| Course | NR 533 Financial Management in Healthcare Organizations |
|---|---|
| Week | 8 |
| Paper type | Budget defense presentation |
| Length | About 1,200 words, 3 pages |
| Format | Slides with speaker notes, APA 7 references |
| School | Chamberlain University |
| Program | MSN, Nurse Executive |
| Updated | September 2026 |
Free sample paper for NR 533 Week 8
Budget Defense: The Palliative Care Unit's $4.26 Million Operating Budget, Each Figure Traced to the Week It Came From, the Shakiest Assumption Named First, and the Two Decisions the Committee Is Being Asked to Make
Student Name
Chamberlain University
NR 533: Financial Management in Healthcare Organizations
Instructor Name
Month Day, Year
Slide 1: Palliative Care Unit Budget, Next Fiscal Year
Operating expense: $4,259,060
3,800 patient days, average census 10.4 in 12 beds
Two decisions requested today
Speaker notes: Good morning. I am presenting the operating budget for the inpatient palliative care unit. The total is $4.26 million for 3,800 patient days. I will ask for two decisions at the end: approval of this budget, and support for renegotiating the hospice contract before renewal. Every figure on these slides comes from a worksheet you have in the packet, and I will say which one as we go.
Slide 2: Where the Volume Comes From
This year: 3,540 patient days (census 9.7)
Plus about 200 days: a referring hospice closed its inpatient facility in February
Plus about 60 days: more comfort-care transfers from intensive care
Occupancy 87%, capped by 12 beds
Speaker notes: Everything in the budget follows from volume, so I start there. The increase has two causes we can see in the referral data since February. I have assumed no other change and no change in the 6.1-day average stay. This is the assumption I am least sure of, and I would rather say so now than have it found later. If the hospice reopens its own unit, volume falls back to about 3,600 days and the budget falls by about $224,000, because almost every line moves with patient days.
Slide 3: Staffing, the Largest Line
11.5 worked hours per patient day, unchanged
43,700 worked hours; 49,659 paid with 12% non-productive time
23.9 paid positions
Salaries $2,845,466; benefits (31%) $882,094
Speaker notes: Staffing is 88% of the budget. The standard of 11.5 worked hours per patient day is not changing. The average hourly rate of $57.30 is this year's March rate, which includes the January differential increase, plus the planned 3% merit. The 12% non-productive allowance is last year's actual. If sick time returned to last winter's peak, it would add about $86,000. That figure is in the sensitivity table in your packet.
Slide 4: Supplies and Pharmaceuticals
Supplies: $39 per patient day, $148,200 (2.6% inflation)
Pharmaceuticals: $96 per patient day, $364,800
Includes about $3 per day saved by cutting infusion waste
Mattress rentals removed: capital request submitted
Speaker notes: Pharmaceuticals are the least predictable line. In March, three patients with bowel obstructions and a drug shortage pushed it to $123 a day. I have not budgeted for months like that, but I will report them separately so they are not read as poor control. The waste reduction is already working: we now hang half-day bags when death is expected soon, and discards fell by about half in April and May.
Slide 5: What a Day Costs
Direct cost per day, next year: $1,121
Allocated facility and overhead: about $543
Full cost per day: about $1,660
Nursing time: just over half of the full cost
Speaker notes: This slide comes from the cost per day worksheet, built from measured minutes rather than averages. It shows that a palliative day is mostly nursing time: continuous symptom management, repositioning and support for families. Any saving large enough to matter would have to come from nursing hours, and reducing them would change the care. I am not proposing that. I am showing it so the committee knows where the money goes.
Slide 6: What a Day Earns
Charge: $3,400 per day, collected by almost no one
Net payment, blended across payers: about $1,340
Hospice contract: $1,150 per day, one-third of our days
Commercial plans are the one payer above full cost
Speaker notes: This is the slide I most want you to remember. Our statement shows revenue at the charge, which makes the unit look profitable. After contractual allowances, we collect about $1,340 a day on average. That covers direct costs but not the full cost. The hospice contract, at $1,150, is the largest single problem, because hospice days are a third of our volume and growing, and the rate has not changed in four years. Chargemaster prices bear little relation to what most payers actually pay (Reinhardt, 2006), so the charge line should not be used to judge the unit.
Slide 7: Why the Unit Is Worth Its Cost
Comfort-care patients leave intensive care sooner when a palliative bed is available
31 intensive care days in six months spent waiting for our beds
Palliative consultation is associated with lower hospital costs
Speaker notes: The unit loses money on a full-cost basis, and I will not pretend otherwise. But its value to the hospital extends beyond its cost center. Pooled data from six hospital samples link palliative consultation to lower total hospital costs (May et al., 2018). When we are full, dying patients wait in intensive care, which is the most expensive place in the hospital to care for someone whose goal is comfort. I have not added those savings to our numbers, because they appear in another unit's budget.
Slide 8: What Could Go Wrong
Volume falls if the hospice reopens: minus about $224,000 in expense
Sick time rises: plus about $86,000
High-cost drug months: plus $8,000 to $10,000 each
Hospice rate unchanged: loss of about $433 per hospice day continues
Speaker notes: These are the four risks in order of size. The first two move expense, and the unit can respond within a pay period. The third we will report as it happens. The fourth is not an expense risk; it is a revenue problem that only the contract negotiation can solve. Financial management texts recommend separating what a unit manager controls from what they do not (Finkler et al., 2013), and this slide is meant to do exactly that.
Slide 9: What I Will Report
Monthly: patient days, worked hours per patient day, pharmaceutical waste
Monthly, requested: net revenue by payer beside charges
Quarterly: hospice volume and referral source
Speaker notes: If you approve the budget, you will see these figures every month. I have asked the finance office to put payer-level net revenue on our statement, because a manager who sees only charges cannot make good decisions about volume. I will also report hospice volume quarterly, since it is the assumption most likely to change.
Slide 10: Decisions Requested
1. Approve the operating budget of $4,259,060
2. Support opening hospice contract renegotiation now, using the unit's cost worksheet
Target rate: at least full cost, about $1,580 per day at current prices
Speaker notes: I am asking for two decisions. The first is approval of the budget as presented. The second is support for opening the hospice contract negotiation now rather than at renewal, with the cost worksheet as the starting point. I understand that the committee may approve the budget without agreeing with every assumption. If so, I would ask which assumption you doubt, so that I can report on it specifically. Thank you. Any figure on these slides can be questioned, and I will show where it came from.
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
Reinhardt, U. E. (2006). The pricing of U.S. hospital services: Chaos behind a veil of secrecy. Health Affairs, 25(1), 57-69. https://doi.org/10.1377/hlthaff.25.1.57
The Chamberlain NR 533 Week 8 instructions
The closing NR 533 assignment usually asks for a presentation defending your unit's budget to a leadership or finance audience. Prompts ask for slides with speaker notes covering the budget's main components, key assumptions, justification, risks and the requests you are making. Build each slide around one point and trace every figure to earlier work. Name your weakest assumption before anyone else does. Explain the difference between charges and net revenue if revenue appears. Show what the unit controls and what it does not. End with specific decisions requested. Use speaker notes to carry the explanation, keeping slides brief. Cite sources in APA 7 on the slides or in notes.
How the NR 533 Week 8 example is put together
The presentation opens with the total, the volume and two requested decisions. The volume slide explains the forecast and names it as the least certain assumption with its financial effect. Staffing, the largest line, is explained through standard, hours, rate and benefits. Supplies and pharmaceuticals show inflation and a waste saving already achieved. Two slides compare the cost of a day with what a day earns across payers. One slide presents value beyond the unit with evidence, uncounted. The risk slide ranks four risks by size. The reporting slide lists what leadership will see monthly, and the final slide states both decisions and asks which assumption the committee doubts.
Where the points sit in the NR 533 Week 8 rubric
Budget presentation rubrics typically reward clear and accurate content, logical organization, sound justification of figures, awareness of risk, effective slides and speaker notes, and professional delivery. Graders favor presentations in which numbers can be traced and assumptions are stated openly. Identifying the weakest assumption early builds credibility. Explaining net revenue rather than charges shows financial understanding. Separating controllable from uncontrollable items demonstrates judgment. Specific decisions requested at the end give the audience something to act on. Brief slides with explanatory notes are generally preferred. Correct citations and consistent figures across slides complete the evaluation. Speaker notes that explain rather than repeat the slide show the presenter understands the numbers.
Common NR 533 Week 8 mistakes, and how to avoid them
The most frequent weakness is slides crowded with numbers and no clear message. Give each slide one point and let the notes explain. Another is defending every figure as certain, which invites challenge on the one that is not. Name it yourself. Students also present charges as revenue. Show net payments. Avoid repeating whole earlier assignments; summarize and trace. Do not end without a request, since a defense that asks for nothing gives the committee nothing to decide. Prepare for questions you cannot answer by saying where the figure came from and promising a follow-up. Finally, check that numbers match across slides. Rehearse aloud with a timer, because a defense that overruns loses the room before the requests.
Get a NR 533 Week 8 example written to your instructions
Send the slide limit, the speaking time and the rubric, and a custom deck with speaker notes comes back inside 24-48h, the first one free. Where earlier assignments from the course are available, send those as well, since the figures on the slides should match whatever you have already handed in.
More NR 533 papers and MSN samples
- NR 533 Week 1: Discussion on Owning a Budget Line
- NR 533 Week 2: Budget Variance Analysis
- NR 533 Week 3: Cost per Case Worksheet
- NR 533 Week 4: Operating Budget Draft
- NR 533 Week 5: Business Case for Two Beds
- NR 533 Week 6: Capital Request Write-Up
- NR 533 Week 7: Reimbursement Brief by Payer
- NR 532 Week 8: Operational Plan
- NR 531 Week 8: Executive Briefing for Decision
- NR 529 Week 8: Management Philosophy Statement
NR 533 Week 8 questions, answered
Are speaker notes graded?
Often, and where they are, write them as sentences you would actually say rather than as a second copy of the slide. Notes repeating the bullets add nothing and read as padding. Notes carrying the transition, the origin of a figure and the answer to the obvious question are what a rubric is looking for.
How do I handle a question I cannot answer?
Name the figure you are missing, say when you could produce it, and move on without apologizing twice. A defense is marked partly on composure, and inventing a number under pressure is the failure that follows a presenter through the rest of the questioning. An indexed appendix removes most of these moments before they arrive.
Should the presentation repeat earlier assignments?
It carries them forward rather than repeating them. One line each on what the variance showed and what a case costs, then the weight falls on the request. A deck reviewing the term chronologically runs out of time before the ask, which is the arrangement most likely to end without a decision.
Where can I find a free NR 533 Week 8 sample paper?
All ten slides of the budget defense, each with its speaker notes, form the NR 533 Week 8 sample shown above, and none of it is locked. If you are defending a different budget, send us its key figures and a presentation with traced numbers can be drafted.
How many slides should the NR 533 budget defense have?
Enough for one point per slide, often eight to twelve, within your section's limit. The sample uses ten slides, each with speaker notes that carry the explanation.