA Internal Medicine, 178(6), 820-829. https://doi.org/10.1001/jamainternmed.2018.0750
The Chamberlain NR 533 Week 4 instructions
In Week 4 you typically prepare an annual operating budget for a nursing unit. Prompts ask for the volume forecast, staffing and salary calculations, benefits, supplies and other expenses, the total and the assumptions behind each line. Start with volume and explain it. Convert worked hours to paid hours using non-productive time, since vacation and sick days are paid too. State the pay rate and any planned increase. Calculate benefits at the organization's rate. Budget supplies and drugs per unit of service with inflation. Keep assumptions next to the lines they drive. Test the draft against its weakest assumptions. Cite budgeting sources in APA 7 and summarize the lines in a table.
How the NR 533 Week 4 example is put together
The draft begins by explaining that it is built in one direction from volume. The forecast section gives this year's patient days and three reasons for next year's increase, capped by the unit's beds. The staffing section converts the standard into worked hours, then paid hours and positions, and prices them with a merit increase and benefits. Supplies and pharmaceuticals use per-day amounts adjusted for inflation and waste reduction, and rentals are removed pending a capital request. Table 1 lists each line with its basis. The sensitivity section prices a volume drop, higher sick time and expensive drug months. The final section adds overhead to reach full cost.
Where the points sit in the NR 533 Week 4 rubric
Operating budget rubrics usually reward a justified volume forecast, correct staffing and salary calculations, appropriate treatment of benefits and non-productive time, reasonable non-salary lines, a correct total and clearly stated assumptions. Graders frequently check the conversion from worked to paid hours and the benefit calculation, so showing those steps earns credit. A table with the basis for each line helps the reader follow. Sensitivity analysis on key assumptions shows financial maturity. Connecting the budget to cost per day or reimbursement demonstrates integration across the course. Clear organization, realistic figures and APA 7 citations complete the grade. Graders also notice when a draft states how the forecast will be monitored during the year.
NR 533 Week 4 help from the desk
A frequent error is budgeting staff by worked hours alone and forgetting paid time off, which understates salaries. Divide by the productive share. Another is copying last year's lines with a flat percentage increase, which hides the effect of volume. Build from volume. Students also leave assumptions unstated, so the reader cannot tell which figures are fragile. Put each assumption beside its line. Avoid budgeting unusual months as if they were typical. Check the table totals. Do not include revenue unless the prompt asks for it, since unit budgets often cover expenses only. Finally, test the draft: say what happens if volume or sick time moves. Keep the draft readable: someone outside the unit should be able to follow it without a spreadsheet open.
Get a NR 533 Week 4 example written to your instructions
Send the template your classroom issues along with any volume figures you have been handed, and a custom example gets written to them and returned inside 24-48h, the first one free. Anything your employer holds is yours to request and to clear for classroom use; what we build runs on published benchmarks or on figures you choose to supply.
More NR 533 papers and MSN samples
- NR 533 Week 1: Discussion on Owning a Budget Line
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- NR 533 Week 3: Cost per Case Worksheet
- NR 533 Week 5: Business Case
- NR 533 Week 6: Capital Request Write-up
- NR 533 Week 7: Reimbursement Brief
- NR 533 Week 8: Budget Defense Presentation
- NR 532 Week 4: Staffing Grid Proposal
- NR 531 Week 4: Policy Approval Brief
- NR 529 Week 4: Coaching Conversation Plan
NR 533 Week 4 questions, answered
Do I need real salary rates?
Published wage data for your region works and is often preferred, because a grader can verify it. Whatever rate you pick, apply it consistently and say where it came from. A draft built on rates a reader can look up survives questioning even when the figures are approximate, and one built on unsourced rates does not survive it at all.
How detailed should the non-salary lines be?
As detailed as your classroom's line categories require, and no further. Most templates want a handful of groupings such as medical supplies, minor equipment, education and purchased services. Inventing thirty lines does not demonstrate control of the money. Tying each grouping to a driver and a basis does, and that is where the available points actually sit.
How far ahead does an annual draft really look?
Far enough that the volume assumption is the weakest thing in it, which is why sections mark the assumption rather than the total. Build the year, then show it by month, because seasonal swings in census are what make an annual figure look wrong by February. A draft existing only as one yearly number cannot be managed against.
Where can I find a free NR 533 Week 4 sample paper?
Above is the palliative unit operating budget draft with its summary table, which makes up the full NR 533 Week 4 sample and is available without a fee. For a draft built from your own unit's volume and rates, share them with us and one can be written line by line.
How do I convert worked hours to paid hours in NR 533?
Divide worked hours by the share of paid time that is productive. The sample divides 43,700 worked hours by 0.88, because 12% of paid time last year went to vacation, sick time and education.