Question
The Pediatric Department of Emory Hospital operates as an individual business unit. The department rents space and beds from Emory Hospital, and accordingly receives charges
The Pediatric Department of Emory Hospital operates as an individual business unit. The department rents space and beds from Emory Hospital, and accordingly receives charges related to janitorial, repairs & maintenance, general & administrative, and rent as listed in the table below. These charges are considered fixed based on the number of beds rented, which is also called bed capacity. When Pediatrics rents a bed, it is rented for the entire year.
In addition, the Pediatric Department is charged for specific patient services based on the number of patient days billed. These services are considered variable with respect to the number of patient days. They include dietary, laundry, lab work, pharmacy, and billing & collections as listed in the table below. Last year, actual costs incurred by the Pediatric department are as follows.
| Basis for Charges | |
| Based on Patient Days (variable) | Based on Bed Capacity (beds rented) (fixed) |
Dietary | $ 600,000 |
|
Janitorial |
| $ 70,000 |
Laundry | 300,000 |
|
Laboratory | 450,000 |
|
Pharmacy | 350,000 |
|
Repairs & Maintenance |
| 30,000 |
General & Administrative |
| 800,000 |
Rent |
| 700,000 |
Billings & Collections | 300,000 |
|
Totals | $ 2,000,000 | $1,600,000 |
During the year, Pediatrics charged each patient an average of $350 per patient day, had a capacity of 60 beds, and had revenue of $7,000,000 for the year.
In addition, the Pediatric Department employed and paid the following personnel directly during the year:
| Annual Salaries | Number Required | Total Annual Salaries |
Supervising Nurses | $80,000 | 4 | $ 320,000 |
Nurses | $50,000 | 10 | 500,000 |
Aides | $20,000 | 20 | 400,000 |
Total |
|
| $1,220,000 |
The Pediatric Department must follow minimum personnel requirements that are published by the Federal Department of Health and are based on the number of patient days that are available during the year. Available patient days are calculated by taking the number of beds times 365 days per year.
Patient Days Available During the year | Number of Aides | Number of Nurses | Number of Supervising Nurses |
Up to 21,900 days | 20 | 10 | 4 |
21,900 to 25,915 days | 24 | 12 | 4 |
25,916 to 30,100 days | 28 | 14 | 5 |
These staffing levels represent full time equivalents (FTE). Pediatrics always employs the minimum number of required FTE in order to meet the federal requirements. Salaries of supervising nurses, nurses, and aides are therefore fixed within the range of patient days available during the year.
Solve the what if statement below:
- 1. It is estimated that if 20 additional beds were available on the 180 days that the Pediatrics department was at 100% capacity, patient demand would have been enough to fill those additional 20 beds. Emory Hospital has an additional 20 beds available for the Pediatrics Department to rent. Such additional rental would increase Pediatrics fixed charges based on additional bed capacity. Note that it is the policy of Emory Hospital that beds must be rented for the entire year. In addition, staffing levels would have to be adjusted accordingly.
- Prepare a what-if analysis showing a contribution margin income statement for next year assuming the additional 20 beds are rented by the Pediatrics department. The projection should include last years results as a starting point, plus an analysis of incremental revenue and cost, and projected total profitability with appropriate profitability ratios. A new capacity % can also be calculated.
- Discuss whether Pediatrics should rent the additional beds? Explain why or why not and be sure to discuss the risks associated with your decision.
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