The Fleming Medical Group financial results are under budget for the first six months of 2022. Using the following table, calculate the volume, revenue, and cost variances for all variances greater than $5,000. What is the primary cause of the negative $40,186 net income variance? Explain the major cause behind the $54,936 increase in expenses.

	YTD 2022	YTD 2022
Description	Actual	Budget	$ Difference	% Difference
Revenue	$2,964,750	$2,950,000	$14,750	0.5%
Operating Expenses
Physician Salaries	$585,306	$576,800	$8,506	1.5%
Nursing Salaries	857,157	829,150	28,007	3.4%
Mgt and clerical salaries	466,971	468,650	{1,679}	-0.4%
FICA	143,397	143,407	{10}	0.0%
Health insurance	238,760	234,325	4,435	1.9%
Retirement	76,763	74,984	1,779	2.4%
Unemployment	18,323	18,746	{423}	-2.3%
Medications	91,687	89,015	2,672	3.0%
Medical instruments	64,287	61,761	2,526	4.1%
Bandaged, gauze	34,140	34,529	{389}	-1.1%
Gloves, gowns	24,476	24,283	193	0.8%
Sterile wipes	15,780	16,114	{334}	-2.1%
Office supplies	69,388	69,216	172	0.2%
Cleaning supplies	23,103	23,461	{358}	-1.5%
Rent	89,251	86,520	2,731	3.2%
Maintenance	11,245	8,270	2,975	36.9%
Electricity	6,684	6,482	202	3.1%
Gas	11,215	11,118	97	0.9%
Water and sewage	4,225	4,059	166	4.1%
Telephone	2,004	1,939	65	3.4%
Housekeeping	21,694	21,630	64	0.3%
Travel/meetings/meals	4,744	4,751	{7}	-0.1%
Prof insurance	15,669	13,447	2,222	16.5%
CME	17,994	17,938	56	0.3%
Other expenses	35,955	34,687	1,268	3.7%
	$2,930,218	$2,875,282	$54,936	1.9%
Net income	$34,532	$74,718	{$40,186}	-53.8%
Profit margin	1.16%	2.53%
Output	Actual	Budget	Difference	%Difference
Visits	15,451	15,408	43	0.3%