| Course | NR 588 Advanced Nursing Leadership Across Complex Systems |
|---|---|
| Week | 7 |
| Paper type | Joint funding brief |
| Length | About 1,110 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Nurse Executive |
| Updated | October 2026 |
Free sample paper for NR 588 Week 7
Joint Funding Brief: A Night Telehealth Service for Maple Grove, Shared 60/40 by a Formula Both Finance Offices Can Recalculate Each Year
Student Name
College of Nursing, Chamberlain University
NR 588: Advanced Nursing Leadership Across Complex Systems
Instructor Name
Month Day, Year
Joint Funding Brief: A Night Telehealth Service for Maple Grove, Shared 60/40 by a Formula Both Finance Offices Can Recalculate Each Year
What Is Being Bought
A night telehealth service for patients discharged from our hospital to Maple Grove: a telehealth cart at the facility, a license for the video platform and coverage from 19:00 to 07:00 by our virtual care team's nurse practitioners, who would see a patient by video within 15 minutes of a call from a facility nurse.
Why Neither Side Buys It Alone
Our hospital could pay for the whole service, but much of the benefit, kept Medicare stays and better readmission performance under Medicare's value-based purchasing program, goes to Maple Grove. Maple Grove could pay, but it cannot employ nurse practitioners at night and would never recover the cost from the patients we send. Each side gains, and neither gains enough to pay for all of it.
Costs, First Year and After
| Item | First year | Each later year |
|---|---|---|
| Telehealth cart and setup | $18,000 | $0 |
| Video platform license | $6,000 | $6,000 |
| Night nurse practitioner time (0.5 full-time equivalent across the virtual team) | $78,000 | $78,000 |
| Total | $102,000 | $84,000 |
The cart is a one-time cost. The license renews every year. Nurse practitioner time is the main recurring cost and is figured from our virtual care team's current rates with benefits.
Expected Benefit
The pilot has reduced readmissions from Maple Grove from 23.0% to about 20% in its first quarter, mostly during the day. Most remaining avoidable transfers happen at night. If the night service avoids 20 readmissions a year, an estimate based on the share of night transfers judged avoidable in case reviews:
Hospital benefit: about $4,500 per avoided readmission, from lower penalty exposure under Medicare's readmission reduction program and the net cost of readmissions we absorb. Twenty avoided: $90,000.
Maple Grove benefit: about $3,000 per avoided readmission, from Medicare skilled days kept and better readmission performance. Twenty avoided: $60,000.
Total expected benefit: $150,000 a year.
A Share You Can Recalculate
Each party pays in proportion to its expected benefit:
Hospital share = hospital benefit / total benefit = $90,000 / $150,000 = 60%.
Maple Grove share = $60,000 / $150,000 = 40%.
The formula is recalculated each year using the actual avoided readmissions from the shared metric and the per-readmission values both finance offices agree in advance. If the hospital's benefit per readmission rises, its share rises.
Figures Gross and Net
First year: hospital pays 60% of $102,000 = $61,200; expected benefit $90,000; net gain $28,800. Maple Grove pays 40% = $40,800; expected benefit $60,000; net gain $19,200.
Each later year: hospital pays $50,400, net gain $39,600. Maple Grove pays $33,600, net gain $26,400.
If only 10 readmissions are avoided, each side's benefit halves and both lose money in the first year: the hospital by $16,200 and Maple Grove by $10,800. The break-even point is about 14 avoided readmissions a year.
Two Calendars, One Purchase
Our fiscal year runs July to June; Maple Grove's chain runs January to December. The cart and the first license are bought in May 2027 from our fiscal 2027 budget and billed to Maple Grove for its 40% share in January 2028, from its 2028 budget. Nurse practitioner time is billed quarterly to each party at its share, so neither has to budget a lump sum in the wrong year.
What Happens if One Side Withdraws
Either party may withdraw at the end of any quarter with 90 days' notice. The cart remains our property. If Maple Grove withdraws, it pays its share for the quarter in progress and returns the cart. If we withdraw, we refund Maple Grove's share of the cart's undepreciated value, calculated over three years.
Evidence for the Service
Ouslander et al. (2011) showed that structured approaches to changes in condition can reduce hospital transfers from nursing facilities. Night video access to a clinician applies the same idea at the hour when transfers happen and staff have least support. Rahman et al. (2013) found that closer working links between a hospital and a facility were associated with fewer readmissions, and a shared service is one form of that link.
Why Video Rather Than Phone
The current after-hours line is a phone call. A nurse practitioner who can see the patient, the patient's breathing and the facility nurse's assessment can decide more safely whether the patient can stay. Video also lets the nurse practitioner guide a facility nurse through a focused examination. The cart costs $18,000 once; a phone-only service would save that but would leave the night clinician deciding without seeing the patient.
What Counts as an Avoided Readmission
The 20 avoided readmissions are estimated from case reviews of the first quarter, in which the nurse practitioner and Maple Grove's director of nursing judged about a third of night transfers avoidable with earlier clinical input. The actual number will be counted from the shared metric: the year's readmissions compared with the expected number at the baseline rate of 23.0%, adjusted for the number of index stays. Mor et al. (2010) found that readmission rates vary widely between facilities, so the comparison uses Maple Grove's own baseline rather than a national figure.
Who Runs It
Our virtual care manager schedules the night nurse practitioners and reports call volumes. Maple Grove's director of nursing makes sure the cart is charged, placed on the unit where most hospital-discharged patients are and that night staff know how to start a call. The monthly review adds a five-minute item on the service.
How the Night Service Fits the Agreement
The service is added to the existing agreement by a written amendment under clause 12. The named roles stay the same. The monthly report adds two figures: night video calls and night transfers after a call.
Approval Requested
From our Chief Financial Officer and Chief Nursing Officer, and from Maple Grove's administrator and the chain's regional finance director, by 30 April 2027.
Risks
The estimates of benefit could be too high; the break-even figure tells both parties how far they can fall before the service loses money. Agency night nurses may not use the cart. The pilot's night call rate, now 31%, is the early warning, and the service starts only after the callback standard from the escalation plan is in place. The per-readmission values are estimates and will be checked against actual costs at the first annual recalculation.
References
Mor, V., Intrator, O., Feng, Z., & Grabowski, D. C. (2010). The revolving door of rehospitalization from skilled nursing facilities. Health Affairs, 29(1), 57-64. https://doi.org/10.1377/hlthaff.2009.0629
Ouslander, J. G., Lamb, G., Tappen, R., Herndon, L., Diaz, S., Roos, B. A., Grabowski, D. C., & Bonner, A. (2011). Interventions to reduce hospitalizations from nursing homes: Evaluation of the INTERACT II collaborative quality improvement project. Journal of the American Geriatrics Society, 59(4), 745-753. https://doi.org/10.1111/j.1532-5415.2011.03333.x
Rahman, M., Foster, A. D., Grabowski, D. C., Zinn, J. S., & Mor, V. (2013). Effect of hospital-SNF referral linkages on rehospitalization. Health Services Research, 48(6, Pt. 1), 1898-1919. https://doi.org/10.1111/1475-6773.12112
NR 588 Week 7 instructions, in plain terms
The Week 7 brief is a funding argument between equals, not a request upward. Open with what is being bought and why neither organization would buy it alone. Derive the share from something, such as relative volume or relative benefit, using a formula both parties could recalculate next year. Show costs by type and separate the first year from every year after. Give figures gross and net. Handle the two organizations' fiscal calendars. Say what happens if one side withdraws. Most rubrics mark down a share with no derivation, costs stated as one lump, a brief that stops at year one and no exit terms.
How this NR 588 Week 7 example is built
The sample buys a telehealth cart, a platform license and night nurse practitioner coverage. A table shows $102,000 in the first year and $84,000 after. Each side's benefit per avoided readmission is estimated with its basis, giving $90,000 and $60,000 for 20 avoided. The share is derived as 60/40 and set to be recalculated from the shared metric. Gross and net figures, a low-volume case and a break-even of about 14 follow. The purchase is timed across July and January fiscal years. Withdrawal terms cover the cart and refunds. Sections justify video, define avoided readmissions, name operators and fit the service into the agreement. Margin notes show where the derivation and the counting rule earn credit.
NR 588 Week 7 rubric: what full points look like
A share with no derivation is the expensive error, asking two finance offices to accept a round number on trust; this share is calculated from estimated benefit. Costs stated as one lump cost the next share, so the cart, license and staff time are separated. Stopping at year one loses a row, and both years are shown gross and net. Ignoring the two calendars leaves the purchase unbudgetable, while billing is timed to each. Exit terms with refunds earn the withdrawal criterion. A break-even figure shows both sides how much the estimate can fall before they lose money. Defining how avoided readmissions will be counted from the shared metric makes the formula checkable.
NR 588 Week 7 help from the desk
Weak NR 588 Week 7 briefs propose an even split without explaining it. Others give one total cost. Many show only the first year. Fiscal years are often ignored, so one partner is asked to pay in a year it has not budgeted. Withdrawal terms are rarely included. Derive the share from each side's benefit or volume, break costs into one-time and recurring, show gross and net for both years and time the billing to each calendar. Say who owns any equipment if a partner leaves. If your purchase differs, send its costs and each side's expected gain, and a sample brief can calculate the share.
Get a NR 588 Week 7 example written to your instructions
Send the prompt, the rubric and whatever you know about the item and the two organizations, and a full Week 7 brief comes back written to your figures inside 24-48h, the first one free. If your section requires a budget table in a set format, send that format, because the table usually carries points the prose cannot recover.
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NR 588 Week 7 questions, answered
Can I use invented numbers?
Use realistic ones and label them as illustrative. Nobody expects a graduate paper to carry a partner's confidential budget, and sections generally accept figures drawn from published salary data, vendor list prices or your own reasoning stated openly. What loses marks is a precise number with no origin, since the reader cannot tell whether it was researched or produced to make the split come out neatly.
Does the split have to be even?
Rarely, and defending an uneven one is usually the stronger paper. Where one organization already funds the staff, holds the room or carries more volume, an even share quietly asks it to pay twice. Show the basis, then show what the share would be under two different bases, and say which you would argue for and why.
What if my organization has no money at all this year?
Then the brief argues for a phased or in-year start, and says so plainly. Options that work include beginning after a fiscal year turns, one party carrying the first year against a larger share later, or reducing the item until it fits. A brief that acknowledges the constraint reads far better than one assuming funds nobody has.
Where can I find a free NR 588 Week 7 sample paper?
The full joint funding brief for a night telehealth service shared by a recalculable formula is on this page.
How is the share derived in the NR 588 Week 7 brief?
Each side pays in proportion to its estimated benefit, $90,000 against $60,000, giving 60% and 40%, recalculated yearly from the shared readmission metric.